Availability of a newly devised ambulatory urodynamics monitoring system based on personal device assistance in patients with spinal cord injury

摘要

Conventional urodynamics systems have been widely used for the assessment of bladder functions. However, they have some drawbacks due to the unfamiliar circumstances for the patient, restrictive position during the test, expense and immovability of the instrument as well as the unphysiological filling of the bladder. To mitigate these problems, we developed a fully ambulatory urodynamics monitoring system, which enables the abdominal pressure to be measured in a non-invasive manner, as well as the manual recording of various events such as the bladder sensations or leakage of urine. Conventional (CMG) and furosemide-stimulated filling cystometry (FCMG) were performed for 28 patients with neurogenic bladders caused by spinal cord injury (24 males and 4 females, age: 49.4 ± 13.9 years, BMI: 23.5 ± 2.4). There were high correlation coefficients (r= 0.97 ± 0.02) between the clinical parameters measured by the conventional rectal catheter and those measured by our non-invasive algorithm in the FCMG studies. Also, 10 of the patients (36%) were diagnosed as having different reflexibility of the bladder between conventional CMG and FCMG (p< 0.05). In the patients with detrusor overactivity, the average volume and detrusor pressure at bladder sensation in FCMG were lower than those in CMG, while the average compliance was higher (p< 0.05). In the patients with areflexic bladders, the number of patients with detrusor overactivity was higher in FCMG and leakage was observed more frequently. These results showed that our system could be a useful additional tool in the clinical assessment of patients in which conventional cystometry failed to explain their symptoms.