Amber-UI: A closed-loop bioelectronic system for urinary incontinence

尿失禁（UI）是一种常见的疾病，可以严重影响身体，精神和经济健康。尽管全球至少有8.5%的人口患有UI，但许多人并不承认，只有不到一半的严重UI成年人寻求医疗保健提供者的帮助;一项研究发现，男性宁愿承认自己有阳痿，也不愿承认自己有失禁的症状。UI将是一种高度创新的植入式生物电子神经假体，旨在为尚未接受人工神经刺激的UI患者提供合成反射。这些患者目前的选择包括高风险，不成功的手术或过时的大小适合所有的电刺激疗法，大多只是减少而不是治愈症状，Amber-UI将带来智能自适应刺激。它将对个体患者的生理学和可测量的生物标志物做出反应，包括“冲动”（突然需要排尿）和“压力”事件（咳嗽，打喷嚏，举重等）。实际上，Amber-UI将恢复大量UI患者的正常呼吸机制，使他们始终保持干燥-改变这些患者的生活。在首次人体研究中进行实验医学，该项目将完善Amber-UI的微创手术技术，使其需要与当前电刺激治疗手术相似的外科医生技能/时间承诺，它将探索和优化Amber-UI传感和刺激，最终为患者提供合成反射控制。

Urinary incontinence (UI) is a common condition that can severely impact physical, mental and financial wellbeing. Though it is thought at least 8.5% of the global population suffer from UI, many do not admit it, with fewer than half of adults with severe UI seeking help from healthcare providers; one study found that men would rather admit to sexual impotence than symptoms of incontinence.Amber-UI will be a highly innovative implantable bioelectronic neuroprosthesis intended to provide synthetic continence reflexes in patients with UI who have not responded to simple treatments like lifestyle changes, pelvic floor exercises, medication, bladder injections, etc.Where current options for these patients consist of high-risk, variably successful surgery or dated on-size-fits-all electrical stimulation therapies that mostly only reduce rather than cure symptoms, Amber-UI will bring intelligent adaptive stimulation. It will respond to the individual patient's physiology and measurable biomarkers of both 'urge' (the sudden need to urinate) and 'stress' events (coughing, sneezing, lifting, etc). In effect, Amber-UI will restore the normal mechanisms of continence in a large group of UI patients so that they remain dry all the time---transforming these patients' lives.Conducting experimental medicine in first-time-in-human studies, this project will refine Amber-UI's minimally-invasive surgical technique so that it requires a similar surgeon skill/time commitment as current electrical stimulation therapy surgeries, and it will explore and optimise Amber-UI sensing and stimulation to ultimately provide patients with synthetic reflex control of continence.