Advancing Patient Care: Innovative Use of Near-Infrared Spectroscopy for Monitoring Urine Volume in Neurogenic Bladder

Purpose Current guidelines recommend clean intermittent catheterization (CIC) at regular time intervals for patients with spinal cord injuries; however, many patients experience difficulties. Performing time-based CIC outside the home is a significant burden for patients. In this study, we aimed to overcome the limitations of the current guidelines by developing a digital device to monitor bladder urine volume in real-time. Methods The optode sensor is a near-infrared spectroscopy (NIRS)-based wearable device intended to be attached to the skin of the lower abdomen where the bladder is located. The sensor’s primary function is to detect changes in urine volume within the bladder. An in vitro study was conducted using a bladder phantom that mimicked the optical properties of the lower abdomen. To validate the data in the human body at the proof-of-concept level, one volunteer attached the device to the lower abdomen to measure the light intensity between the first voiding and immediately before the second voiding. Results The degree of attenuation at the maximum test volume was equivalent across experiments, and the optode sensor with multiplex measurements demonstrated robust performance for patient diversity. Moreover, the symmetric feature of the matrix was deemed a potential parameter for identifying the accuracy of sensor localization in a deep-learning model. The validated feasibility of the sensor showed almost the same results as an ultrasound scanner, which is routinely used in the clinical field. Conclusions The optode sensor of the NIRS-based wearable device can measure the urine volume in the bladder in real-time

Advances in Assistive Electronic Device Solutions for Urology

Recent technology advances have led urology to become one of the leading specialities to utilise novel electronic systems to manage urological ailments. Contemporary bladder management strategies such as urinary catheters can provide a solution but leave the user mentally and physically debilitated. The unique properties of modern electronic devices, i.e., flexibility, stretchability, and biocompatibility, have allowed a plethora of new technologies to emerge. Many novel electronic device solutions in urology have been developed for treating impaired bladder disorders. These disorders include overactive bladder (OAB), underactive bladder (UAB) and other-urinary-affecting disorders (OUAD). This paper reviews common causes and conservative treatment strategies for OAB, UAB and OUAD, discussing the challenges and drawbacks of such treatments. Subsequently, this paper gives insight into clinically approved and research-based electronic advances in urology. Advances in this area cover bladder-stimulation and -monitoring devices, robot-assistive surgery, and bladder and sphincter prosthesis. This study aims to introduce the latest advances in electronic solutions for urology, comparing their advantages and disadvantages, and concluding with open problems for future urological device solutions

A Smart Framework for Predicting the Onset of Nocturnal Enuresis (PrONE) in Children and Young People

Bed wetting during normal sleep in children and young people has a significant impact on the child and their parents. The condition is known as nocturnal enuresis and its underlying cause has been subject to different explanatory factors that include, neurological, urological, sleep, genetic and psychosocial influences. Several clinical and technological interventions for managing nocturnal enuresis exist that include the clinician’s opinions, pharmacology interventions, and alarm systems. However, most have failed to produce any convincing results; clinical information is often subjective and often inaccurate, the use of desmopression and tricyclic antidepressants only report between 20% and 40% success, and alarms only a 50% success fate. This paper posits an alternative research idea concerned with the early detection of impending involuntary bladder release. The proposed framework is a measurement and prediction system that processes moisture and bladder volume data from sensors fitted into undergarments that are used by patients suffering with nocturnal enuresis. The proposed framework represents a level of sophistication and accuracy in nocturnal enuresis treatment not previously considered

Compression under pressure: physiological and methodological factors influencing the effect of compression garments on running economy

