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


INTRODUCTION: Near-infrared spectroscopy (NIRS) non-invasively detects changes in the concentration of the chromophores oxygenated (DeltaO(2)Hb) and deoxygenated hemoglobin (DeltaHHb) 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 DeltaO(2)Hb, DeltaHHb and total hemoglobin (DeltatHb) were obtained from all 20 patients. Data during uroflow showed reproducible patterns of bladder chromophore change between asymptomatic subjects (rise in DeltatHb/DeltaO (2)Hb), consistent with laser instrument data. In contrast, all 6 symptomatic children had a negative trend in DeltatHb, with falls in DeltaO(2)Hb. 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 asymptomatic subjects 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.

Canadian Urological Association Journal