Measurement of Urinary Bladder Pressure: A Comparison of Methods.

Pressure is an essential parameter for the normal function of almost all organs in the human body. Measurement of pressure is therefore highly important in clinical practice and medical research. In clinical practice, pressures are often measured indirectly through a fluid line where the pressure is transmitted from the organ of interest to a remote, externally localized transducer. This method has several limitations and is prone to artefacts from movements. Results from an in vitro bench study comparing the characteristics of two different sensor systems for bladder assessment are presented; a new cystometry system using a MEMS-based in-target organ sensor was compared with a conventional system using water-filled lines connected to external transducers. Robustness to measurement errors due to patient movement was investigated through response to forced vibrations. While the new cystometry system detected real changes in applied pressure for excitation frequencies ranging from 5 Hz to 25 Hz, such small and high-frequency stimuli were not transmitted through the water-filled line connected to the external transducer. The new sensor system worked well after a resilient test at frequencies up to 70 Hz. The in-target organ sensor system will offer new possibilities for long-term monitoring of in vivo pressure in general. This opens up the possibility for future personalized medical treatment and renders possible new health services and, thereby, an increased patient empowerment and quality of life.

Development of clinically relevant implantable pressure sensors: perspectives and challenges.

This review describes different aspects to consider when developing implantable pressure sensor systems. Measurement of pressure is in general highly important in clinical practice and medical research. Due to the small size, light weight and low energy consumption Micro Electro Mechanical Systems (MEMS) technology represents new possibilities for monitoring of physiological parameters inside the human body. Development of clinical relevant sensors requires close collaboration between technological experts and medical clinicians.  Site of operation, size restrictions, patient safety, and required measurement range and resolution, are only some conditions that must be taken into account. An implantable device has to operate under very hostile conditions. Long-term in vivo pressure measurements are particularly demanding because the pressure sensitive part of the sensor must be in direct or indirect physical contact with the medium for which we want to detect the pressure. New sensor packaging concepts are demanded and must be developed through combined effort between scientists in MEMS technology, material science, and biology. Before launching a new medical device on the market, clinical studies must be performed. Regulatory documents and international standards set the premises for how such studies shall be conducted and reported.

From wires to waves, a novel sensor system for in vivo pressure monitoring.

Pressure monitoring in various organs of the body is essential for appropriate diagnostic and therapeutic purposes. In almost all situations, monitoring is performed in a hospital setting. Technological advances not only promise to improve clinical pressure monitoring systems, but also engage toward the development of fully implantable systems in ambulatory patients. Such systems would not only provide longitudinal time monitoring to healthcare personnel, but also to the patient who could adjust their way-of-life in response to the measurements. In the past years, we have developed a new type of piezoresistive pressure sensor system. Different bench tests have demonstrated that it delivers precise and reliable pressure measurements in real-time. The potential of this system was confirmed by a continuous recording in a patient that lasted for almost a day. In the present study, we further characterized the functionality of this sensor system by conducting in vivo implantation experiments in nine female farm pigs. To get a step closer to a fully implantable system, we also adapted two different wireless communication solutions to the sensor system. The communication protocols are based on MICS (Medical Implant Communication System) and BLE (Bluetooth Low Energy) communication. As a proof-of-concept, implantation experiments in nine female pigs demonstrated the functionality of both systems, with a notable technical superiority of the BLE.

An Evaluation of Parylene Thin Films to Prevent Encrustation for a Urinary Bladder Pressure MEMS Sensor System.

Recent developments in urological implants have focused on preventive strategies to mitigate encrustation and biofilm formation. Parylene, a conformal, pinhole-free polymer coating, has gained attention due to its high biocompatibility and chemical resistance, excellent barrier properties, and low friction coefficient. This study aims to evaluate the effectiveness of parylene C in comparison to a parylene VT4 grade coating in preventing encrustation on a urinary bladder pressure MEMS sensor system. Additionally, silicon oxide (SiOx) applied as a finish coating was investigated for further improvements. An in vitro encrustation system mimicking natural urine flow was used to quantify the formation of urinary stones. These stones were subsequently analyzed using Fourier transform infrared spectrometry (FTIR). Encrustation results were then discussed in relation to coating surface chemical properties. Parylene C and VT4 grades demonstrated a very low encrustation mass, making them attractive options for encrustation prevention. The best performance was achieved after the addition of a hydrophilic SiOx finish coating on parylene VT4 grade. Parylene-based encapsulation proved to be an outstanding solution to prevent encrustation for urological implants.

An in vivo MEMS sensor system for percutaneous measurement of urinary bladder.

An in vivo sensor system for direct measurement of pressure in the human urinary bladder is developed. The core component in the system is a small-sized and highly sensitive piezoresistive MEMS pressure sensor element integrated in a sensor catheter. The sensor catheter is wired to an external module for biasing, sampling, conversion and storage of sensor measurements. Our solution provides a target sensor placed directly into the urinary bladder and a reference sensor placed outside the bladder wall through a suprapubic and minimally invasive technique. Physiological recordings through natural filling and emptying cycles of the bladder are achievable. The case report from the first 17-hours investigation in a patient is presented in this paper. It reveals that the procedure was successful and no complications occurred. The patient expressed good experience during the participation. A functionality test shows that the percutaneous pressure sensor system responds immediately to external pressure stimuli.

An in vitro Study of Protein Adsorption to Biocompatible Coatings.

The motivation for these experiments was to investigate the amount and type of protein adsorption on surfaces that can be used as protective coatings on membrane based in vivo devices. Adsorption of proteins to a selection of biocompatible coatings (titanium oxide, diamond-like carbon, parylene C) and typical construction materials for Micro Electro Mechanical Systems (silicon, silicon nitride), were investigated during in vitro tests. The samples were incubated in human liver extract and bovine serum albumin (BSA) for up to 12 hours. The amount of protein adsorption was found to be low for all surfaces. Measurements of bound Iodine-125 labeled BSA, showed a protein adsorption of up to 0.2 µg BSA/cm2. The specific proteins adsorbed to the surfaces after incubation in human liver extract were identified using mass spectrometry. Most of the identified adsorbed proteins were intracellular, but plasma proteins like Immunoglobulin (Ig) and serum albumin as well as hemoglobin were also identified.