Investigating incontinence - looking for new treatments for people with bladder problems
This research was completed on 31 October 2008
Published on 25 December 2007
Around 12% of adults in the UK suffer from urinary incontinence - the involuntary release of urine.(1) Many find treatments are not very effective. The stigma and inconvenience associated with this largely hidden problem can force sufferers to lead lives of quiet desperation and social isolation. Researchers are investigating what causes abnormal contractions of the bladder - a vital step in the development of new treatments.
What's the problem and who does it affect?
A terrible taboo
Nearly 66 million people in the European Union suffer bladder problems.(2)(3) Common complaints include a frequent or urgent need to urinate, which can mean people don't always reach the toilet in time, and leakage of urine - when coughing, sneezing, laughing or taking part in physical activity, for example. Many sufferers find their problem so embarrassing that they keep it to themselves - few people would feel comfortable about admitting they regularly wet themselves. Just one in four sufferers seeks help.(4) Many find treatments are not very effective, with only a small minority regaining long-lasting, normal control of their bladder.(2)(5) Urinary incontinence is most prevalent in the older population, with 40% of women and 10% of men over the age of 70 being affected.(6) But incontinence can affect people of any age, particularly those with diabetes or prostate disease, and those who've suffered an injury or a stroke. While some people develop coping strategies, others hide away and live like a recluse. Bladder problems can also be expensive - many people spend large amounts of money on laundry, disinfecting chairs and beds, and incontinence pads, for example.
What is the project trying to achieve?
What controls when the bladder empties itself?
Incontinence often results from abnormal contraction of smooth muscle in the wall of the bladder. Nerves and other cells affect the contraction of this muscle. The muscle's contractions must be tightly regulated to allow the bladder to store urine and then to empty efficiently when a socially convenient time arrives. This regulation process is not fully understood. The researchers working on this project suspect that a group of cells, called Interstitial Cells, may play an important part in controlling the contractions of the smooth muscle in the wall of bladder. Interstitial cells were recently discovered in the bladder. Similar cells in the gut have already been extensively studied, and they are well established as pacemakers, driving and coordinating muscle contractions. The team is studying the actions of Interstitial Cells in the bladder, and their positioning with respect to smooth muscle and nerves. They are using samples of human tissue taken, with consent, from the bladders of people who are undergoing surgery.
What are the researchers' credentials?
|Project Leader||Dr K D McCloskey PhD|
|Location||Division of Basic Medical Sciences, Medical Biology Centre, Queen's University Belfast|
|Grant awarded||25 September 2007|
|Start date||1 November 2007|
|End date||31 October 2008|
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The project leader, Dr Karen McCloskey, is a leading international expert on the role of the recently discovered Interstitial Cells in the urinary tract and bladder. Dr McCloskey has published papers on these cells in leading journals and she lectures at national and international conferences. Dr McCloskey is also a founding member of a European network of researchers, called InComb, which aims to combat incontinence. Dr McCloskey works with a young, enthusiastic and dedicated team, who have expertise in a broad range of laboratory techniques, enabling them to conduct research at the level of the gene, cell, tissue or whole organ. They are located in newly refurbished, state-of-the-art laboratories in Belfast.
Who stands to benefit from this research and how?
Increased freedom and confidence to participate fully in life
The researchers aim to provide a better understanding of what controls the contraction of the human bladder, focusing in particular on the role of Interstitial Cells. Abnormal contractions are seen in many people with incontinence. The ultimate hope is to build on this understanding by devising new, improved treatments for incontinence, treatments that can liberate sufferers from the debilitating and far-reaching effects of their condition. Researchers envisage new treatments would work by targeting abnormalities in the activity of the bladder muscle. The majority of people with urinary incontinence do not benefit from currently available treatments. While incontinence is not life threatening, it can seriously reduce the sufferer's quality of life. As people are generally living longer, and incontinence is more prevalent in the older population, the number of people who would benefit from a new treatment is set to increase. An effective drug would transform sufferers' daily lives, by freeing them from the embarrassment, inconvenience and expense that comes with incontinence. It would give people greatly increased confidence and freedom to participate fully in society.
1. McGrother CW, et al (2003): Continence. In Health Care Needs Assessment: The Epidemiologically Based Needs Assessment Reviews. Stevens AR, Raftery J and Mant J. (Eds) Abingdon: Radcliffe Medical Press Ltd. 2. Milsom I, Abrams P, Cardozo L, Roberts RG, Thuroff J, Wein AJ. How widespread are the symptoms of an overactive bladder and how are they managed? A population-based prevalence study. BJU Int 2001; 87: 760-6. 3. Irwin DE, Milsom I, Hunskaar S et al. Population-based survey of urinary incontinence, overactive bladder, and other lower urinary tract symptoms in five countries: results of the EPIC study. Eur Urol 2006; 50: 1306-15. 4. Minassian VA, Drutz HP, Al-Badr A. Urinary incontinence as a worldwide problem. Int J Gynaecol Obstet 2003; 82(3):327-38. Review. 5. Wagg A, Majumdar A, Toozs-Hobson P, Patel AK, Chapple CR, Hill S. Current and future trends in the management of overactive bladder. Int Urogynecol J Pelvic Floor Dysfunct. 2007; 18(1):81-94. 6. Hunskaar S et al: 2nd International Consultation on Incontinence. In: Abrams P, Cardozo L, Khoury S, et al (Eds): Health Publication Ltd. Plymouth, U.K., 2002