Research at BioMed
New technologies
BioMed projects:
- New device for bladder drainage
- Urine odour and leakage detectors
- An early warning catheter encrustation sensor
- Suprapubic Foley Catheter Introduction Set
- Catheterisation training model
- Automatic catheter valve
- New urethral catheter
- Bladder stone removal device
New device for bladder drainage
Patients who have difficulty in emptying their bladder can be treated by:
- major surgery to make a channel in their abdomen (called a Mitrofanoff procedure), through which they can pass a single use (intermittent) catheter to regularly empty their bladder
- use of a intermittent catheter to regularly empty their bladder through their urethra
- insertion of a long-term catheter to continuously empty their bladder either through their abdomen or their urethra
This project aims to develop a new medical device which will reduce some of the problems associated with the current treatments. The SmartPort device will be inserted through the patient’s abdomen, forming a 'port' through which the bladder is emptied using an intermittent catheter.
The SmartPort will be similar in function to the mitrofanoff channel, but without the complications associated with major surgery, and offer the advantages of intermittent catheterisation. These include a reduced risk of urinary tract infection, and discreet and dignified bladder empyting. At the same time, it will incorporate some of the benefits of draining the bladder through the abdomen rather than the urethra, such as less need for dexterity and mobility, no risk of damage to the urethra, and greater freedom for sexual activity.
This project is being carried out in collaboration with Mediplus Ltd and TWI Ltd, and it is funded by the Technology Strategy Board. The project was started in April 2008, and will run for 2 years.
Urine odour and leakage detectors
The BioMed is part of a consortium of universities, small companies and charitable organisations that are working together on a £1.6 million project to find ways to reduce the impact of continence difficulties for older people. This project is titled ‘Tackling Ageing Continence through Theory, Tools and Technology’ (TACT3). The project is a collaborative interdisciplinary research project, lead by the Brunel Institute for Ageing Studies (BIAS) and funded by a Research Council New Dynamics of Ageing programme grant.
The research will be carried out by teams at Brunel University, the Royal College of Art, the University of Manchester, the University of Sheffield, the University of the West of England, Smartlife Technology, and the BioMed.
The project will cover three key areas of continence research:
1. Treatment of incontinence: how can we improve outcomes for older people through improvements in NHS service provision?
2. Environmental barriers to continence: how can we design toilet facilities that are accessible and available for older people so that their lives are not restricted by a lack of suitable facilities?
3. Assistive technologies: how can sensor-based technology be applied to continence management to make continence problems easier and less stressful to manage?
The research started in November 2008 and will run for three years. The BUI’s role in the project is testing and trialling the assistive technologies.
The latest edition of the TACT3 newsletter is now available, click here to open.
For further information please visit:
http://people.brunel.ac.uk/~tact3/index.php
An early warning catheter encrustation sensor
Catheter blockage is unpredictable. A sensor to detect the rise in urinary pH following infection with P. mirabilis has been developed by Dr David Stickler and Professor Mark Waters. Proof of concept was established using strips of polymer placed in the urinary drainage bag, which changed from yellow to dark blue when the crystalline biofilm started to form on catheter surfaces. In laboratory bladder models, the sensors signalled positive on average 42 hours prior to blockage. Electron microscopy also confirmed that at this point encrustation had started to form. A clinical study on a group of 20 catheterised patients demonstrated promising results. This sort of early warning of encrustation gives patients and healthcare professionals time to take action to avoid the crisis of catheter blockage.
Stickler DJ et al. A sensor to detect the early stages in the development of crystalline Proteus mirabilis biofilm on indwelling bladder catheters. J Clin microbial 2006 Apr; 44(4):1540-2
Suprapubic Foley Catheter Introduction Set
Suprapubic insertion usually takes place in hospital under general anaesthetic. This is costly and time consuming and subjects patients to the risk of anaesthetics. The Suprapubic Foley Catheter Introduction Set, developed and produced by Mediplus Ltd, enables insertion to be conducted more easily and under local anaesthetic. It uses the Seldinger technique to introduce a trocar and peel-away sheath into the bladder cavity before passing the catheter through the sheath. The initial introduction of the guidewire through the needle used to administer the local anaesthetic secures the route into the bladder and gives the operator a greater sense of confidence when applying pressure on the trocar.
