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.

Objectives: The objective of this study was to identify differences in bladder shape changes between individuals with overactive bladder (OAB) and unaffected individuals during ultrasound urodynamics.Methods: A prospective urodynamic study was performed with concurrent transabdominal ultrasound (ultrasound urodynamics) on individuals with and without OAB based on validated International Consultation on Incontinence Questionnaire -OAB survey scores. Three-dimensional ultrasound images were acquired at 1-minute increments during filling and used to measure bladder diameters in the height, width, and depth orientations. The engineering strain for each diameter was compared between participants with OAB and controls during urodynamic filling. The height-to-width ratio at capacity was used to determine if individuals were shape outliers.Results: A total of 22 subjects were enrolled, including 11 with OAB and 11 without OAB. During urodynamic filling in both groups, the greatest degree of geometric strain was found in the height orientation, indicating that bladders generally fill in a craniocaudal shape. The mean ± SD

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.

between the groups. The percentage varied significantly between NF (27.6AE11%) compared to IAEMG (40.6AE31%) p<0.0001.CONCLUSIONS: We have shown that a system of normalizing, smoothing and standardizing flows has a significant impact on the Qmax, and Qmax flow index aside from the timed based measures that were routinely prone to errors in doing the calculations necessary to obtain uroflow results. These time-based errors further erode the quality and confidence of any data we obtain that is determined by uroflowmetry across different investigators.