Cleveland Clinic, Glickman Urological & Kidney Institute, Cleveland, OH, USA.
Advanced Platform Technology Center, Louis Stokes Cleveland Veterans Affairs Medical Center, Cleveland, OH, USA.
Curr Urol Rep. 2020 Aug 18;21(10):41. doi: 10.1007/s11934-020-00989-w.
This manuscript reviews recent technological advances in ambulatory urodynamics.
Ambulatory urodynamics is currently recommended by the International Continence Society as a second-line diagnostic tool in patients with nondiagnostic traditional urodynamics. Novel techniques involving telemetric monitoring are in development, which utilize catheter-free wireless systems to address several recognized shortcomings of inoffice urodynamic studies. Current research in catheter-free bladder pressure measurements involves either an intravesical, intradetrusor, or transdetrusor approach. Real-time bladder volume estimation may be performed using ultrasonography, near-infrared spectroscopy, or bladder volume conductance measurement. Ambulatory urodynamics can measure bladder function in the "real world" setting, capturing physiological bladder filling and emptying and allowing patients to reproduce the activities that may trigger their symptoms. Telemetric devices being developed represent further advances in this field and focus upon improving diagnostic capabilities, evaluating patient response to treatment, and facilitating closed-loop bladder control with neuroprosthetic integration.
本文综述了动态尿动力学领域的最新技术进展。
国际尿控协会目前推荐动态尿动力学作为传统尿动力学检查结果不明确患者的二线诊断工具。涉及遥测监测的新技术正在开发中,这些技术利用无导管的无线系统解决了门诊尿动力学研究的几个公认的缺点。目前无导管膀胱压力测量的研究涉及经尿道、逼尿肌内或逼尿肌外途径。可以使用超声、近红外光谱或膀胱容量传导测量来实时估计膀胱容量。动态尿动力学可以在“真实世界”环境中测量膀胱功能,记录生理膀胱充盈和排空情况,使患者能够重现可能引发其症状的活动。正在开发的遥测设备是该领域的进一步进展,重点是提高诊断能力、评估患者对治疗的反应以及通过神经假体整合实现闭环膀胱控制。