For more details contact James Urie at Mediplus Ltd
NHS Technology Adoption Centre How to why to Guide... for a copy please click.
Catheterisation training model
A Training Model was produced in conjunction with Limbs & Things Ltd for teaching urethral and suprapubic catheterisation techniques to medical students and nurses.
The Limbs & Things training model for suprapubic and urethral catheterization
The model creates a realistic sense of resistance when passing the catheter through the urethral sphincter or through the linea alba when performing urethral or suprapubic catheterisation respectively.
For more information contact Nick Gerolemou (Nick.gerolemou@limbsandthings.com) at Limbs & Things
Automatic catheter valve
Studies have shown that if the natural cycle of filling and emptying the bladder can be achieved, there is a significant reduction in the rate of catheter blockage. Manual valves allow the natural cycle to be simulated, but they are often difficult to use especially for people with poor manual dexterity. ETB and Durham University developed a urine drainage device system that enables the bladder to fill and empty in a natural cycle automatically. It is an external automatic micro-valve system, which will operate in conjunction with a long-term catheter and drainage collection bag. Early tests demonstrated that no commercially available micro-valve could achieve the required levels of flow performance, power consumption & size without unacceptable rates of bio-encrustation & blockage. A prototype design developed and tested using the lab process available through the BioMed Centre was shown to perform successfully in highly contaminated urine in-vitro tests, increasing the time to encrustation up to 4 times. A high-performance, low cost development programme was then accelerated to produce a custom designed valve with encrustation resistant features and a very-low-power electronic actuator for controlling flow.
Reference: Sabbuba NA, Stickler DJ, Long M, Dong Z, Short TD. Does the valve- regulated release of urine from the bladder reduce the encrustation and blockage of indwelling catheters by crystalline Proteus mirabilis biofilms? Journal of Urology 2005, 173: 262-266.
Patent :GB2395128B, Granted 16th November 2005 .
The above schematic shows one of the earlier designs which was trialed during the project.
For more information contact Dr Diana Hodgins at ETB
New Urethral Catheter
One of the problems with the Foley Catheter is that the balloon that holds the catheter in place creates a reservoir of urine in which bacteria thrive. The aim was to develop a catheter that would allow the bladder to empty completely. Ranier Ltd already had a patented concept and a first pre-prototype of one component part. During the course of the programme, the design and materials evolved and a further four patents relating to the device design have been filed. A succession of prototypes have been manufactured. Testing in accordance with the International and EU Standards has demonstrated that the catheter permits a faster flow rate of liquid than a conventional Foley catheter. In other respects it was shown to perform equally well. Use of the bladder model system was invaluable in demonstrating that the new catheter took longer to block than conventional silicone Foley catheters of the same Charrier size when challenged with the ‘worst case scenario’ in terms of infection by P. mirabilis and urine production rate. Preliminary clinical trials have been performed at the BioMed Centre and in Denmark .
For more information contact Sam Martin at Ranier Ltd
Bladder stone removal device
We are applying for funding to develop a better way to remove bladder stones from elderly patients.
Bladder stones can cause pain and discomfort in the suprapubic region and are common in people with long term catheters. They can also be seen in elderly males with benign prostatic hypertrophy. These people cannot completely empty the bladder and the residual urine acts as a source for stone formation. Stones can also harbour bacteria, thus increasing the risk of infection. This is particularly important as the majority of patients on long term catheters have significant co-morbidities with a very limited physiological reserve to deal with infections.
We aim to design a device to assist with the fragmentation and removal of bladder stones without the need for a general anaesthetic which often requires admission to hospital. This project will explore several concepts and then take one of them forward to the design and construction of a prototype. BioMed is collaborating with biomedical engineers at the Bath Institute of Medical Engineering on this project.
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