HOME USE OF CYSTOMANOMETER IN PATIENTS WITH A NEUROGENIC BLADDER
Christopher S. Cooper, M.D., Megan A. Bonnett, B.A., Denise Juhr, B.S., Gina M. Lockwood, M.D., Douglas W. Storm, M.D..
University of Iowa, Iowa City, IA, USA.
BACKGROUND: Patients with neurogenic bladder benefit from periodic urodynamics. The cystomanometer (CM) is a handheld device that attaches to the end of any catheter and records and stores the opening bladder pressure, time, and date, and wirelessly transmits data to a smartphone. We report the first experience of patients with a neurogenic bladder using the CM at home. METHODS: Inclusion criteria include patients with a neurogenic bladder on clean, intermittent catheterization having an iPhone. Software was downloaded to the iPhone in clinic at time of enrollment. Patients were provided the CM and written instructions and asked to use twice daily for two weeks. CM data is displayed on the smartphone app and transmitted to a hospital Redcap database. Patients were asked to complete a short usability feedback form. RESULTS: To date, 14 patients (8 males) with neurogenic bladder secondary to meningomyelocele have been enrolled in the study, including patients catheterizing via urethra or appendicovesicostomy. Average age = 14.7 (5-21) years. 13 of 14 patients used the device. Pressure readings ranged from 3-83 cm H2O with an average intra-patient pressure variability of 18 cm H2O. Regarding durability, 2 devices stopped working: 1 after being dropped in the toilet and another after the device tubing was partly dislodged. CONCLUSIONS: We report the first home use of a handheld electronic CM with wireless data transmission to a smartphone and hospital database. Significant durability issues were noted with the CM prototype and design improvements to address these issues are ongoing. Routine use of the CM may permit a more tailored approach to medication and catheterization and holds the potential to significantly improve the care of patients with neurogenic bladder.
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