Wireless electrostimulation implants enable sphincter neuromuscular improvement toward mixed urinary incontinence

Abstract

Abstract Mixed urinary incontinence, involving concurrent or diagnostically unclear components of urge- and stress-related dysfunction, remains poorly addressed by current therapeutic strategies. State-of-the-art electrostimulation relies primarily on sacral neuromodulation for urge-predominant symptoms, requiring bulky (~3 cm³) and costly (>$10,000) implants, while stress incontinence is largely managed by mechanical or surgical interventions that do not restore sphincter neuromuscular function. Here, we propose wireless-powered implanted programmable electrostimulation of sphincters (WIPES) that bypasses long nerve loops and provides on-site stimulation at the urethral sphincter. The adhesive-patch-like soft implant integrates wireless power receiving and tunable pulse generation, enabling long-term controlled stimulation with reduced size (<0.3 cm³) and weight (<0.9 g). In rats with experimentally induced urge or stress incontinence (in separate rat models of urge and stress incontinence established under the same experimental conditions), WIPES delivered free-moving stimulation and achieved average alleviation rates of 90.62% (UUI) and 97.92% (SUI) in voiding frequency and volume. WIPES was associated with peri-urethral neuromuscular remodeling and improved bladder–urethral functional outcomes, supporting its potential role in coordinated continence control.