WO2015032677A1 - Sonde - Google Patents

Sonde Download PDF

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Publication number
WO2015032677A1
WO2015032677A1 PCT/EP2014/068222 EP2014068222W WO2015032677A1 WO 2015032677 A1 WO2015032677 A1 WO 2015032677A1 EP 2014068222 W EP2014068222 W EP 2014068222W WO 2015032677 A1 WO2015032677 A1 WO 2015032677A1
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WO
WIPO (PCT)
Prior art keywords
catheter
pressure
urethra
sensors
sensor
Prior art date
Application number
PCT/EP2014/068222
Other languages
German (de)
English (en)
Inventor
Oliver Sawodny
Michael Ederer
Philipp RAPP
Mario Klünder
Original Assignee
Universität Stuttgart
Priority date (The priority date is an assumption and is not a legal conclusion. Google has not performed a legal analysis and makes no representation as to the accuracy of the date listed.)
Filing date
Publication date
Application filed by Universität Stuttgart filed Critical Universität Stuttgart
Priority to EP14755832.4A priority Critical patent/EP3041410A1/fr
Publication of WO2015032677A1 publication Critical patent/WO2015032677A1/fr

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Classifications

    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B5/00—Measuring for diagnostic purposes; Identification of persons
    • A61B5/20—Measuring for diagnostic purposes; Identification of persons for measuring urological functions restricted to the evaluation of the urinary system
    • A61B5/202—Assessing bladder functions, e.g. incontinence assessment
    • A61B5/205—Determining bladder or urethral pressure
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B5/00—Measuring for diagnostic purposes; Identification of persons
    • A61B5/06—Devices, other than using radiation, for detecting or locating foreign bodies ; determining position of probes within or on the body of the patient
    • A61B5/065—Determining position of the probe employing exclusively positioning means located on or in the probe, e.g. using position sensors arranged on the probe
    • A61B5/067—Determining position of the probe employing exclusively positioning means located on or in the probe, e.g. using position sensors arranged on the probe using accelerometers or gyroscopes
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B5/00—Measuring for diagnostic purposes; Identification of persons
    • A61B5/68—Arrangements of detecting, measuring or recording means, e.g. sensors, in relation to patient
    • A61B5/6846—Arrangements of detecting, measuring or recording means, e.g. sensors, in relation to patient specially adapted to be brought in contact with an internal body part, i.e. invasive
    • A61B5/6847—Arrangements of detecting, measuring or recording means, e.g. sensors, in relation to patient specially adapted to be brought in contact with an internal body part, i.e. invasive mounted on an invasive device
    • A61B5/6852—Catheters
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61N—ELECTROTHERAPY; MAGNETOTHERAPY; RADIATION THERAPY; ULTRASOUND THERAPY
    • A61N1/00—Electrotherapy; Circuits therefor
    • A61N1/02—Details
    • A61N1/04—Electrodes
    • A61N1/05—Electrodes for implantation or insertion into the body, e.g. heart electrode
    • A61N1/0507—Electrodes for the digestive system
    • A61N1/0514—Electrodes for the urinary tract
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B2560/00—Constructional details of operational features of apparatus; Accessories for medical measuring apparatus
    • A61B2560/02—Operational features
    • A61B2560/0223—Operational features of calibration, e.g. protocols for calibrating sensors
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B2562/00—Details of sensors; Constructional details of sensor housings or probes; Accessories for sensors
    • A61B2562/04—Arrangements of multiple sensors of the same type
    • A61B2562/043—Arrangements of multiple sensors of the same type in a linear array
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B5/00—Measuring for diagnostic purposes; Identification of persons
    • A61B5/103—Detecting, measuring or recording devices for testing the shape, pattern, colour, size or movement of the body or parts thereof, for diagnostic purposes
    • A61B5/107—Measuring physical dimensions, e.g. size of the entire body or parts thereof
    • A61B5/1077—Measuring of profiles
