title: Suburothelial Bladder Contraction Detection with Implanted Pressure Sensor.
abstract: OBJECTIVE
  Managing bladder pressure in patients with neurogenic bladders is needed to improve rehabilitation options, avoid upper tract damage, incontinence, and their associated co-morbidities and mortality. Current methods of determining bladder contractions are not amenable to chronic or ambulatory settings. In this study we evaluated detection of bladder contractions using a novel piezoelectric catheter-free pressure sensor placed in a suburothelial bladder location in animals.
  
  
  METHODS
  Wired prototypes of the pressure monitor were implanted into 2 nonsurvival (feline and canine) and one 13-day survival (canine) animal. Vesical pressures were obtained from the device in both suburothelial and intraluminal locations and simultaneously from a pressure sensing catheter in the bladder. Intravesical pressure was monitored in the survival animal over 10 days from the suburothelial location and necropsy was performed to assess migration and erosion.
  
  
  RESULTS
  In the nonsurvival animals, the average correlation between device and reference catheter data was high during both electrically stimulated bladder contractions and manual compressions (r = 0.93±0.03, r = 0.89±0.03). Measured pressures correlated strongly (r = 0.98±0.02) when the device was placed in the bladder lumen. The survival animal initially recorded physiologic data, but later this deteriorated. However, endstage intraluminal device recordings correlated (r = 0.85±0.13) with the pressure catheter. Significant erosion of the implant through the detrusor was found.
  
  
  CONCLUSIONS
  This study confirms correlation between suburothelial pressure readings and intravesical bladder pressures. Due to device erosion during ambulatory studies, a wireless implant is recommended for clinical rehabilitation applications.
authors.affiliation: Advanced Pltatform Technology Center, Louis Stokes Veterans Affairs Medical Center, Cleveland, OH, United States of America.|Department of Electrical Engineering and Computer Sciences, Case Western Reserve University, Cleveland, OH, United States of America.|Department of Biomedical Engineering, Cleveland Clinic, Cleveland, OH, United States of America.
authors.forename: Steve J A
authors.identifier: http://orcid.org/0000-0002-5057-0189
authors.initials: SJ
authors.lastname: Majerus
authors.affiliation: Advanced Pltatform Technology Center, Louis Stokes Veterans Affairs Medical Center, Cleveland, OH, United States of America.|Department of Biomedical Engineering, Cleveland Clinic, Cleveland, OH, United States of America.
authors.forename: Paul C
authors.initials: PC
authors.lastname: Fletter
authors.affiliation: Division of Urology, Louis Stokes Veterans Affairs Medical Center, Cleveland, OH, United States of America.|Urology Institute, University Hospitals, Case Medical Center, Cleveland, OH, United States of America.
authors.forename: Elizabeth K
authors.initials: EK
authors.lastname: Ferry
authors.affiliation: Advanced Pltatform Technology Center, Louis Stokes Veterans Affairs Medical Center, Cleveland, OH, United States of America.|Division of Urology, Louis Stokes Veterans Affairs Medical Center, Cleveland, OH, United States of America.|Glickman Urological and Kidney Institute, Cleveland Clinic, Cleveland OH, United States of America.
authors.forename: Hui
authors.initials: H
authors.lastname: Zhu
authors.affiliation: Urology Institute, University Hospitals, Case Medical Center, Cleveland, OH, United States of America.|Department of Biomedical Engineering, Case Western Reserve University, Cleveland, OH, United States of America.|Functional Electrical Stimulation Center, Louis Stokes Veterans Affairs Medical Center, Cleveland, OH, United States of America.
authors.forename: Kenneth J
authors.initials: KJ
authors.lastname: Gustafson
authors.affiliation: Advanced Pltatform Technology Center, Louis Stokes Veterans Affairs Medical Center, Cleveland, OH, United States of America.|Department of Biomedical Engineering, Cleveland Clinic, Cleveland, OH, United States of America.|Glickman Urological and Kidney Institute, Cleveland Clinic, Cleveland OH, United States of America.|Department of Biomedical Engineering, Case Western Reserve University, Cleveland, OH, United States of America.
authors.forename: Margot S
authors.initials: MS
authors.lastname: Damaser
mesh_terms: D000818:Animals; D002415:Cats; D004285:Dogs; D004567:Electrodes, Implanted; D008991:Monitoring, Physiologic / Q000379:methods*; D009119:Muscle Contraction; D019736:Prostheses and Implants; D001743:Urinary Bladder; D001750:Urinary Bladder, Neurogenic / Q000503:physiopathology*; D014563:Urodynamics