Feasibility study of intelligent autonomous determination of the bladder voiding need to treat bedwetting using ultrasound and smartphone ML techniques

Kaya Kuru,Martin Jones,Peter Leather,Darren Ansell,Christian De Goede

doi:10.1007/s11517-018-1942-9

Abstract

Unsatisfactory cure rates for the treatment of nocturnal enuresis (NE), i.e. bed-wetting, have led to the need to explore alternative modalities. New treatment methods that focus on preventing enuretic episodes by means of a pre-void alerting system could improve outcomes for children with NE in many aspects. No such technology exists currently to monitor the bladder to alarm before bed-wetting. The aim of this study is to carry out the feasibility of building, refining and evaluating a new, safe, comfortable and non-invasive wearable autonomous intelligent electronic device to monitor the bladder using a single-element low-powered low-frequency ultrasound with the help of Machine Learning techniques and to treat NE by warning the patient at the pre-void stage, enhancing quality of life for these children starting from the first use. The sensitivity and specificity values are 0.89 and 0.93 respectively for determining imminent voiding need. The results indicate that customised imminent voiding need based on the expansion of the bladder can be determined by applying a single-element transducer on a bladder in intermittent manner. The acquired results can be improved further with a comfortable non-invasive device by adding several more features to the current features employed in this pilot study.Graphical Ultrasound device design: echoed US pulses reflected from the bladder and related tissues around the bladder is detected. These pulses are analysed, and an alarm is triggered when needed to treat nocturnal enuresis.

Highlights

Nocturnal enuresis (NE), i.e. bed-wetting, is the involuntary discharge of urine at night in a child in the absence of congenital or acquired defects of the central nervous system or urinary tract
The main objective of this study is to develop an effective dry alarm to treat NE and manage the bed-wetting, which would be more acceptable than currently available moisture alarms until the child has learned to control the bladder
This device will be unique in that it recognises the warning signs of a pending emptying of the bladder via tracking expansion of the bladder volume over time, and will wake the patient up in time to prevent it. This process is customised or tuned to an individual patient’s bladder volume trigger point. This more accurate advanced warning system will help the children to alter their behaviours over time, reducing the frequency of nocturnal enuresis [10, 11] through learning bladder control over time

Summary

Introduction

Nocturnal enuresis (NE), i.e. bed-wetting, is the involuntary discharge of urine at night in a child in the absence of congenital or acquired defects of the central nervous system or urinary tract. NE can affect normal daily routines and social activities such as sleep overs or school trips. It can generate much more serious feelings and behaviours, such as a sense of helplessness and a lack of hope and optimism [5], feelings of being different from others, feelings of guilt and shame, humiliation, victimisation and loss of self-esteem [6, 7]. Bed-wetting causes many practical problems as well, such as constantly having to change wet sheets and bedding It can affect staying away overnight and going on holiday or trips. Bed wetting can affect sleep patterns and often it causes frustration and exhaustion

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