Noninvasive assessment of detrusor pressure and dysfunction

无创评估逼尿肌压力和功能障碍

• 批准号: 10389800
• 负责人: Azra Alizad
• 金额: $ 60.47万
• 依托单位: MAYO CLINIC ROCHESTER
• 依托单位国家: 美国
• 财政年份: 2022
• 资助国家: 美国
• 起止时间: 2022-02-15 至 2025-12-31
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/10389800
• 关键词: Adult; Benign Prostatic Hypertrophy; Bladder; Bladder Dysfunction; Catheterization; Catheters; Clinic; Clinical; Clinical Research; Computer software; Development; Diagnosis; Elasticity; Environment; Evaluation; Frequencies; Functional disorder; Goals; Hematuria; Human; Measurement; Measures; Methods; Monitor; Morphologic artifacts; Nature; Neurologic; Nocturia; Operative Surgical Procedures; Overactive Bladder; Patient Care; Patient Monitoring; Patients; Performance; Phase; Physiological; Population; Prevalence; Prostate; Quality of life; Rectum; Reporting; Research; Resources; Risk; Selection for Treatments; Symptoms; Techniques; Technology; Testing; Therapeutic Intervention; Time; Translating; Translational Research; Trauma; Treatment Failure; Urinary Retention; Urinary tract; Urodynamics; Urology; Vagina; Woman; adverse outcome; base; clinical practice; cost; detrusor muscle; efficacy evaluation; experience; follow-up; in vivo; lower urinary tract symptoms; male; mechanical properties; men; micturition urgency; new technology; novel; novel diagnostics; patient population; portability; pressure; prognostic; quantitative ultrasound; research facility; response; therapy outcome; tool; treatment planning; treatment response; ultrasound; urinary; urologic

Lower urinary tract symptoms are highly prevalent in adult men and women, with an estimated prevalence of up to 50%, and can have a significant impact on quality of life. Urodynamic studies (UDS) are routinely performed in the assessment of lower urinary tract symptoms. Presently, UDS is used in the clinic to detect detrusor overactivity. Detrusor overactivity is caused by unintentional transient contraction of the bladder detrusor muscle, increasing the internal pressure in the bladder. Detrusor overactivity is a common problem. It is estimated that 20% of the total population suffer from overactive bladder, and of those with overactive bladder who are tested by UDS, 65% have detrusor overactivity. Another application of UDS is to assess bladder function in men with benign prostatic hyperplasia (BPH). BPH is a common clinical entity. Millions of men develop lower urinary tract symptoms and seek treatment for this entity. Surgery to de-obstruct the urinary tract may be pursued to treat these patients. Clinically, a UDS test includes the use of multiple pressure catheters (placed in the bladder and rectum/vagina), retrograde bladder filling for an assessment of urinary storage function, and a pressure-flow study to assess for abnormalities of the voiding phase. UDS is limited by its invasiveness, patient discomfort, testing artifacts, and the risk of complications. Adverse outcomes, including urinary retention, catheter trauma, or hematuria, are reported in up to 19% of men and 1.8% of women. Considering UDS limitations, there is a need for a noninvasive alternative to UDS. To overcome the limitations of UDS, we propose a noninvasive ultrasound technique, Quantitative Ultrasound Bladder Vibrometry (QUBV). This technique measures changes in the detrusor’s pressure due to detrusor overactivity. Since this method does not require catheterization, it does not expose the patients to the risks and discomfort associated with UDS. Other advantages of QUBV include a direct measure of the detrusor pressure without the influence of bowl contractions, low cost, and portability. Also, since QUBV is noninvasive and low cost, it is suitable for repeated longitudinal tests for monitoring and evaluating response to treatment. The goal of this project is to evaluate the efficacy of QUBV applications in detrusor overactivity and BPH. To achieve our goal, we propose the following Specific Aims: (1) Evaluate the performance of quantitative ultrasound bladder vibrometry (QUBV) in diagnosing detrusor overactivity; (2) Prognostically determine and monitor patients with BPH that may benefit from surgery to de-obstruct the urinary tract. Each Aims will be tested in a population of patients. Our team has over a decade of experience in developing new technology for application in urology, thus has the expertise and resources to achieve the goals of this project. Also, the project benefits from the world-class clinical research and facilities at the Mayo Clinic. Successful completion of this project may have a significant impact on the diagnosis and management of bladder dysfunction.

在成年男女中，较低的尿路症状高度普遍 多达50％，可能会对生活质量产生重大影响。尿动力学研究（UDS）通常是 在评估较低的尿路症状时进行。目前，UDS用于诊所检测 迫害者过度活动。批准器过度活动是由膀胱的无意瞬态合同引起的 逼尿肌的肌肉增加了膀胱中的内部压力。迫害者过度活动是一个普遍的问题。它 据估计，总人口中有20％患有过度活跃的膀胱，其中有活动过度的人群 经UDS测试的膀胱，有65％的叶子过度活动过度。 UDS的另一个应用是评估 良性前列腺增生（BPH）的男性膀胱功能。 BPH是一个常见的临床实体。数百万 男性患有较低的尿路症状，并为该实体寻求治疗。手术以脱离攻击 可以追求尿路来治疗这些患者。临床上，UDS测试包括使用多重压力 导管（放置在膀胱和直肠/阴道中），逆行膀胱填充物以评估尿液 存储功能和压力流研究，以评估空隙阶段的异常。 UDS受到限制 它的侵入性，患者不适，测试工件以及并发症的风险。不利的结果， 据报道，包括尿retention屈，导管创伤或血尿在内，有多达19％的男性和1.8％ 女性。考虑到UDS的限制，需要使用非侵入性替代品。克服 UDS的局限性，我们提出了一种非侵入性超声技术，定量超声膀胱 振动法（QUBV）。该技术衡量由于迫害者过度活动而导致的迫害者压力的变化。 由于此方法不需要导管插入术，因此不会使患者面临风险和不适感 与UDS相关。 QUBV的其他优势包括直接衡量迫切压力的情况 碗收缩，低成本和便携性的影响。另外，由于QUBV是无创和低成本的，因此 适用于重复的纵向测试，用于监测和评估对治疗的反应。目标的目标 项目是为了评估码头应用程序在批准过度活动过度和BPH中的效率。为了实现我们的目标， 我们提出以下特定目的：（1）评估定量超声膀胱的性能 诊断截然器过度活跃中的振动法（QUBV）； （2）预后确定和监测 BPH患者可能受益于手术，从而消除尿路。每个目标都是 在一群患者中进行了测试。我们的团队在开发新技术方面拥有十多年的经验 因此，泌尿外科的应用具有实现该项目目标的专业知识和资源。另外， 项目受益于梅奥诊所的世界一流临床研究和设施。成功完成 该项目可能会对膀胱功能障碍的诊断和管理产生重大影响。