Innovation for Pelvic Health

Many of us have heard of jumping on the bandwagon, an expression used to describe someone following a trend or movement.
 

At LABORIE, when we think about our quality goals or our customer-service initiatives, we want everyone in our company on the bandwagon, thinking along the same path or philosophy. When it comes to product technology, however, the technology plane instead of the bandwagon is much more appropriate.  After all, when you think of bandwagons, we conjure images of horse-drawn carriages and endless circling when under threat.  This is not at all what we at Laborie want to project.  The airplane is much more sophisticated and of course, it is the modern way to travel.  

However, in this day of terrorism and high fuel prices, you would think that air travel is on the decline. Not so: While significant temporary dips in ticket sales have been recorded, there is still no substitute for being on site, wherever that may be. In response, companies such as Boeing and Airbus continue to produce new models of airplanes, and the focus has been on fuel efficiency and extended range.

Recently, I experienced probably one of my longest non-stop fl ights to date —Toronto to Hong Kong. The trip lasted 15 hours and 40 minutes, and I managed to get some decent sleep along the way. Better fuel efficiency and direct flights are a godsend to the frequent traveler, as they mean stable travel costs and less time wasted queuing up for security checks at connecting airports. Even the subject of supersonic and hypersonic travel is coming up again, and obviously this is because newer technology makes this possible (at least on a theoretical basis). So air travel continues to evolve, and technology makes the necessary adjustments for whatever roadblocks we encounter.

What does all this mean in incontinence studies and treatment? Technology is the enabler for the advancement of medical science and thus clinical practice. Just as in the airline industry, subtle-seeming yet profound technological changes have been occurring in our field that allow incontinence assessment, treatment, and management to move forward.

Let’s review some of this new technology, from the patient contacts to the clinician, and starting with the catheters themselves.

Catheter advancements
The main changes over the past few years have been in manufacturers’ abilities to get precision extrusions to make the main catheter bodies. Having better control of the quality and precision of manufacture has allowed smaller and smaller catheters to be made. The trend (luckily for the patients’ comfort) has been to smaller catheters.

A better selection of water- and, now, air-charged catheters gives clinicians more choices than before. For water-catheter users, catheter kits and self-closing flush lines are proving to be valuable timesavers for both clinicians who evaluate upwards of 8 cases a day as well as those who evaluate only a few cases per week.

Water-pressure transducer domes have also been improved, sliding on more easily and flushing faster. A signal-check button on each transducer allows the clinician to quickly troubleshoot any pressure lines when things do not go as planned.

Electromyelograph electrodes designed specifically for incontinence use (with pre-wired cabling) are finally coming on the market. Gone are the days when adaptations of large electrocardiograph electrodes were inappropriately used in "wet" environments.

Sensor technology
Sensors — components that measure pressure and fl ow — are much more consistent in manufacture, and this speeds up the calibration and quality control process. Soon, the notion of fi eld calibration will be done away with as all the new sensors will be digitally calibrated for the life of the sensor. This will be yet another time-saver for the clinician, and one less thing to worry about.
 

Analog-digital technology
The part of the electronics that handles sensor-to-computer conversion is also improving. Analog-digital chips are smaller, faster, and more precise than their counterparts of even 2 years ago. This has allowed battery applications to come of age. Yes, that means high-speed precision measurements are possible that also have a low power consumption.  Normally, the faster your sample or the greater the resolution, the greater the power supply requirements.  Using the latest silicon chip offerings, we can explore more portable solutions down the road that improve the convenience factor, patient comfort and even data quality (through fewer artifacts).

Bluetooth technology
Bluetooth (BT) technology is maturing nicely not only in the consumer market but in the medical market as well. At LABORIE, we’re developing our third-generation BT devices whereas other providers may be only contemplating their first. 

What have these improvements entailed? First, connection setup times have improved, as has device compatibility. Microsoft now supplies its own BT drivers (meaning that Microsoft recognizes that BT technology is popular for Windows usage), whereas previously we had to develop our own, proprietary drivers. Second, BT radios are now integrated options in many laptops. No additional USB or PC Cards need to be added to make a computer BT-enabled.

PC facilities
To think that a normal PC runs at 2 GHz and beyond (3 GHz and up for desktops), and is still improving! More computing speed means better performance and more time to perform more sophisticated tasks not previously possible with slower hardware. LCD screens have finally supplanted the old cathode-ray tubes. These thin solid-state devices make urodynamics displays easier to read and take up much less space in already-cramped treatment rooms. As a result, laptop computers are very cost-effective for small-offi ce urodynamics systems.

Software
Last but not least: With faster computers, better software can be developed. While maintaining backward compatibility (a Laborie credo), our urodynamics software has improved and been made even more convenient to use while retaining the program fl exibility it is famous for. A part of this is the ability to connect to hospital EMR (electronic medical records) systems as well as our own clinicaldecisions support offerings (i-List).

We should not forget that bladder modeling software (such as VBN) would never be possible if the computer handling the millions of calculations was not up to the task. In the pioneering days of electronics, super computers were used to model situations and run simulations. Now with the common desktop computer, bladder modeling by any clinican is possible.

Conclusion
These various advancements contribute to making urodynamics testing equipment more affordable, simpler to operate, and more compact while retaining all the accuracy and reliability of systems of the past. So, going back to our fl ying analogy, the plane ride to urodynamics development has been a fast one indeed, and the future continues to look very bright. 

I once met an elderly gentleman who reminisced with me about all the technology currently available that was not around when he was in his prime (internet, cellular phones, computers, etc.). He concluded our nostalgic discussion by saying that he will regret missing all the technological advancement that the future will bring after he leaves this earth. I rebutted by saying that we all have our time to live, some longer than others. The point is not to lament what we will miss but to cherish what we experience.

Now think of this discussion in terms of urodynamics: Stick with a partner that gives you the best technological ride so that today and tomorrow you can participate in all the best things incontinence assessment and treatment technology has to offer. That is a conscious choice we all can make today.

Ing Goping is a CSO and chief Scientific Officer at LABORIE. He received his formal training in electronic engineering from the University of Waterloo, Waterloo, Ont.  Mr. Goping has been actively involved in the field of incontinence and urodynamics for over 20 years and is attributed with having created the first  commercial computerized urodynamics system.  Much of Mr. Goping’s time is now spent consulting with incontinence specialists, researching and developing newer and better technology.

Mr. Goping can be reached by phone at 1-802-857-1300 or email igoping@laborie.com.