Noninvasive electrical stimulation device to improve bladder control for women with spinal cord injury - neurogenic bladder dysfunction after neurologic disease or injury such as spinal cord injury…

The National Institute of Neurological Disorders and Stroke awarded The Cleveland VA Medical Research & Education Foundation $572,132 on August 22, 2026, under the Extramural Research Programs in the Neurosciences and Neurological Disorders program (CFDA 93.853) to design and test a prototype noninvasive electrical stimulation device and determine its effect on bladder control for women with spinal cord injury–related neurogenic bladder dysfunction.

The project targets bladder hyperreflexia, a condition in which the bladder reflexively contracts at small volumes, causing incontinence, urinary tract infections, renal damage, and reduced quality of life in individuals with spinal cord injury. The recipient is developing a surface genital nerve stimulation (GNS) device that uses electrical stimulation to inhibit reflexive bladder contractions. Prior research demonstrated that surface GNS reduces incontinence during one month of home use, but participant feedback identified design limitations including poor electrode interface, wired connections, and device size. This award funds prototype refinement and a one-month home-use study to validate the improved device's effect on bladder control in women with spinal cord injury. Successful completion is intended to support a multi-site study and eventual clinical implementation.

Work is performed in Cleveland, Ohio. The period of performance runs through July 31, 2028. The award is classified as a Project Grant, assistance type supporting extramural research in neuroscience and neurological disorders.

Noninvasive electrical stimulation device to improve bladder control for women with spinal cord injury - neurogenic bladder dysfunction after neurologic disease or injury such as spinal cord injury (SCI) can lead to bladder hyper-reflexia where the bladder reflexively contracts repeatedly at small bladder volumes. Bladder hyper-reflexia can trigger autonomic dysreflexia, result in incontinence, urinary tract infections, renal damage and decreased independence and quality of life. Restoring bladder control is considered a high priority, but remains a critically unmet need requiring further development, especially for women with SCI. Our long-term goal is to develop and clinically implement a "bladder pacemaker" able to restore bladder control for individuals with SCI. Electrical stimulation of the sensory genital nerves inhibits the spinal neural circuits involved in hyper-reflexive bladder spasms. Genital nerve stimulation (GNS) has been used by multiple groups to inhibit reflexive neurogenic bladder contractions during acute (1 visit) urodynamic testing and limited chronic take-home testing. We have recently demonstrated that surface GNS inhibits reflexive bladder contractions and reduces incontinence in individuals with SCI during one month of home use using a limited stimulation system. Participant feedback from these studies identified a number of stimulation system issues that created nontrivial inconveniences, which affected activities of daily living and prevented some participants from participating in the study. Required improvements include, but are not limited to better electrode interface, elimination of wired connections, and a smaller device. The purposes of this proposal are to 1) design and test a prototype device for bladder control for women using GNS and 2) determine effect of at-home genital nerve stimulation on bladder control. The success of this study will be used to conduct a multi-site study of GNS and lead to clinical implementation.