Novel Electric Impedance Myography for Neurogenic Bladder Function Evaluation
Background
Neurogenic Bladder (NB) is a common condition where bladder control is lost due to damage to the nerves that control bladder function, leading to difficulties in emptying or holding urine. It may arise from damage to the brain, spinal cord, or nerves, form post pelvic surgery, or may also be seen in patients with diabetes, Alzheimer’s disease, Parkinson’s disease, multiple sclerosis, and spina bifida. It can lead to urinary incontinence and lower urinary tract symptoms such as urinary frequency, urgency, pain, retention, and urinary tract infection. In the United States alone, NB is associated with a significant healthcare burden with billions of dollars spent annually. Besides Botox injections, which may be difficult to accurately administer, and which only help manage symptoms, there is no cure for NB and treatment plans rely on the accurate evaluation of patient bladder function.
Urodynamic study (UDS) is the gold standard to evaluate and monitor bladder function in patients with NB. However, UDS can have significant inter-observer variability. Inter-observer reliability heavily relies on several individuals performing the same visual task, which can cause great inconsistency and variability. As a result, Electric Impedance Myography (EIM) is a new technique that has gained momentum in evaluating neuromuscular diseases. EIM is a non-invasive method that is used to measure the electrical impedance of muscles to assess muscle health.
Technology Overview
Boston Children's Hospital researchers have developed a novel EIM probe design, which provides accurate and reproducible EIM measurement of the bladder detrusor muscle. This probe incorporates the EIM sensors and electric lead into small caliber needles that can be passed via existing endoscopic instruments such as a cystoscope. The EIM sensor provides accurate real-time measurements of the impedance of the bladder detrusor muscle. This information can be used for bladder detrusor evaluation, drug effect monitoring, tissue plane selection for intervention, and prediction of interventional success. Additionally, this invention can help guide surgeons monitoring previous Botox injection responses as well as to assess the best area for injection. Furthermore, the accumulated EIM data will also be used to develop algorithms to help predict treatment response and further enhance the capability to reach the lowest, yet most effective dose of Botox.
Applications
- Patients with Neurogenic Bladder
- EIM probe can be integrated in small caliber needles that can be passed via endoscopic instruments such as a cystoscope.
- Real-time EIM measurement of target tissue/muscles, such as the bladder detrusor muscle
Advantages
- Non-invasive and patient-friendly compared to traditional urodynamic studies.
- Provides real-time, quantitative data for accurate diagnosis and monitoring.
- Highly reproducible results, reducing inter-observer variability.
- Enables targeted treatment by identifying optimal injection sites for therapies.
- Potentially reduces healthcare costs by streamlining diagnosis and treatment processes.
Publications
- Wang, HH.S., Thaker, H., Bigger-Allen, A. et al. Novel phenotype characterization utilizing electrical impedance myography signatures in murine spinal cord injury neurogenic bladder models. Sci Rep 13, 19520 (2023). https://doi.org/10.1038/s41598-023-46740-6