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61M—DEVICES FOR INTRODUCING MEDIA INTO, OR ONTO, THE BODY; DEVICES FOR TRANSDUCING BODY MEDIA OR FOR TAKING MEDIA FROM THE BODY; DEVICES FOR PRODUCING OR ENDING SLEEP OR STUPOR
    • A61M25/00—Catheters; Hollow probes
    • A61M2025/0001—Catheters; Hollow probes for pressure measurement
    • A61M2025/0002—Catheters; Hollow probes for pressure measurement with a pressure sensor at the distal end
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61M—DEVICES FOR INTRODUCING MEDIA INTO, OR ONTO, THE BODY; DEVICES FOR TRANSDUCING BODY MEDIA OR FOR TAKING MEDIA FROM THE BODY; DEVICES FOR PRODUCING OR ENDING SLEEP OR STUPOR
    • A61M25/00—Catheters; Hollow probes
    • A61M2025/0008—Catheters; Hollow probes having visible markings on its surface, i.e. visible to the naked eye, for any purpose, e.g. insertion depth markers, rotational markers or identification of type

Definitions

  • the present invention relates to what is claimed in the preamble and accordingly deals with measuring instruments for the treatment of incontinence.
  • Incontinence is the unwanted escape of urine. Incontinence can vary greatly; for instance, in mild cases, urine may escape unintentionally only if the heavily filled bladder of the affected person is exposed to a sudden increase in pressure in the body, for instance as a result of coughing or sneezing; In particularly serious cases of incontinence, on the other hand, unintentional urine loss may already occur while lying down and without additional stress. Incontinence can also have a number of causes. For example, incontinence may be the result of damage to various muscles involved in bladder emptying or their associated nerves; These muscles include, among others, the muscles surrounding the bladder and the muscles of the urethra.
  • incontinence may occur due to nerve diseases such as Alzheimer's, multiple sclerosis, Parkinson's.
  • incontinence can be very uncomfortable for those affected and may significantly reduce the quality of life, it is desirable to be able to treat incontinence efficiently.
  • Pressure measurement can be accomplished by introducing a catheter fitted with a pressure sensing sensor through the urethra into the urinary bladder (or back out of the bladder) and taking pressure measurements along the way. With suitable uroceters pressure profiles of the urethra and urinary bladder can be determined.
  • a pressure-measuring ureteral catheter is e.g. known from US 2009 / 0306539A1.
  • the pressure in the urethra to be determined by inflating a balloon, which is arranged on the catheter circumference and whose interior communicates via a lumen with a pressure sensor.
  • AI is an accelerometer-based monitoring of the frequency dynamics of the isovolumic contraction phase and pathological cardiac vascular known.
  • a one-, two- or three-axis accelerometer which is to be inserted in a guide catheter, thereby information about the heart condition are determined.
  • a plurality of acceleration sensors even multiple multi-axis acceleration sensors, can be used in order to be able to detect vibrations of specific frequency ranges better.
  • acceleration sensors are well suited for measuring vibrations and displacement movement. It is also discussed that more accurate acceleration measurements can be obtained if the influence of gravity on the acceleration sensors is taken into account.
  • An intercranial catheter which also uses an accelerometer as one of several sensors to navigate the catheter through the brain to a desired location, is known from US 2012/0302875. It is desirable to allow a better diagnosis of incontinence causes.
  • the object of the present invention is to provide new products for commercial use.
  • the solution to this problem is claimed in an independent form. Preferred embodiments can be found in the subcransprints.
  • the present invention thus proposes a first basic idea
  • a urethral catheter comprising sensing means for sensing urethral pressure and determining means for determining the location of the catheter in the urethra, wherein the determining means is comprised of a triaxial accelerometer to determine how the catheter is to be subjected to pressure sensing in the urethra the urethra is oriented. According to a basic idea, this does not just allow pressure in a particular one
  • the size of the area for which the pressure is determined locally depends on various factors.
