Ambulant monitoring of bladder oxygenation and hemodynamics using wireless near-infrared spectroscopy

Authors

  • Andrew John Macnab Department of Urology, Faculty of Medicine, University of British Columbia, UBC Hospital Bladder Care Centre, Vancouver BC
  • Babak Shadgan UBC Bladder Care Centre, University of British Columbia, Vancouver BC
  • Lynn Stothers Department of Urology, Faculty of Medicine, University of British Columbia, UBC Hospital Bladder Care Centre, Vancouver BC
  • Kourosh Afshar Department of Urology, British Columbia’s Children’s Hospital, Vancouver, BC

DOI:

https://doi.org/10.5489/cuaj.271

Abstract

Introduction: Near-infrared spectroscopy (NIRS) non-invasively detects changes in the concentration of the chromophores oxygenated (ΔO2Hb) and deoxygenated hemoglobin (ΔHHb) as the bladder detrusor muscle contracts during voiding. Such data provide novel information on bladder oxygenation and hemodynamics. We evaluated the feasibility of monitoring ambulant subjects using a wireless NIRS device.

Methods: The wireless device uses paired light-emitting diodes (wavelengths 760 and 850 nm) and a silicon photodiode detector. We monitored 14 asymptomatic subjects (10 adults, 4 children) and 6 symptomatic children with non-neurogenic lower urinary tract dysfunction (NLUTD) during spontaneous voiding after natural filling. The device was taped to the abdominal skin 2 cm above the symphysis pubis across the midline. The wireless NIRS data (patterns of change in chromophore concentration) were compared between subjects and to the data obtained using a laser-powered instrument.

Results: Graphs of ΔO2Hb, ΔHHb and total hemoglobin (ΔtHb) were obtained from all 20 patients. Data during uroflow showed reproducible patterns of bladder chromophore change between asymptomatic subjects (rise in ΔtHb/ΔO2Hb), consistent with laser instrument data. In contrast, all 6 symptomatic children had a negative trend in ΔtHb, with falls in ΔO2Hb. One adult experienced “shy” bladder and changes in hemodynamics/oxygenation occurred while bladder volume was unchanged.

Conclusions: Wireless NIRS bladder monitoring is feasible in ambulant adults and children; wireless and laser-derived data in asymptomaticsubjects are comparable. Pilot data suggest that subjects with symptomatic NLUTD have impaired bladder oxygenation/hemodynamics. The fact that chromophore changes occur when bladder volume remains constant supports the concept that NIRS data are a physiologic measure.

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Published

2013-02-20

How to Cite

Macnab, A. J., Shadgan, B., Stothers, L., & Afshar, K. (2013). Ambulant monitoring of bladder oxygenation and hemodynamics using wireless near-infrared spectroscopy. Canadian Urological Association Journal, 7(1-2), E98–104. https://doi.org/10.5489/cuaj.271

Issue

Vol. 7 No. 1-2 (2013): CUAJ February

Section

Original Research

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