Validation of a Wireless Catheter-Free Ambulatory Urodynamics Device in Women With Neurogenic Bladder

Abstract

Aims: Urodynamics (UDS) is critical for patients with neurogenic bladder but remains artificial given retrograde filling and voiding around a catheter in an uncomfortable setting. We have developed a wireless device for catheter-free real-time measurement of intravesical pressure during natural filling. Women with neurogenic bladder secondary to multiple sclerosis (MS) may experience discomfort, detrusor overactivity, or inability to urinate while observed during UDS which might belie true voiding patterns. The aim of this study was to test the wireless device in women with neurogenic bladder due to MS. Methods: Ten female participants with neurogenic bladder secondary to MS underwent standard UDS, after which the device was inserted and a second UDS study performed. Patients then ambulated with only the device in place for an additional void. Results: There were no significant differences in UDS results, pain or discomfort between the first and second cycle. The device captured 98% of UDS events, including 100% of detrusor overactivity. Post void residual volume after UDS (160 ± 179 mL [Range 0–454]) was significantly greater than after ambulation with the wireless device alone (19 ± 18 mL [Range 0–46]; p = 0.01), demonstrating greater voiding efficiency with the wireless device alone than with the UDS catheter in place. Conclusions: The device was well tolerated without complications, captured urodynamic data with a high degree of fidelity, and demonstrated additional utility in patients with borderline obstruction or inability to urinate while observed who cannot void during standard UDS. This device offers a promising alternative to the critical information provided by UDS in a less-invasive, more physiologic manner.