  • the actual pressure sensor will typically be located inside the catheter and communicate with the fluid in the urethra via a breakthrough or a window in the catheter wall.
  • the size of such a window thus has a clear influence on the area at which the pressure is determined locally.
  • such a window is sealed by the urethra attached to the catheter. How close to the window the urethra nestles and how small or large it is the area at which the pressure is recorded locally depends on the interaction between the urethra and the catheter.
  • the bending of the typically flexible catheter in the urethra may result in the urethra abutting the catheter better at certain points and at certain orientations than at other points.
  • Such effects may cause the area for which the pressure is actually measured to be larger than the window leading to the pressure sensor in the catheter interior.
  • oversampling may be performed in one area. It should also be noted that irrespective of the tissue structure of the urethra, which has longitudinal folds in the unfilled state, a seal is achieved through the urethra which is only slightly larger than the respective opening leading to a pressure sensor in the catheter wall.
  • this area will not be substantially greater than three times the length along any distance defined on the catheter jacket surface
  • the urethra is so close to the catheter that the opening size practically corresponds to the measuring surface, but it will be appreciated that in preferred variants of the catheter, in which a plurality of sensors to the Are distributed around the circumference of the catheter, for example, egg-shaped, the sensors at equal angular intervals relative to each other
  • Cross-sectional projection will be arranged. Depending on the sensor window size and
  • Catheter diameters may be reduced upon implementation of preferred non-overlapping sensors e.g. approximately eight sensors are arranged along the circumference of a (projected) cross-section in a non-overlapping manner.
  • the arrangement along the circumference of only one projected cross section is typically necessary because the sensors in the interior of the catheter together with the associated lines and signal conditioning circuits occupy so much space that they can not all be arranged at the same axial position, but axially offset from each other Need to become.
  • the pressure can also be applied at e.g. equiangularly distributed around the circumference sensors are detected by rotation of the sensor. This allows oversampling in the direction of rotation.
  • pitch heights ie Rotations per extension distance of the catheter from the lariat tube can be selected.
  • the preferred pitch heights depend on e.g. of the number of sensors around the circumference, the spacing along the axis, the modeling to be laid out, etc. Therefore, it is desirable for the pitch height to be predeterminable. It should be noted, moreover, that at typical urethral catheter withdrawal rates of a few mm per second, e.g. 1 Omm / s, and conventional sampling rates of e.g. 1kHz, enough measurements can be taken to apply noise reduction techniques without causing excessive loss of information.
  • acceleration sensors are used, from the current components of the gravitational acceleration, ie from the components of gravity, the act on the individual sensors of the multiaxial accelerometer, as well as from the moment of insertion by the integration of asster motion state changes are closed to the urethra location. Even without integration of the total movement of the catheter since insertion (taking into account only the current force components caused by gravitation), the alignment of the catheter in the urethra or the bladder can still be detected, in some cases even very well.
  • anatomical peculiarities such as the end of the urethra on the bladder, etc., may also be deduced.
  • the detection of deflections of the catheter in the urethra is on the one hand advantageous because it allows the urethral profile in the sagittal plane to be determined and ergo anomalies can be detected.
  • the presence of the urethra on the catheter means that pressure can even be measured locally, but that, for example, the bend of the catheter in the urethra can lead to the urethra not resting evenly. Deviations can be taken into account here; this is possible, on the one hand, in modeling in which the surface of the hamming tube is to be detected. On the other hand, it is also possible without such modeling, a doctor information about the
  • the measurement of pressure in a given direction also significantly improves the diagnostic possibilities.
  • the intramedullary tube is partly fused with other organs or attached to them.
  • the recording of the pressure conditions over the total The lateral surface therefore provides valuable information for identifying lesions, etc., which in turn is very helpful in the treatment of incontinence causes.
  • the signals obtained with the accelerometer can also be used to determine an insertion depth.
