[CCoE Notice] Cullen College Dissertation Defense Announcement

Hutchinson, Inez A iajackso at Central.UH.EDU
Thu Apr 18 09:30:00 CDT 2024


[Dissertation Defense Announcement at the Cullen College of Engineering]

Selective Neuromodulation Treatment for Female Stress Urinary Incontinence

USING MINIATURIZED WIRELESS NEURAL ELECTRODE



Farial Samira Rahman

April 18, 2024; 2:00 - 3:30 PM (CST)
Location: Room: 2028, Science and Engineering Research Center

 3517 Cullen Blvd, Houston, TX 77204

Zoom: https://urldefense.com/v3/__https://uh-edu-cougarnet.zoom.us/j/82419456425?pwd=djcrazByWXpQRERNSHZxQXNqZWdnQT09__;!!LkSTlj0I!AxVEShtKdqXM9yw2P82KkzhntMPwIDS-ZcL_Q1OC7vvtWAbsGdicqOfMMrGy28XSRh1dQ6zs2xicx2Vizg-iJxef_fM$ 

Committee Chair:
Metin Akay, Ph.D.

Committee Members:

Mario Romero-Ortega, Ph.D. | Yasemin Akay, Ph.D. | Mohammad Reza Abidian, Ph.D. | Philippe Zimmern, M.D.

Abstract

Stress urinary incontinence (SUI) is a pelvic floor disorder that affects over 26% of all adult women and can result from damage to perineal and pelvic floor muscles, which function as secondary sphincters in maintaining continence. Current treatment options for SUI do not provide an effective and sustained improvement in severe SUI cases as these cannot effectively treat the underlying pathophysiology. This thesis aims to investigate the use of direct targeted neuromodulation of perineal (bulbospongiosus, BsN) and pelvic (pubococcygeus, PcN) floor nerves to recruit the damaged muscles, thus re-stablishing their normal strength and coordinated stimulation, and reversing SUI-related deficits. First, young nulliparous healthy female rabbits were used to evaluate the individual, sequential and synergistic roles of BsM and PcM in assisting urethral closure, and to optimize the stimulation parameters for neuromodulation treatment. Unilateral stimulation of the BsN at 40 Hz was found to be sufficient to achieve effective secondary sphincter activity. Next, a sub-chronic study was conducted using mature multiparous disease-state female rabbits and the effect of the neuromodulation treatment on BsN using optimized parameters for 4-weeks was investigated. Unilateral neuromodulation of the BsN at 40 Hz resulted in significantly decreased leak events (40%), increased micturition volume (60%), and improved bladder function, and increased voiding efficiency. Finally, a second sub-chronic (3-week) neuromodulation study was conducted to evaluate the neuromodulation treatment effect in the early phases of regeneration in a standardized cryo-crush injury in the BsN of young nulliparous female rabbits. BsN histomorphometrical analysis after a cryo-crush injury demonstrated that neuromodulation treatment significantly accelerates myelin clearance after injury, increased Schwann cell proliferation, increases unmyelinated axon growth and radial sorting efficiency, and reduces myelination aberrations. Therefore, this research shows that BsM has secondary sphincter role in maintaining continence in the female rabbit model. Targeted neuromodulation of the BsN improved SUI-like deficits and accelerated regenerative mechanisms after injury, and therefore should be investigated further as a potential treatment for SUI in women.

[Engineered For What's Next]


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