EPSRC-NIHR HTC Partnership Award 'Plus': IMPRESS

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IMPRESSPlus has been designed to maximise and extend the impact of the current IMPRESS network by applying engineering sciences to deliver novel solutions to the many challenges that exist in the management and treatment of incontinence. There is a critical lack of scientific research in this area compared to areas such as vascular, cardiac and orthopaedic healthcare - each of which have shown huge gains through the application of focussed basic and translational science.Faecal Incontinence (FI) is defined as the inability to fully control the passage of faeces through the anus. This may arise due to a weakened anal sphincter muscle (typically following child birth), problems with nerve supply (e.g. stroke, multiple sclerosis), or in association with other gastrointestinal conditions (e.g. irritable bowel syndrome). It is a common and distressing condition that causes shame, embarrassment, depression, social isolation, secrecy, poor self-esteem, and sexual avoidance. As a result, more than 54% of patients with FI have not discussed their symptoms with a physician , and only one-quarter of patients with FI are referred by their GP for specialist treatment . Its exact prevalence is difficult to determine but best estimates suggest that in the adult population it is around 10%, and that 0.5% - 1% below 65 years and 3% - 8% over 65 years' experience regular faecal incontinence. Urinary Incontinence (UI) is defined as involuntary leakage of urine, UI presents a major burden on NHS resources. It is a common and distressing condition, which impacts of quality of life. The main forms of UI are stress incontinence (SUI), which is leakage with physical exertion, and urge incontinence (UUI), which is leakage with a strong desire to void. Mixed urinary incontinence is a combination of SUI and UUI. The prevalence of UI increases with age and is higher in institutionalised adults, who tend to be older and suffer associated co-morbidity. It is more often a problem for females, with prevalence rates of UI ranging from 4.5% to 53% in women, as compared to 1.5% and 24% in men. Although previously considered in isolation, it is increasingly recognised that many forms of FI and UI share a common underlying pathophysiology and frequently co-exist with pelvic organ prolapse.Incontinence places a massive burden on the NHS and impacts significantly on quality of life for thousands of patients in the UK. Whilst many areas of medical engineering share a growth in the engagement of engineers and scientists to push forward the exploitation of emerging technologies it is arguably the case that the nature of this disease prevents engineering and science research leaders seeing the potential for some rich research challenges. To date the IMPRESS network has been successful in fulfilling its objectives of increasing the number of leading UK technologists (from academia and industry) that are engaged with research into the clinical changes associated with incontinence. This is demonstrated through a range of exciting new collaborative projects that have arisen from IMPRESS workshops and events and have been supported by competitive pump-priming funding from the network. IMPRESSPlus will secure the legacy of the existing IMPRESS network. This will be achieved by:1) strategically supporting emerging research with feasibility project funding 2) running international IMPRESSPlus conference workshops to build the network3) using a researcher secondment scheme to aid knowledge-transfer with industry and leading international research centres4) disseminating the networks findings to researchers, patients, healthcare providers and policy makers5) identifying long-term funding for the network and its researchIn summary, through the IMPRESS network we aim to resolve the current impasse that stifles innovation and translation of new engineering technologies for the management, treatment and prevention of incontinence.