Evidence for the effects of compression garments on sports performance and physiological responses to dynamic exercise remains equivocal. Contradictory findings within the sporting literature are confounded by methodological heterogeneity in terms of; intensity and modality of exercise, type of garment worn, and the interface pressure produced by the garment. The interface pressure applied by compression clothing is an important measure in evaluating the bio-physical impact of compression. Interface pressure values obtained in vivo with two portable pressure devices (PicoPress and Kikuhime) were compared against a reference standard (HOSY). The PicoPress satisfied the a priori thresholds for acceptable validity at the posterior and lateral orientation with calf stockings and tights, confirming its future use to assess interface pressure. A small, likely beneficial improvement in running economy was observed with correctly fitted (95%:5%:0%; η2 = 0.55) but not oversized compression tights, indicating that a certain level of interface pressure is required. Compression tights improved running economy only at higher relative exercise intensities (77.7 - 91.5% V̇O2max). The absence of any improvement at lower intensities (67.1 - 77.6 % V̇O2max) suggest that changes in running economy from compression are dependent on relative exercise intensity when V̇O2max (%) is used as an anchor of exercise intensity. Comparing measures from two portable, wireless near-infrared spectroscopy (NIRS) devices (PortaMon and MOXY) we found that the low-cost and light-weight MOXY device gave tissue oxygen saturation values at rest and during exercise that were physiologically credible and suitable for future research. Compression tights did affect ground contact time but not tissue oxygen saturation, cardiovascular or other kinematic parameters during running at intensities equivalent to long-distance race speed. Compression tights can produce small improvements in running economy, but effects are restricted to higher intensity exercise and appear dependent on garment interface pressure. It remains unlikely that this small positive effect on running economy, in very specific conditions, is enough to result in a meaningful impact on running performance

INTEGRATED MICROSYSTEM-BASED APPROACH FOR DETECTION AND TREATMENT OF BACTERIAL BIOFILMS ON URINARY CATHETERS

Biofilms are a ubiquitous mode of growth for bacteria and present a significant challenge in healthcare due to their resistant nature towards traditional antibiotic therapy. Particularly, biofilms can form on indwelling urinary catheters, leading to catheter-associated urinary tract infections, which are one of the most prevalent healthcare-acquired infections. In recent years, microsystems-based approaches have been developed to measure and study bacterial biofilms. In this dissertation, microsystems are adapted for the catheterized urinary tract environment to address biofilm infections in situ. Specifically, a proof-of-concept device comprised of gold interdigitated electrodes on a flexible polyimide substrate is fabricated and characterized in vitro. This substrate allows the device to conform seamlessly with the cylindrical surface of a catheter. Real-time impedance sensing is demonstrated, showing an average decrease in impedance of 30.3% following 24 hours of biofilm growth. The device also applies the bioelectric effect, which yields an increase in impedance of 12% and the lowest biomass relative to control treatments. Furthermore, 3D-printed molds and commercial modeling software show that the cylindrical conformation does not have an appreciable impact on performance. This device is integrated with a commercially available Foley catheter using two disparate approaches: (1) integration of the flexible proof-of-concept device using a 3D-printed catheter insert and (2) electroless plating directly onto the catheter lumen. In addition to electrode integration, miniaturized electronic systems are developed to control sensing and treatment wirelessly with a minimal form factor. A smartphone mobile application is developed in conjunction with this effort, to provide a user-friendly interface for the system. Several functions are verified with the integrated system, including biofilm sensing, wireless signal transmission, bladder drainage, and balloon inflation. To decrease the risk associated with this system for future research in vivo and in a clinical setting, sensing and treatment are evaluated under realistic conditions. The biochemical aspect of the catheterized environment is recreated using artificial urine, and the physical aspect is recreated using a silicone model of a human bladder and a programmable pump. A 13.0% decrease in impedance is associated with bacterial growth; this decreased magnitude relative to the proof-of-concept device is due to the reduced degree of growth in artificial urine. The bioelectric effect is demonstrated as well, showing a reduction in planktonic bacteria of 1.50×107 CFU/ml and adhered biomass equivalent to OD590nm = 0.072 relative to untreated samples. This work provides a framework for developing microsystem-based tools for biofilm infection management and research from proof-of-concept to integrated system, particularly for CAUTI. The results demonstrate that the cylindrical conformation does not interfere with device sensing or treatment performance and that the system maintains functionality under realistic conditions, laying the groundwork for future in vivo and clinical testing. The system will provide in situ and real-time data regarding catheter biofilm colonization in a way that is not possible with existing techniques. Finally, the system can serve to reduce reliance on antibiotics and reduce the spread of antibiotic resistance in CAUTI and other vulnerable areas