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

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 Abstract 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. Electronic supplementary material The online version of this article (10.1007/s11517-018-1942-9) contains supplementary material, which is available to authorized users.

Intelligent autonomous treatment of bedwetting using non-invasive wearable advanced mechatronics systems and MEMS sensors

“…A comprehensive team from various disciplines has been established after the satisfactory results obtained from our feasibility study [1] to build an ergonomic and robust solution for children with NE. Software (SW) and electronics engineers, designers, commercial innovators, health economists, physicians, radiologists, nurses, and psychologists have been brought together in this team.…”

“…A moisture detection alarm as a first-line treatment is recommended for up to 3 months, depending on the dry nights, by both The National Institute for Health and Care Excellence (NICE) [9] and European Society for Paediatric Urology (ESPU) [10]. A number of noninvasive products that can be categorised as (i) bedwetting alarms, (ii) pad and bell alarms, and (iii) bladder scanners currently available in the market to support the monitoring, diagnosis, and treatment of bed-wetting are yet to be found satisfactory in alleviating the predicaments of children with NE [1]. Similarly, medications (e.g.…”

“…The initial request for innovation in this area, a more optimal device originated from clinicians, parents, and children who were unsatisfied with the performance of the traditional urinary post-void moisture alarms and medications [1] where alarms are considered to be more effective than medications [13]. 1 In this regard, there have been several attempts to find a pre-void solution for NE sufferers [14,15]. An analysis of these attempts was presented in our previous study [1].…”

“…1 In this regard, there have been several attempts to find a pre-void solution for NE sufferers [14,15]. An analysis of these attempts was presented in our previous study [1]. The conclusion drawn is that there is no product in the market that can predict a pre-void occurrence so far.…”

“…There is an urgent need to develop an effective and comfortable device that (1) harbours artificial intelligence (AI) techniques to learn and evaluate the dynamic characteristics of the bladder and its surrounding tissues intelligently, (2) has customisable abilities for the children with various types of body morphologies, (3) determines imminent voiding need, and finally (4) provides pre-void alerts accordingly, in order to allow a patient to void in a dignified manner. We analysed the feasibility of such a system in our previous study [1]. That study was developed to explore whether existing technologies could be synchronised, enhanced, and modulated to form an intelligent alarm system that could provide a pre-void warning system for sufferers.…”