Detection and quantification of overactive bladder activity in patients: Can we make it better and automatic?

To explore the use of time-frequency analysis as an analytical tool to automatically detect pattern changes in bladder pressure recordings of patients with overactive bladder (OAB). To provide quantitative data on the bladder's non-voiding activity which could improve the current diagnosis and potentially the treatment of OAB.

We developed an algorithm, based on time-frequency analysis, to analyze bladder pressure during the filling phase of urodynamic studies. The algorithm was used to generate a bladder overactivity index (BOI) for a quantitative estimation of the average bladder non-voiding-activity. We tested the algorithm with one control group and two groups of patients with OAB symptoms: one group with detrusor overactivity (DO), assessed by an experienced urologist (OAB-with-DO group), and another group for which detrusor overactivity was not diagnosed (OAB-without-DO group).

The algorithm identified diagnostically significant data on the bladder non-voiding activity in a specified frequency range. BOI was significantly higher for both OAB groups compared to the control group: the median value of BOI was twice as big in OAB-without-DO and more than four times higher in OAB-with-DO compared to control group. Moreover the algorithm was successfully tested to detect episodes of detrusor overactivity.

We have shown that a simple algorithm, based on time-frequency analysis of bladder pressure, may be a promising tool in the clinical setting. The algorithm can provide quantitative data on non-voiding bladder activity in patients and quantify the changes according to phenotype. Moreover the algorithm can detect DO, showing potential for triggering conditional bladder stimulation.

Neurourology and urodynamics. 2017 Jul 26 [Epub ahead of print]

Thomas Niederhauser, Elena S Gafner, Tarcisi Cantieni, Michelle Grämiger, Andreas Haeberlin, Dominik Obrist, Fiona Burkhard, Francesco Clavica

Institute for Human Centered Engineering, Bern University of Applied Sciences, Biel, Switzerland., Department of Urology, Bern University Hospital, Bern, Switzerland., ARTORG Center, University of Bern, Bern, Switzerland.