How Health Care Works: An Innovation in Bladder Control
It's easy to get excited about a lifesaving new heart surgery or a potential cure for breast cancer. Advanced prosthetics that might help a paraplegic walk? Front page of the Sunday science section. For these heart-tugging inventions and research projects, the money pours in.
But Jason Bittel argues that one of the most important new inventions in health care wouldn't help us walk, or even help our hearts beat. It would help people urinate:
Most of us take the ability to urinate for granted, but doing so requires a network of firing nerves, contracting muscles, and communication with the brain. Unfortunately, the nerves that control bladder (and bowel) functions are near the bottom of the spine -- which means those with traumatic spine injury usually suffer from a severed connection. Without constant management, urine can back up into the kidneys or empty at unpredictable times. Other woes include bladder and kidney damage, life-threatening infection, and bladder cancer.
But there may soon be a new method for achieving better bladder control, according to a study published in this month's Science Translational Medicine. Scientists have been working on a neuroprosthesis that would tap into the nervous system and interpret electrical messages from the bladder. One day, these messages may be able to set off a buzzer letting the user know that the bladder is full and even allow her to empty it at the touch of a button.
That doesn't sound particularly romantic, but if scientists can make it work, this will be a major health-care advance. It could help not just paraplegics, but also people who suffer from degenerative conditions such as multiple sclerosis or Lou Gehrig's disease. Bladder infections are deadly for people with damage to the nerves at the base of the spine. And pumping folks full of antibiotics to treat them also carries significant risks, including creating resistant bacteria that could infect others.
Discussions of medical innovation often neglect this sort of thing. It's unsexy. And it's not a "cure" -- it doesn't make the problem go away. It just makes bad problems less deadly.
That's how most medical innovation works, however. We've been spoiled by penicillin; we think that doctors are supposed to be in the business of hunting cures. What they're actually in the business of doing is chipping away at hard and often icky problems, 5 percent at a time. But if you string together enough 5 percent improvements, you can almost work miracles.
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Megan McArdle at email@example.com