Aims: There is currently no standardized method of characterizing changes in bladder sensation during bladder filling outside of the urodynamics laboratory. The purpose of this investigation was to characterize real-time bladder sensation events using a sensation meter during oral hydration in individuals with normal bladder function. Methods: Participants enrolled in an accelerated hydration study drank 2 L Gatorade-G2® and utilized a sensation meter to record real-time bladder sensation (0–100%), verbal sensory thresholds, and sensation descriptors of “tense,” “pressure,” “tingling,” “painful,” and “other” for two consecutive fill-void cycles. Results: Data from 21 participants (12 females/9 males) were obtained and demonstrated an average of 8–9 sensation events (significant changes in sensation) per fill with no differences in the total number of sensation events and volume between sensation events (fill 1 vs fill 2). An increased number of sensation events occurred at higher capacity quartiles. Event descriptors of “pressure” and “tingling” were the most commonly chosen descriptors in both fills. Conclusions: The innovative sensation meter includes the sensation event descriptors of “tense,” “tingling,” “pressure,” and “painful,” to enable a more comprehensive understanding of bladder sensation as well as real-time identification, quantification, and characterization of sensation events. The study demonstrates 8–9 events per fill, acceleration of sensation during filling, and unique sensation event descriptor patterns. This technology may be helpful in the identification of novel sensation patterns associated with overactive bladder (OAB) and aging.

Objectives A non‐invasive protocol was previously developed using three‐dimensional ultrasound and a sensation meter to characterize real‐time bladder sensation. This study the protocol by measuring the effects of fill rateand ultrasound probe pressure during oral hydration. Methods Healthy volunteers with no urinary symptoms (based on International Consultation on Incontinence Questionnaire on Overactive Bladder surveys) were recruited into an oral hydration study. Throughout two complete fill–void cycles, participants drank 2 L Gatorade G2 (The Gatorade Company, Inc., Chicago, Illinois) and used a touch‐screen sensation meter to record real‐time bladder sensation (0%‐100%). The study was repeated three times, once per week (Visits A, B, and C). In Visits A and B, ultrasound was used to measure bladder volume every 5 minutes. Ultrasound was not used in Visit C except at 100% capacity. Volume data from Visit B were used to estimate volumes throughout the fills in Visit C. Sensation–capacity curves were generated for each fill for comparative analysis. Results Ten participants completed three visits (60 total fills). Increased fill rate led to decreased sensation throughout filling, andultrasound probe pressure led to increased sensation. Participants reported higher sensation at low volumes during Fill 1 of Visit A before training with the sensation meter. Sensation curves with intermittent ultrasound showed repeatability for Fill 2 in Visits A and B. Fill rate and ultrasound probe pressure affect real‐time bladder sensation during oral hydration. Conclusions This study demonstrated repeatability of real‐time bladder sensation during a two‐fill oral hydration protocol with ultrasound.

Background Hormone replacement therapy and various devices exist to treat signs of aging, such as skin thinning, yet there are no reviews summarizing or evaluating their role in neocollagenesis and the associated increase in skin thickness.Objective To review the literature regarding stimulation and generation of new collagen in the dermis in two parts. Part 2 reviews oral and topical hormone replacement therapy as well as energy-based devices.Methods The PubMed database was searched for related literature. Studies involving the use of hormone supplements and energy devices with a resultant change in collagen production or skin thickness were obtained and reviewed for evidence.Results Hormones, including estrogen, testosterone, and dehydroepiandrosterone, and human growth hormone have been reported with substantiating evidence for neocollagenesis and dermal thickening. Energy devices, including radiofrequency, ultrasound, and laser therapy, have also been reported to stimulate neocollagenesis.Limitations The results presented in certain literature are not based on randomized controlled trials. ConclusionHormone deficient individuals can regain skin thickness with hormone replacement therapy. Dermal heating can provide a substantial amount of neocollagenesis; however, laser technology, specifically CO 2 , appears to be the most effective at increasing skin collagen and tightening.

INTRODUCTION AND OBJECTIVES: Currently, ICS-defined verbal sensory thresholds are the only objective measures of real time bladder sensation in the micturition filling phase. A non-invasive protocol was previously developed using 3D ultrasound and a sensation meter to more completely characterize real time bladder sensation and its correlation with bladder volume/shape/rhythm. This study validates the protocol by measuring the effects of participant training and ultrasound probe pressure in oral hydration studies.METHODS: Healthy volunteers with no urinary symptoms (ICIq-OAB scores) were recruited into an oral hydration study. Throughout 2 complete fill/void cycles, the participants drank 2L Gatorade G2 and used a touch-screen sensation meter. Participants used the sensation meter to record real-time bladder sensation (0-100%). The study was repeated 3 times, once a week (Visits A, B, and C). In visits A and B, ultrasound images were obtained every 5min. The ultrasound was not used in visit C. For each 5% sensation increment, bladder volumes were calculated by measuring the bladder capacity/time (assuming constant fill rates).RESULTS: 10 participants (3 male/7 female) completed all visits. Fig1 shows %sensation vs. %capacity. In the group receiving ultrasound, the untrained participants (A1) had a decreased sensation (left shift) occurring mainly at low capacities (5-50%), likely representing the effect of training. With the removal of the ultrasound (C1 and C2), there is a further decrease in sensation (left shift), likely representing an additional sensation effect from the ultrasound probe.CONCLUSIONS: Because both visits A and B had ultrasound, the decreased sensation (left shift) at low capacities likely represents the effects of training (Fig1, red arrow). In visit C where the ultrasound probe was withheld, there was a further decrease in sensation (left shift), likely due to the probe pressure (Fig 1, blue arrow). This validation study demonstrates that during oral hydration studies, training and ultrasound probe pressure can affect real-time bladder sensation. This will further clarify variables that influence non-invasive metrics for filling phase sensation.