International audienceManagement of male severe stress urinary incontinence is currently achieved by the treatment of choice: an artificial urinary sphincter (AUS). This implantable system is designed to exert a constant circumferential force around the urethra. Although continence is totally or partially recovered in most of the patients, this method has some significant drawbacks. Besides the difficulty and discomfort of using the device, the revision rate caused by constant urethral compression, leading to urethral injuries, remains high. We present in this study a new AUS concept, with an ergonomic control, providing a lower exerted pressure on the urethral tissues and improving the continence efficiency. In fact, the implant includes a system which automatically detects circumstances involving high-intravesical pressure and adapts the occlusive pressure accordingly. The device was evaluated using isolated goat urethra, and then, in vivo. Recorded data of 16 human subjects performing different daily exercises were used to assess the detection algorithms. It is shown that occlusive pressure can be controlled by the implant with an accuracy of 1 cm H2O (98 Pa). Acceptable detection performance of seven of the eight targeted activities was observed

We recently developed a novel active implant for the treatment of severe stress urinary incontinence. This innovative medical device has been developed with the main purpose of reducing the mean urethral occlusive pressure of the current prosthesis. This goal is achieved by detecting circumstances implying either high or low intra-abdominal pressures by a single 3-axis accelerometer. In fact, posture and activity of the patient are monitored in real time. We investigated in this study the possibility of detecting cough events (one of the main causes of urine loss in incontinent patient) by MechanoMyoGraphy (MMG) of the Rectus Abdominis (RA) using the same accelerometer. We compared MMG signal detection characteristics (burst onset times and RMS values) to the method of reference, the ElectroMyoGraphy (EMG). It is shown that detection of cough effort by MMG presents lower performances, mostly in terms of cough anticipation, than EMG detection. However, MMG still remains a good option for an implantable system comparing to implantable EMG disadvantages.