Abstract
You have accessJournal of UrologyInfections/Inflammation of the Genitourinary Tract: Kidney & Bladder II1 Apr 2015MP20-06 OPTICAL MONITORING OF DETRUSOR TISSUE OXYGEN SATURATION IN ACUTE LOWER URINARY TRACT INFECTION: A CASE CONTROL COMPARISON Babak Shadgan, Lynn Stothers, Andrew Macnab, Mark Nigro, and A Kajbafzadeh Babak ShadganBabak Shadgan More articles by this author , Lynn StothersLynn Stothers More articles by this author , Andrew MacnabAndrew Macnab More articles by this author , Mark NigroMark Nigro More articles by this author , and A KajbafzadehA Kajbafzadeh More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2015.02.978AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES The diagnosis of lower urinary tract infection (LUTI) is based on history and clinical symptoms confirmed by positive urine culture. However, reliance on the clinical symptoms and history is problematic in certain clinical scenarios such as in young children and individuals with neurogenic bladder (e.g. spinal cord injury) where history and / or sensation of dysuria are lacking. The purpose of this study was to determine if a quantifiable measure of detrusor oxygen saturation, derived using a transcutaneous near-infrared spectroscopy (NIRS) system could distinguish between subjects with and without LUTI. METHODS Children referred to a pediatric urology clinic for evaluation of acute LUTI, and a matched control group, were studied. The presence or absence of UTI was confirmed by urine culture. Participants had transcutaneous measurement of an absolute measure of tissue oxygen saturation (TSI%) in their bladder wall, and a quadriceps muscle control site. The measurement was made using a miniature spatially-resolved wireless NIRS device (Portamon, Artinis Medical Technologies) applied over the bladder and on a quadriceps control site, with data collected at 10Hz for 1 minute with the patient in the supine position. NIRS wavelengths were 760 and 850 nanometers. To ensure that NIRS light penetrated bladder tissue the thickness of the supra-pubic fat layer was measured using ultrasound. Average measures of bladder wall TSI% (B.TSI%) and quadriceps TSI% (Q.TSI%) and their differences (TSI.diff) were calculated and compared between those with LUTI and controls by performing a two-way ANOVA. RESULTS Forty-eight patients met the inclusion criteria (24 LUTI and 24 controls). Comparing LUTI to controls B.TSI% and TSI.diff values were significantly higher in the LUTI group (p<0.0001), while Q.TSI% values were not significantly different. In all UTI patients the SR NIRS-derived TSI.diff value was equal to or higher than 5.2, while in all non-UTI subjects the TSI.diff was lower than 2.6. Table – Group comparison CONCLUSIONS NIRS optical monitoring of an absolute measure of bladder wall oxygenation may offer a means of screening for LUTI where history and/or clinical signs are not available or adequate. © 2015 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 193Issue 4SApril 2015Page: e225 Peer Review Report Advertisement Copyright & Permissions© 2015 by American Urological Association Education and Research, Inc.MetricsAuthor Information Babak Shadgan More articles by this author Lynn Stothers More articles by this author Andrew Macnab More articles by this author Mark Nigro More articles by this author A Kajbafzadeh More articles by this author Expand All Advertisement Advertisement PDF downloadLoading ...
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