Innovative Tools for Diagnosis and Treatment of Overactive Bladder and Incontinence (with Bern University Hospital & Bern University of Applied Sciences)

Patients suffering from overactive bladder (OAB) live with a continuous urge to urinate even at low bladder filling volumes, often leading to incontinence. OAB has an enormous impact on the quality of life of affected patients. Despite the high prevalence, the understanding of the mechanism underlying OAB remains limited and, as consequence, treatment options are scarce. UGE has developed several tools aiming at identifying specific patterns in bladder pressure and bladder nerve signals associated to overactive bladder. We developed an algorithm which is able to generate alarms before the start of an unwanted bladder contractions (see figure). The algorithm was successfully tested first in rats and then in patients. It could be used to warn the patient about an impending bladder contraction (to take action against incontinence) or/and to trigger conditional sacral nerve stimulation (i.e. stimulation of bladder nerves to inhibit the bladder contraction before incontinence). Moreover our group has pioneered the use of cardiac catheters for minimally invasive electrophysiological investigations in the urinary tract. In a proof-of-concept study, we have shown that cardiac catheters can detect and track the propagation of electrical signals in the lumen of the ureter. Further investigations will apply this technology to bladder smooth muscle.