Event-Triggered Electrical Control of Urinary Continence

Individuals with spinal cord injury or neurological disorders may develop involuntary bladder contraction at low volumes (bladder hyper-reflexia), which can lead to significant health problems. Current devices can eliminate nascent contractions through continuous stimulation, but do not have a means to detect the onset of bladder contraction to stimulate conditionally. The pudendal nerve trunk (PNT) electroneurogram (ENG) has been shown that the ENG could be used as to detect bladder contractions and as an input to a control system to trigger conditional electrical stimulation. The objective of this study is to determine whether event-triggered electrical control of urinary continence allows the bladder to fill to greater volume than continuous control, PNT ENG was the input to the control system and served as a trigger for inhibitory stimulation to maintain continence. Conditional inhibitory stimulation controlled by the PNT ENG allowed the bladder to fill to at least the same volume as continuous stimulation before continence was lost. However, the event-triggered control system had a 65% reduction in stimulation time as compared to continuous stimulation. These results support the use of an event-triggered control system to maintain urinary continence