Glickman Urological and Kidney Institute, Cleveland Clinic, Cleveland, Ohio.
Advanced Platform Technology Center, Louis Stokes VA Medical Center, Cleveland, Ohio.
J Urol. 2023 Jul;210(1):186-195. doi: 10.1097/JU.0000000000003451. Epub 2023 Jun 9.
Urodynamics is the standard method of diagnosing bladder dysfunction, but involves catheters and retrograde bladder filling. With these artificial conditions, urodynamics cannot always reproduce patient complaints. We have developed a wireless, catheter-free intravesical pressure sensor, the UroMonitor, which enables catheter-free telemetric ambulatory bladder monitoring. The purpose of this study was twofold: to evaluate accuracy of UroMonitor pressure data, and assess safety and feasibility of use in humans.
Eleven adult female patients undergoing urodynamics for overactive bladder symptoms were enrolled. After baseline urodynamics, the UroMonitor was transurethrally inserted into the bladder and position was confirmed cystoscopically. A second urodynamics was then performed with the UroMonitor simultaneously transmitting bladder pressure. Following removal of urodynamics catheters, the UroMonitor transmitted bladder pressure during ambulation and voiding in private. Visual analogue pain scales (0-5) were used to assess patient discomfort.
The UroMonitor did not significantly alter capacity, sensation, or flow during urodynamics. The UroMonitor was also easily inserted and removed in all subjects. The UroMonitor reproduced bladder pressure, capturing 98% (85/87) of voiding and nonvoiding urodynamic events. All subjects voided with only the UroMonitor in place with low post-void residual volume. Median ambulatory pain score with the UroMonitor was rated 0 (0-2). There were no post-procedural infections or changes to voiding behavior.
The UroMonitor is the first device to enable catheter-free telemetric ambulatory bladder pressure monitoring in humans. The UroMonitor appears safe and well tolerated, does not impede lower urinary tract function, and can reliably identify bladder events compared to urodynamics.
尿动力学是诊断膀胱功能障碍的标准方法,但涉及到导管和逆行膀胱充盈。在这些人为条件下,尿动力学并不能总是重现患者的抱怨。我们开发了一种无线、无导管的膀胱内压力传感器,即 UroMonitor,它可以实现无导管的遥测式膀胱监测。本研究的目的有两个:评估 UroMonitor 压力数据的准确性,并评估其在人体中的安全性和可行性。
招募了 11 名患有膀胱过度活动症症状的成年女性患者进行尿动力学检查。在基线尿动力学检查后,将 UroMonitor 通过尿道插入膀胱,并通过膀胱镜确认位置。然后同时使用 UroMonitor 传输膀胱压力进行第二次尿动力学检查。在移除尿动力学导管后,UroMonitor 在私人环境中进行步行和排尿期间传输膀胱压力。使用视觉模拟疼痛量表(0-5)评估患者的不适程度。
UroMonitor 在尿动力学检查期间不会显著改变容量、感觉或流量。UroMonitor 也很容易在所有受试者中插入和移除。UroMonitor 重现了膀胱压力,捕捉到 98%(85/87)的排尿和非排尿尿动力学事件。所有受试者仅在放置 UroMonitor 时排尿,残余尿量低。使用 UroMonitor 进行的日常活动疼痛评分中位数为 0(0-2)。没有术后感染或排尿行为的改变。
UroMonitor 是第一个能够在人体中实现无导管遥测式膀胱压力监测的设备。UroMonitor 似乎安全且耐受良好,不会妨碍下尿路功能,并且可以与尿动力学相比可靠地识别膀胱事件。