# Neuromodulation of Individual Pelvic Floor Muscle Activity in Urinary Incontinence

> **NIH NIH R01** · UNIVERSITY OF HOUSTON · 2020 · $533,221

## Abstract

Romero-Ortega+
!
Summary
Pelvic floor muscles (PFM) form a dome-shaped muscle complex are critical in urinary continence,
defecation and sexual functions, and weakening pelvic floor muscles can cause uncontrolled detrusor
activity, urgency, and urinary incontinence (UI), a condition that affects 30-60% of women in the US.
Recently, there is an increasing appreciation for the importance of the specific pattern of activity of
antagonistic muscles in the pelvic floor, and a realization that dysfunctional timing, reduced amplitude or
disorganized pattern of activity in individual muscles, critically impact their ability to maintain the urethra
closed, resulting in urine leakage. Here, we hypothesize that selective and coordinated stimulation of
individual PFM nerves will re-establish their normal strength and activity patterns, effectively reversing the
symptoms of UI. To that end, we have established a rabbit model of UI that replicates several aspects of the
human condition, including the specific pattern of activation of individual levator ani and perineal muscles
during the storage and voiding phases. This proposal is innovative in that it uses a state-of-the-art
miniaturized wireless electrodes to enable the interfacing of small PFM efferent nerves and directly
modulate their individual activity. Our preliminary studies show that compromised micturition resulting from
altered PFMs activity caused by multi-parity or aging in rabbits, can be reversed using selective PFM
neuromodulation (SPNM). We specifically seek to: 1) define the activation parameters for maximal muscle
force and limited fatigue for individual PFM, 2) evaluate the efficacy of patterned PFM activity by SPNM in
young multiparous and aging multiparous animals, and 3) demonstrate that chronic electrical stimulation of
PFM nerves can improved UI symptoms long-term, and test if that SPNM benefit persists after discontinuing
the neuromodulation treatment. This proposal will provide new information on the physiological role of the
PFM in urinary function, and will evaluate the selective neuromodulation of these muscles as a potential
therapy for drug resistant UI.

## Key facts

- **NIH application ID:** 10235847
- **Project number:** 7R01DK120307-03
- **Recipient organization:** UNIVERSITY OF HOUSTON
- **Principal Investigator:** Mario Ignacio Romero-Ortega
- **Activity code:** R01 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2020
- **Award amount:** $533,221
- **Award type:** 7
- **Project period:** 2020-08-01 → 2023-07-31

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10235847

## Citation

> US National Institutes of Health, RePORTER application 10235847, Neuromodulation of Individual Pelvic Floor Muscle Activity in Urinary Incontinence (7R01DK120307-03). Retrieved via AI Analytics 2026-05-24 from https://api.ai-analytics.org/grant/nih/10235847. Licensed CC0.

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