Querrey Simpson Institute for Bioelectronics, Northwestern University, Evanston, IL 60208.
School of Advanced Materials Science and Engineering, Sungkyunkwan University, Suwon 16419, Republic of Korea.
Proc Natl Acad Sci U S A. 2024 Apr 2;121(14):e2400868121. doi: 10.1073/pnas.2400868121. Epub 2024 Mar 28.
Partial cystectomy procedures for urinary bladder-related dysfunction involve long recovery periods, during which urodynamic studies (UDS) intermittently assess lower urinary tract function. However, UDS are not patient-friendly, they exhibit user-to-user variability, and they amount to snapshots in time, limiting the ability to collect continuous, longitudinal data. These procedures also pose the risk of catheter-associated urinary tract infections, which can progress to ascending pyelonephritis due to prolonged lower tract manipulation in high-risk patients. Here, we introduce a fully bladder-implantable platform that allows for continuous, real-time measurements of changes in mechanical strain associated with bladder filling and emptying via wireless telemetry, including a wireless bioresorbable strain gauge validated in a benchtop partial cystectomy model. We demonstrate that this system can reproducibly measure real-time changes in a rodent model up to 30 d postimplantation with minimal foreign body response. Studies in a nonhuman primate partial cystectomy model demonstrate concordance of pressure measurements up to 8 wk compared with traditional UDS. These results suggest that our system can be used as a suitable alternative to UDS for long-term postoperative bladder recovery monitoring.
部分膀胱切除术程序涉及与膀胱相关的功能障碍,需要长时间的恢复期,在此期间,尿动力学研究(UDS)间歇性评估下尿路功能。然而,UDS 对患者不友好,存在用户间变异性,并且仅代表时间上的瞬间快照,限制了收集连续、纵向数据的能力。这些程序还存在与导尿管相关的尿路感染的风险,如果高危患者的下尿路长时间操作,可能会进展为上行性肾盂肾炎。在这里,我们介绍了一个完全可植入膀胱的平台,该平台允许通过无线遥测连续实时测量与膀胱充盈和排空相关的机械应变变化,包括在台式部分膀胱切除术模型中验证的无线生物可吸收应变计。我们证明,该系统可以在植入后 30 天内重复测量啮齿动物模型中的实时变化,并且异物反应最小。在非人类灵长类动物部分膀胱切除术模型中的研究表明,与传统 UDS 相比,该系统的压力测量结果在 8 周内具有一致性。这些结果表明,我们的系统可以作为 UDS 的替代方法,用于长期术后膀胱恢复监测。