Under the direction of Co-Founder and CEO David Constantine, Juniper Biomedical is tackling critical unmet needs in pelvic health, beginning with the treatment of mixed urinary incontinence. By introducing a unique neuromodulation micro-implant, the company seeks to provide a solution to treat both urge and stress symptoms in individuals suffering from mixed urinary incontinence.
Founded in 2019, Juniper Biomedical began as a collaboration between David Constantine and Dr. Mario Romero-Ortega, the Head of the Biomedical Engineering Department at the University of Arizona. Reflecting on the company’s early days, Constantine shared, “Mario and I met through a commercialization program where I was a mentor. He was working on another project at the time, and while I didn’t think that effort had a lot of legs, I really liked him as a human being and prolific innovator.”
Their collaboration began when Romero-Ortega shared new compelling data, offering a window into the game-changing potential for neuromodulation technology. Constantine explained, “We spent about a year and a half building trust and exploring this opportunity before officially creating the entity. This is not my first startup, and I know how critical it is to have the right team.”
The driving force behind Constantine’s commitment to Juniper Biomedical stems from the opportunity to make a meaningful difference in the lives of those suffering from pelvic health conditions. “Before we started this company, I didn’t realize how many people around me—close friends and family—were suffering from pelvic health conditions. When these individuals shared their experiences, it was a profound realization for me. The chance to have a real impact on this patient population—that’s where the rubber meets the road."
Pelvic health, particularly mixed urinary incontinence, remains an area of significant unmet need. 78 million women in the United States experience urge or stress incontinence, and at the very least, one-third of these patients show symptoms of both. Constantine highlighted the lack of innovation in the field: “Pelvic health has suffered from a real lack of profound innovation over the past decades. There’s been a lot of incremental progress but no game-changers.”
Mixed urinary incontinence, a combination of urge and stress incontinence, is particularly challenging. “For these patients, there’s no single consolidated solution,” Constantine said. “Doctors have to tease out which condition is dominant to offer an advanced care option. However, these treatments are most often large invasive implants, and most patients don’t want them. Over 90% of good candidates for these therapies don’t receive them—and for those who do, it only treats half of their condition if they have mixed incontinence.”
Juniper Biomedical’s solution is a neuromodulation micro-implant designed to treat mixed urinary incontinence by delivering precise stimulation to distal nerves. “The battery-powered implant is about half the size of a U.S. dime and is implanted under local anesthesia in a single 20-minute procedure,” Constantine explained. “Once it’s in place, the patient doesn’t have to wear anything or do anything to activate therapy.”
What sets the implant apart is the company’s approach to nerve stimulation. “Most current neuromodulation technologies stimulate the trunk of the tree—the large, multi-fascicular nerves,” Constantine said. “That usually requires very high power and results in imprecise therapy prone to patient-to-patient variability and side effects. We target distal nerves instead, where the number of innervations is smaller. This allows us to deliver lower-power, more precise stimulation with consistent results.”
Juniper Biomedical has achieved significant milestones since its inception. “We’ve conducted over 20 preclinical studies and refined the implant through hundreds of prototypes,” Constantine said. “The technology is now in the clinical design phase, and we’re conducting an early feasibility study to refine the procedure and stimulation paradigms.”
The company recently closed an oversubscribed Seed funding round and secured a win in the NIH Neuromod Prize Phase 2 competition. “Winning the Neuromod Prize was a great validation for us,” Constantine shared. “It put us in the company of top-tier neuromodulation innovators and affirmed the potential of what we’re building.”
While the initial focus is on mixed urinary incontinence, Constantine hinted at broader applications in pelvic health and beyond. “This is a platform technology,” he said. “We can adapt the same device to treat multiple conditions by targeting different nerves and adjusting the settings.”
There has been an increasing interest in using neuromodulation/neurostimulation to treat various forms of incontinence. This interest has been further increased by Boston Scientific’s $3.7 billion acquisition of Axonics, which was announced in January and closed in November.
Neuromodulation is a promising and effective means to treat incontinence. The approach allows patients to obtain the quality of life improvements they seek through a personalized, minimally invasive procedure.
According to LSI’s Market Analysis & Projections (MAP) database, a global device market sizing database, the $6 billion neuromodulation devices market is projected to experience moderate growth from 2023 to 2028. Within the neuromodulation devices market, the product segment for implantable devices for incontinence treatment (i.e., sacral nerve stimulation [SNS]) is projected to experience the strongest growth from 2023 to 2028, increasing at a CAGR of 7.0%. By the end of 2024, LSI estimates that the SNS market will be valued at $1.7 billion (or approximately 28%) of the entire neuromodulation devices market.
Constantine has been selected to present at LSI USA ‘25 next March 17-21 in front of hundreds of global medical technology companies. Join us in welcoming Constantine to the event in Dana Point, CA, where he will share the latest updates on Juniper Biomedical’s technology and development.
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