Stories about: urinary incontinence

Nerve-growth agent could treat incontinence caused by spinal cord injury

Image of Rosalyn Adam, a urology researcher hoping to develop new treatments for incontinence, working in the laboratory
Rosalyn Adam is the director of urology research at Boston Children’s Hospital.

When the nerves between the brain and the spinal cord aren’t working properly, bladder control can suffer, resulting in a condition called neurogenic bladder. It’s a common complication of spinal cord injury; in fact, most people with spina bifida or spinal cord injury develop neurogenic bladders. Spontaneous activity of the smooth muscle in the wall of the bladder — called the detrusor muscle — commonly causes urine leakage and incontinence in people with neurogenic bladders.

“For children and adults, incontinence can be one of the most socially and psychologically detrimental complications of spinal cord injury,” says Rosalyn Adam, PhD, who is director of urology research at Boston Children’s Hospital. “The ultimate goal of our research is to return bladder control to the millions of Americans with neurogenic bladders.”

Now, Adam and a team of researchers think that they may have found a practical way to treat neurogenic detrusor overactivity by delivering medication directly into the bladder through self-catheterization, a practice that many people with neurogenic bladders already need to perform regularly.

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Smart pad would provide biofeedback for Kegel incontinence exercises

biofeedback Kegel exercises urinary incontinence

If you’ve ever been given Kegel exercises to strengthen your pelvic floor, you may have wondered if you’re doing them right or if you’re getting better. Two physicians at Boston Children’s Hospital have developed a stick-on pad called NumberOne that could someday tell you.

Carlos Estrada, MD, director of the Spina Bifida Center and co-director of Urodynamics and Neurourology, and Jeanne (Mei Mei) Chow, MD, director of Uroradiology at Boston Children’s both work with children who have urinary incontinence. In the clinic, Estrada has equipment that provides biofeedback as kids practice squeezing their pelvic floor muscles. But parents had been asking for a home solution. “They say, ‘it’s hard to do it at home without getting any feedback,’” says Estrada.

Done right, Kegels can have an 85 percent success rate, he says. But lacking feedback, most people give up on them, including adults. “Adults can get monitoring, but it’s done in specialized clinics with intrarectal and intravaginal probes,” Estrada says.

Most people take a pass on that.

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