Tibial Nerve Intervention for Overactive Bladder

Overactive bladder (OAB) is a common medical condition among elderly individuals, often resulting in Urinary Incontinence (UI). It can have significant impacts on general quality of life, potentially leading to urinary tract infection. However, overactive bladder remains under-researched and stigmatised.

Project Objectives: The aim of this project is to develop a neuroprosthetic device to aid the treatment of OAB using neuromodulation. To achieve this broad aim, we will study of the poorly understood neural circuitry that drive the modulation of the micturition response via the tibial nerve. In addition to this neuroscientific exploration, the project aims to test the dose-related efficacy of the technique, thereby optimising the intervention. In doing so, the predicted findings will contribute to an ongoing multidisciplinary project concerning the AI-driven monitoring, prediction, and prevention of urinary tract infection.

Novelty: The project is novel in both its approach to our current understanding of bladder modulation, and the treatment of OAB. Firstly, while the efficacy of tibial nerve stimulation as an intervention is known, the exact topography of the neural circuit remains a "black-box". Consequently, the present project provides vital insight into the function of a circuit with significant therapeutic potential.

Secondly, present interventions for OAB are typically pharmacological in nature, and as such are associated with a range of undesirable side-effects often resulting in high rates of patient drop-off. Unfortunately, alternate non-pharmacological interventions such as percutaneous tibial nerve stimulation do not entirely solve this issue. While effective, these techniques remain invasive and uncomfortable, requiring a trained medical professional for administration. Therefore, the present project provides the possibility of a non-invasive, well-tolerated intervention that may be used with as little impact on daily life as possible, in theory encouraging patient retention.

In addition, the portability of the prosthetic device enables longer-term control of the condition, which is not presently feasible. Finally, through providing a greater understanding of the mechanistic underpinnings of peripheral bladder control, the project may lay the groundwork for future research concerning alternative targets for OAB intervention.

Methodological Approach: Working closely with stakeholders, (e.g., patients and clinicians), we will explore the efficacy and mechanism of the intervention.

Summary: In conclusion, the present project will provide much-needed insight into a clinically relevant neural circuit and aid the development of a patient-centred intervention.