  • the catheter will typically have a flexible and at least slightly twistable body in its entirety. He is preferred to be so stiff that the introduction is facilitated, but at the same time so slippery that it introduced to the patient is not too uncomfortable and bending-related artifacts are minimal. It is preferred if the pressure sensors of the pressure sensor means are arranged close to the accelerometer, so that only a limited torsion between accelerometer and pressure sensor means is possible. It is understood that a possible twist between
  • Accelerometer and pressure sensor means will affect the accuracy of the measurement. Therefore, it is preferred that the possible typical torsion between pressure sensing means and accelerometer be limited to 5 ° to 10 ° (a 360 ° full circle). It should be explicitly pointed out that the term torsion in this case refers to the rotation of the cathe- Tcrs in itself and not for example as the rotation of the catheter about its axis meant for helical or helical measurement.
  • the urethra is characterized by means of a device according to the invention Urokatheters;
  • the sensor means comprises a plurality of pressure sensors which are distributed over the circumference and / or in the axial direction. Not all pressure sensors must be at the same axial height. Full detection of urethral sheath area pressure ratios is thus possible with less total catheter movement.
  • a rotation of the sensor may be advantageous, which may need to be less rotated in order to achieve the same measuring point density around the circumference. This also applies where a helical movement is desired.
  • the modeling of the lateral surface can take into account, using measurement data of a catheter which moves in a helical manner with a plurality of sensors distributed over the circumference, that the sensors often do not rest on one and the same helix, because the sensors may indeed be arranged helically on the lateral surface of the catheter, but the spiraling of the sensor arrangement on the catheter jacket surface may have a different pitch than the pitch height of the helical movement of the catheter (for example effected by a suitable pulling device and with a predetermined pitch height) Urethra. While in general pulling out completely without turning would be particularly advantageous for the modeling, it will be appreciated that - since a slight rotation already occurs by the typical insert pull-out motion - even without external deliberate specification of a rotating one
  • Such artifacts can also be well corrected, at least as far as the urethra is modeled.
  • the pressure sensors are typically mounted near the proximal end of the catheter, i. close to the tip of the catheter to be inserted into the patient. In this case, a small distance of the pressure sensors to the tip can be provided in order to ensure greater flexibility there, to allow a rounding of the tip and thus to allow a simpler and above all painless insertion of the catheter. However, the sensors are typically placed so close to the proximal end of the catheter that measurement of pressure conditions within the urinary bladder is possible.
  • the arrangement of a plurality of pressure sensors close to one another contributes to approximately similar bending conditions occurring in each sensor, that is scanned in a rotational or helical movement of the catheter through the urethra very shortly in succession to all orientations around a given location, so that the dynamic Behavior of the urethra, at least in part, can be disregarded and that the arrangement is easier to produce st.
  • the urological catheter according to the present invention is assigned an evaluation unit which has an input for accelerometer-based signals, an input for signals based on measurements with at least one pressure sensor and preferably an input for signals related to a depth of insertion.
  • the depth of penetration will typically be digitized by means of the pulling device, which is a clear advantage even where no urethral surface is considered.
  • the evaluation unit can work completely digitally and so if appropriate only a single physical port is provided for serially received, digitized conditioned signals.
  • the evaluation unit will preferably be designed to determine the pressure conditions on a urethral surface in response to pressure sensor and accelerometer signals. In this case, even a determination of the pressure ratio on a urethral sheath outer surface can preferably be made, i. modeling a typical 1-lam tube behavior that is determined inside the urethra by the pressure conditions prevailing in it
  • Fig. 1 shows a urethral catheter according to the present invention
  • Fig. 2 shows a pressure profile taken with the urological catheter of the present invention as it moves in a model of a urethra.
  • a urethral catheter 1 generally designated 1, includes a urethral pressure sensing means 2 and a urethral urinary catheter determining means 3, the sensing means 3 comprising a triaxial accelerometer to determine. how urological catheter 1 is oriented when pressure is detected in the urethra.
