I am Professor of Human Physiology in Newcastle University, Newcastle upon Tyne, England, and I have been working on bladder physiology and patho-physiology for more than a decade. My early work focused on isolated detrusor smooth muscle, characterizing intracellular Ca2+ mobilisation and contraction. From this work it became clear that alterations to the smooth muscle might not be the primary defect underlying bladder pathology, the overactive bladder (OAB) or the target for therapeutic drugs. This led me to consider other possibilities and to re-investigate phenomena and systems discovered over 100 years ago. This work described the physiological and pharmacological properties of mechanisms within the bladder wall that initiate and modulate intrinsic contractile activity: the autonomous bladder. These concepts led to the identification of new cells systems in the bladder wall involving interstitial cells, intra-mural ganglia and urothelium. In turn, ideas are being developed to put these components into the wider context of bladder function and dysfunction in relation to afferent nerve activity and sensation: the concept of afferent noise. Our challenge is now to integrate these ideas into the current understanding of CNS function and perceived sensation. We are now exploring the nature and description of bladder sensation using psychological techniques: cognitive voiding. What is clear is that we have major gaps in our understanding that need careful reflection, interpretation, thought and development.
In recent years it has been emerged that there are novel systems operating within the lower urinary tract. Remarkably, in the 21st century, we know very little about these systems, their nature or importance. As we explore and develop these concepts new insights are emerging into bladder physiology, pharmacology and pathology. We are now entering a new and exciting period in Functional Urology. It is important we realize this and develop all these new areas and ideas.
I have been asked to stand for election to the Scientific Committee (non-clinical) of the ICS. I have allowed my name to go forward because I feel we are now poised to make major leaps in our understanding of how the bladder works and how different pathologies might arise. For the first time we are beginning to have insight into how therapeutic drugs might work in this system. We must address these new ideas and new thinking if the field is to advance. A key way to do this is to participate in the Scientific Structures of the ICS. If I were to be elected I would bring to the Scientific Committee basic physiological, pharmacological and patho-physiological insight and understanding. Importantly, I would also bring an appreciation and drive to develop these new insights, ideas and concepts that will be needed to fully understand bladder function and dysfunction.
My specific goals and proposed initiatives would include:
• To maintain the production of high quality of research within the ICS
• To facilitate innovation in the development of ideas and experimental approaches
• To support the evolution of new and novel techniques in functional urology
• To facilitate the application of integrative approaches: ‘molecule to man’ ‘bench to bedside’
• To develop the basic science behind bladder dysfunction
• To support the identification and establishing clear rationale for developing and applying therapies
• To create informed debate and constructive criticism in urological research
• To broaden understanding of the complexities of bladder physiology, pharmacology and patho-physiology
• To encourage early stage career participation and involvement with research
• To support continuing Physiological and Pharmacological education for established clinicians
• To promote greater interaction within the science fora at ICS meetings
• To explore setting up separate research orientated meetings under the auspices of ICS focused on specific emerging topics
• To evolve the publication of these proceedings