Advances in Ambulatory Urodynamics
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FEMALE UROLOGY (L COX, SECTION EDITOR)
Advances in Ambulatory Urodynamics Neil J. Kocher 1 & Margot S. Damaser 1,2,3 & Bradley C. Gill 1,4
# Springer Science+Business Media, LLC, part of Springer Nature 2020
Abstract Purpose of Review This manuscript reviews recent technological advances in ambulatory urodynamics. Recent Findings Ambulatory urodynamics is currently recommended by the International Continence Society as a second-line diagnostic tool in patients with nondiagnostic traditional urodynamics. Novel techniques involving telemetric monitoring are in development, which utilize catheter-free wireless systems to address several recognized shortcomings of inoffice urodynamic studies. Current research in catheter-free bladder pressure measurements involves either an intravesical, intradetrusor, or transdetrusor approach. Real-time bladder volume estimation may be performed using ultrasonography, near-infrared spectroscopy, or bladder volume conductance measurement. Summary Ambulatory urodynamics can measure bladder function in the “real world” setting, capturing physiological bladder filling and emptying and allowing patients to reproduce the activities that may trigger their symptoms. Telemetric devices being developed represent further advances in this field and focus upon improving diagnostic capabilities, evaluating patient response to treatment, and facilitating closed-loop bladder control with neuroprosthetic integration. Keywords Ambulatory urodynamic monitoring . Urodynamics . Telemetric . Wireless sensor . Bladder pressure . Urinary incontinence
Introduction Clinical urodynamics (urodynamic studies; UDS) refers to a collection of diagnostic examinations including filling cystometry, pressure-flow studies, uroflowmetry, urethral function testing, and electromyography—all of which provide physiologic assessment of lower urinary tract function [1••]. Human cystometry was first described in 1882 by Mosso and Pellacani, with advances during the early twentieth century that included the development of uroflowmetry by William This article is part of the Topical Collection on Female Urology * Bradley C. Gill [email protected] 1
Cleveland Clinic, Glickman Urological & Kidney Institute, Cleveland, OH, USA
2
Advanced Platform Technology Center, Louis Stokes Cleveland Veterans Affairs Medical Center, Cleveland, OH, USA
3
Department of Biomedical Engineering, Cleveland Clinic, Lerner Research Institute, Cleveland, OH, USA
4
Division of Urology, Surgical Service, Louis Stokes Cleveland Veterans Affairs Medical Center, 9500 Euclid Ave, Cleveland, OH 44195, USA
Drake Jr. in 1948 and introduction of the term “urodynamics” by Davis in 1954 [2–4]. Since the 1960s, UDS have been used to objectively characterize lower urinary tract dysfunction (LUTD) for a variety of conditions, such as stress urinary incontinence, overactive bladder and/or urge urinary incontinence, neurogenic bladder, as well as bladder outlet obstruction, and/or lower urinary tract symptoms. While the technological basis of traditional UDS has n
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