  • the urethral catheter 1 is dimensioned such that its front end 1a can be advanced into the interior of the bladder in a male adult patient.
  • the patient side. towards the inside of the body (proximal) tip lal of the urological catheter 1 is rounded in order to avoid injury to the urethra during insertion and to facilitate a less painful and less unpleasant insertion for the patient.
  • a pressure sensor for measuring the IInventn bubble internal pressure is provided, compare la2.
  • the proximal tip will be formed of medical grade stainless steel or the like.
  • the pressure sensor which detects the urinary bladder pressure
  • an opening will be provided therein; the sensor itself is placed inside the tip. This will allow the sensor to communicate with the port itself and not measure the pressure exerted on a balloon or the like.
  • the sensor but could be upstream of a membrane above.
  • the sensor on the catheter tip will also be located very close to the opening.
  • Fig. 1 is further between the pressure sensor la2 for detecting the bubble internal pressure and the sensor means 2 for detecting the pressure in the
  • Urethral flexible catheter area la3 provided whose length is dimensioned here so that the adult male patient, for whom in the described embodiment, the Urokatheter 1 is designed, the ürucksensoren 2 a to 2 c can be pushed into the bladder, without passing through the proximal tip Lal injury to the urinary bladder occur. This is easily feasible. It is understood that in the design of the urological catheter 1 for children, the distance la3 corresponding to the body size and the not yet fully grown organs will be shorter, as well as there the catheter diameter will be smaller.
  • electrodes 3 a, 3 b, 3 c are provided on the urological catheter 1 between the pressure sensor provided at the proximal end 11 a and the pressure sensors 2 for determining the pressure in the lacrimal tube. While the pressure sensor is provided lal on a metal tip and the section la3 will be formed of flexible plastic, the electrodes are typically formed of mutually insulated metal rings, so that the urethra inside or the transition from urinary bladder to iliary tube (ostium-Urethrae- Internum ) can be electrically stimulated. It is understood that in the interior of the catheter leads are led to the electrodes 3a, 3b, 3c, via which suitable voltages can be applied to the electrodes.
  • a muscle stimulation can be effected and in particular also be recorded how the pressure in the urethra or at the output of 1 Harnblase changes to urethra, if there (the smooth, ie the conscious will not subject) Musculature is excited.
  • This can make the diagnosis much easier.
  • the sensor means 2 for detecting the pressure in the urethra is now realized with a here about 1, 2 cm to 3 cm long metal tube on the catheter, which carries a total of eight pressure sensors, of which in the figure only three (2a, 2b, 2c) are shown.
  • a total of eight pressure sensors of which in the figure only three (2a, 2b, 2c) are shown.
  • an opening is provided in the metal tube, so that the pressure sensor located inside the catheter can detect the pressure acting at the respective opening.
  • the openings for the eight pressure sensors are helically wound around the circumference of the catheter.
  • the here eight pressure sensors around the catheter circumference around - or the projections of the eight pressure sensors here on a perpendicular to the catheter axis cross-section - here are preferably distributed as equiangular , Each center of a sensor is thus removed by an arc of 45 ° from the nearest sensor on the cross-sectional project.
  • the eight sensors will not all be arranged at the same axial height, but be axially offset from each other. This may be the case, but a number of sensors may also be provided so that e.g. always pairs of pressure are provided in diametrically opposite directions sensing sensors at a given axial position.
  • the axial offset of the windows for the pressure sensors in the tube is such that the distal end of a window lies slightly farther toward the interior of the body than the proximal end of the pressure sensor window next following in the helical direction.
  • other geometries than the can be used here as preferred helical This may also depend on the overall size allowed for a given patient's dummy. It is also possible, for example, to use fewer or even more than eight sensors in children.
  • a window size of, for example, 1 mm x 2 mm sufficient and useful; while the larger edge of the window is oriented in the axial direction.
  • the acceleration sensor 3 is formed as a tri axial accelerometer, i. With the acceleration sensor arranged in the interior of the tube segment, it is possible to determine three components of an acceleration vector that are mutually orthogonal to one another.
