Researchers have developed a digital tool designed to promote bladder health in adults aged 50 and over.
A team from the University of Manchester, Lithuanian Sports University and the University of Vic in Spain developed the tool, called KOKU Bladder.
The initiative brings together evidence-based education, pelvic floor muscle training, behaviour change techniques and gamification to support engagement and long-term adherence.
Professor Emma Stanmore from The University of Manchester is CEO of KOKU Health, a UK digital health company which originated as a research project at the University of Manchester.
She said: “By embedding gamification within a clinically credible framework, we aim to make self‑management both motivating and meaningful.”
The programme is designed for people to use independently at home while also complementing face-to-face care delivered by healthcare professionals.
Around one in three adults over 60 experience urinary incontinence, rising to nearly half of those aged 80 and above.
Despite its scale and impact, incontinence remains one of the most under-discussed and under-treated health conditions, often hidden due to stigma, embarrassment and fragmented services.
Professor Javier Jerez-Roig from the University of Vic, principal investigator, said: “KOKU Bladder is not just another digital tool; it is a solution shaped directly by the people who will use it and the professionals who support them.”
Although several digital pelvic health tools already exist, a recent review identified only four evidence-based solutions that include people over 50, and none have been genuinely co-designed with end users and professionals.
In 2025, a total of 54 people across Spain, Lithuania and the UK contributed to the co-design of KOKU Bladder, including 31 potential users, 15 healthcare professionals and eight experts in pelvic health and ageing.
Participants highlighted the need for clinically trustworthy content, adaptive pelvic floor training, meaningful personalisation, multimedia guidance and embedded behaviour change techniques such as goal setting, self-monitoring and feedback.
KOKU Bladder is now in its pilot phase, with 75 participants testing the platform across English, Spanish and Lithuanian versions.
The next stage of the project will be an experimental study beginning this summer in Manchester, led by the University of Manchester to formally evaluate feasibility, engagement and user experience.
