Yongqi Zhang, Eric M Yeatman, Ranan Dasgupta
Current treatment options for chronic urinary retention secondary to detrusor underactivity are limited, and the mainstay is simply drainage by catheterization. The interdisciplinary field of bioelectronics could help to advance the prospect of artificial bladder emptying: first, by restoring continence control using human-in-the-loop mechanical compression to facilitate voiding and, second, by providing some of the components for managing detrusor overactivity, possibly using autonomous, closed-loop neuromodulation to inhibit aberrant contractions during storage. Pneumatic, magnetic and dielectric elastomer actuators are emerging and demonstrate varying levels of technology readiness; each type is associated with mechanical and biological challenges of implantation, including fibrotic encapsulation and power delivery. Furthermore, algorithmic continence control has ethical implications and the regulatory pathways for adaptive machine learning in bioelectronics must be created to outline the definitive roadmap required for this technology to reach clinical reality.