Home monitoring of bladder pressure in pediatric patients with spina bifida

Patients with spins bifida who can not empty their bladder are at high risk for developing kidney dysfunction due to high bladder pressures. Currently, because of the high cost of a cystometrogram (CMG), a filling bladder pressure-volume curve, bladder pressure monitoring is not performed very frequently. Therefore, we have developed a simple method of measuring bladder pressures at home in patients, such as those with spina bifida, who use clean intermittent catheterization to empty the bladder. Eleven subjects have used the home device to measure both full and empty bladder pressures once a week for an average of 5 months with no adverse effects. In one subject, the home bladder pressure increased to 2-3 x normal values one day prior to diagnosis of a urinary tract infection. Eight of these subjects have undergone clinical CMGs to compare to the home recordings. Simultaneous clinical CMG pressure measurement demonstrated the accuracy of the home gauge. Pressures increased with volume during CMG. The range of bladder pressures was similar during CMG and at home, but the pressure was independent of volume when measured at home. Home bladder pressure measurement could be a useful adjunct to clinical CMGs for frequent monitoring of the bladder.