  • the pressure sensors Ia2, 2 and the acceleration sensor 3 signal lines and S ignalkonditionierstoff are assigned to feed outside of the Urokatheters 1 and outside of the patient, where the Urokatheter to be used, the respective signals to a data evaluation unit , Depending on the requirements of the clinic or practice, a signal amplification, an impedance conversion, a digitization, if necessary a consideration of calibration or calibration data, signal filtering and / or other conditioning, a conversion to appropriate data protocols each within the Urokatheters using highly integrated circuits of low power or outside the Urokatheters done. In a preferred variant, however, the signals of the pressure sensors and the acceleration sensor are in any case digitized for further data processing.
  • the Urokatheter 1 is otherwise provided with marks l a5, which allow a determination of the insertion depth without reference to the signals, possibly integrated and processed signals, the acceleration sensor. This contributes to the fact that even in case of failure of the acceleration sensors, the catheter is not inserted too deeply and, moreover, a plausibility check of the integrated signals by the attending physician during the treatment can take place at any time.
  • the evaluation unit can be designed for either a modeling in real time or at least to a display of the current pressure values in certain directions in real time, preferably in graphical form, such as display of excellent directions towards determined pressure and the Hanrröhrenprofils in the sagittal plane.
  • the urethral catheter 1 of the present invention is now used as follows: After preparing the patient and optionally applying lubricants, etc., to the catheter, the urethral catheter 1 is inserted into the patient's urethra until the pressure sensors 2 lie within the bladder. It will generate a certain bubble level. The catheter is then successively withdrawn from the urethra, here in sections in each case by a little less than the length of the section 2 of the catheter. After each extraction movement by a distance which is slightly shorter than the length of the section 2, the catheter is rotated by approximately 360 ° and it is the pressure detected with each of the eight pressure sensors, and, at least initially, and the pressure inside the bladder.
  • the three components of the acceleration sector are permanently recorded, ie they are repeatedly scanned, digitized and written off or stored as required, ie also recorded during the rotation. It is understood that, if necessary, a rotation in a clockwise direction alternately, a withdrawal of the catheter to a stretch that is slightly shorter than the length of section 2, and thereafter counterclockwise rotation can be made 360 °, etc. This prevents the catheter as a whole from being twisted massively with associated conduits, etc. Next is the possibility of a helical
  • a plurality of knife values can be detected during the rotation, and from each j ene can be selected, for which the accelerometer indicates that they were picked up at a certain rotational position.
  • the rotation during extraction i. superimposed to can take place and insofar as a helical movement can be selected.
  • a pulling device is provided, which causes such a helical movement and the catheter is designed for a continuous rotation in one direction, to which it can be provided with suitable rotary joints for the electrical supply and signal lines, which in its interior, ie e.g.
  • the pressure signals obtained during extraction and gating can now be displayed, after signal conditioning and integration of the acceleration sensor signals, as if all openings for the pressure sensors were arranged along a straight line parallel to the catheter axis and with each pressure sensor in each outlet. peg position measurements would be detected with full rotation. It is thus made by reference to the signals of the acceleration sensor, an assignment of the pressure detection to the exact (rotational) position of the sensors in the urethra and measured the pressure at respective points of the urethral surface. At the same time it is also corrected that the catheter was not pulled out by exactly the same distance from measurement to measurement.
  • a model which is particularly robust against the expected variations and inaccuracies.
  • a model may instead be used in which equidistant tangents to the idealized helix are considered, and then again lattice points are defined on these tangents.
  • Such grids have advantages in terms of boundary conditions, because for the interpolation of the real measured values on functions with others
  • Pulling movement caused to detect what can be done on the catheter itself or about the drive of the pulling device.
  • the preferred and in particular under suitable evaluation for the modeling preferred catheter movements can also be implemented mechanically well.
