UBC Reports | Vol. 51 | No. 7 | Jul. 7, 2005

New Device Promises Relief for Those Facing Bladder Disorders

By Hilary Thomson

A new diagnostic device developed by a UBC research team has got people -- including investors -- talking about urinary incontinence (UI).

An interdisciplinary research trio of technician, pediatrician and urologist has developed a non-invasive diagnostic tool that uses near infrared spectroscopy (NIRS) to test bladder function. The tool will be available for sale within two years and experts in innovative medical technologies predict that soon after, it will be the new “gold standard” for diagnosing bladder disorders.

Pediatrics critical care professor Andrew Macnab and research technician Roy Gagnon are the most experienced Canadian researchers using NIRS to measure blood flow to the brain, particularly in infants. In 2003, they were temporarily sharing lab space at Vancouver General Hospital with urologist Dr. Lynn Stothers and, over coffee, described the difficulties they were having because signals related to bladder function were interfering with their NIRS study of the spinal cord.

Stothers recognized that what was a problem for Macnab and Gagnon could offer a solution for the hundreds of thousands of patients who undergo an uncomfortable, invasive and humiliating bladder function test.

The current technique involves catheters inserted in the rectum and urethra to gauge bladder pressure and create an indirect measure of bladder function. It is estimated about 40 per cent of patients with clinical symptoms aren’t properly diagnosed because they refuse to take the test.

Based at Children’s & Women’s Health Centre of British Columbia, Macnab and Gagnon, with Stothers’ guidance, developed an external monitor, like a large adhesive patch, that sticks on the abdomen over the site of the bladder. The painless exam uses energy from light (NIRS) to gather data about bladder health and function.

“A non-invasive technology means more individuals will comply with testing,” says Stothers, who directs the new Bladder Care Centre at UBC Hospital, where the NIRS methods are undergoing trials. “Also, the data is more comprehensive -- it takes the guesswork out of diagnosis. Working as a team and seeing the possibilities for patients -- that’s been very motivating.”

NIRS technology is based on sophisticated physics. It uses photons, or units of energy from different wavelengths of light, diffused through tissue. Different constituents of tissue, such as oxygen-carrying blood cells, absorb light differently. The difference can be measured and analyzed to monitor changes in oxygen levels and blood supply.

Blood flow to the bladder is important because the organ is susceptible to ischemia, or blood deficiency, due to constriction or obstruction of a blood vessel. Ischemia can permanently impair how an organ functions.

Almost 42 million people in North American suffer from UI and the numbers are expected to double within 20 years as the population ages. UI most often affects middle-aged women, long-term care residents, and those with spinal cord injury. The condition is a particular problem in the developing world where childbirth complications leave many women with damaged bladders.

“I couldn’t really believe the potential impact of our modification of NIRS and I wasn’t sure about switching my research career focus from brain to bladder,” says Macnab. “I wasn’t completely sold on the whole idea of commercialization -- I needed some convincing.”

That was Brad Wheeler’s job. As a University-Industry Liaison Office (UILO) technology transfer manager, he led the commercialization effort and worked with Stothers, Macnab and Gagnon to assess the market for the technology and explain how they would be supported through the patenting and commercialization process.

“Licensing the use of NIRS in urology is a great example of commercialization being the most effective way to get new technology to physicians and their patients,” says Wheeler.

Last month MDX Medical, a Vancouver-based company that commercializes medical device technologies, announced the finalization of the licensing agreement with UBC and acquisition of rights to the technology, which they will develop and sell worldwide.

“Because we’ve worked with NIRS for years, we’ve been able to adapt it quickly and inexpensively,” says Gagnon, who has worked with Macnab for 15 years. “It’s exciting for me to develop a device that directly benefits patients. Eureka! We finally did it.”

MDX has termed the technology “disruptive,” which means that the current diagnostic technology for UI will be made obsolete when NIRS hits the market. Further validation came from the American Urological Association, which last year gave their top research award to Macnab, Stothers and Gagnon.

Macnab says one of the most satisfying parts of the commercialization journey is knowing for sure that his research will translate rapidly into a benefit for patients.

He, Gagnon and Stothers will further refine the technique and software. MDX is building a clinical prototype of the equipment and sponsoring the clinical trials required for Health Canada approval before the technology is made available for regular clinical use.

Research at Vancouver General Hospital is part of Vancouver Coastal Health Research Institute (VCHRI).

A joint venture between UBC and Vancouver Coastal Health, VCHRI promotes development of new researchers and research activity.

Children’s & Women’s Health Centre of British Columbia is an agency of the Provincial Health Services Authority, and includes BC Children’s Hospital and Sunny Hill Health Centre for Children, and BC Women’s Hospital & Health Centre.