  • oversampling can also be present in the case of a two-dimensional scan, ie that there is an optimal measured value density even in the case of two-dimensional measurements in the surface if the structures to be detected do not fall below a certain spatial size.
  • the eight sensors will be calibrated to give the same signals at the same pressure. If necessary, this can be done by pre-calibration and storage of calibration curves or the like. Such pre-calibration can be done by determining the air pressure before the actual examination.
  • the air pressure does not necessarily have to be determined absolutely exactly, but rather a measurement is to be made with all pressure sensors, in particular all sensors communicating via openings in the wall of the catheter with fluid in the urethra, which will result in identical measured values independently of position, and thus an adjustment of the Sensors with each other easier.
  • the sensors are in front of
  • Measurement of urethral characteristics are typically inserted into the urinary bladder.
  • the bladder is filled with a defined amount of liquid. This makes it possible during the filling, if the catheter according to the invention has a corresponding lumen for the filling or emptying of the bladder, to carry out the calibration during the filling in the case of several filling states. As a result, a calibration that is normally at least usable is usually automatic without special features. achieved. If desired, it is also possible to measure completely without catheter rotation.
  • FIG. 2 shows a pressure profile 1 obtained on the model.
  • This model comprises a silicone tube instead of the urethra.
  • the sphincter muscle was modeled on a cord loop model.
  • the silicone tube is oriented horizontally for the trial to model a recumbent patient. Iiier the pressure curves are plotted, which were detected for the respective sensors 2a, 2b ...
  • a finite element model is used for such elasto static modeling, in which at least four times more points around the circumference are (equidistant) as sensors are distributed around the circumference.
  • at least thirty-two nodes of a finite element model should be determined around the circumference of the urethra being modeled. Measuring points are used, which are recorded after one-eighth of the rotation.
  • the cutoff frequency will typically be about 1.5 times the spatial Nyquist frequency. If such modeling is desired, it is understood that the use of equidistant sensors is particularly preferred because this simplifies the mapping of the data to the nodes. After modeling, the examining doctor receives not only a curve according to FIG. 2, but also a modeling of the outer surface of the hernia which makes it even easier to detect defects.
  • the catheter of the present invention is preferably operated with a pulling device which imparts rotation to the catheter simultaneously to withdraw the catheter from the bladder, preferably with a selectable pitch. It should also be noted that the pulling-out distance can preferably be determined with the pulling device in order to make the digitized values available in the modeling and / or the measuring value preparation.
  • a urocatheter having a sensor means for detecting urethral pressure and determining means for determining the location of the catheter in the urethra, characterized in that the determining means comprises a triaxial accelerometer to determine how of the
  • Catheter is oriented at pressure detection in the urethra.
  • the sensor means has a plurality of pressure sensors distributed in cross-sectional projection over the circumference.
  • the sensor means for simultaneously detecting the pressure in the urethra is formed with a plurality, preferably all, of the sensors.
  • a urocatheter arrangement with such a urethra catheter and an evaluation unit comprising an input for signals obtained with the accelerometer, an input for signals based on signals obtained with at least one pressure sensor, and preferably an input for signals of a processing unit related to a insertion depth, in response to pressure sensor and
  • Accelerometersignale make a determination of the pressure conditions on a H urrthröhrenman- tcl surface, and an output for outputting a relation to these pressure conditions output signal

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Abstract

L'invention concerne une sonde urinaire comprenant un moyen de détection pour détecter une pression dans l'urètre et un moyen de détermination pour déterminer le placement de la sonde dans l'urètre. Selon l'invention, le moyen de détermination comprend un accéléromètre triaxial qui sert à déterminer l'orientation de la sonde lors de la détection de pression dans l'urètre.
PCT/EP2014/068222 2013-09-05 2014-08-28 Sonde WO2015032677A1 (fr)

Priority Applications (1)

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EP14755832.4A EP3041410A1 (fr) 2013-09-05 2014-08-28 Sonde

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