The obstetric fistula epidemic in Sub-Saharan Africa has resulted in a significant need for better understanding why many patients suffer from persistent urinary incontinence even after their fistula has been repaired (click here to read more about our Fistula Research Initiative). Since incontinence can have different causes that require different treatments, urodynamic testing is typically used in the diagnostic process.
Urodynamics, or UDS, is the term given to a number of tests that look at how well the lower urinary tract (bladder, sphincters, urethra) is working. The goal of most UDS tests is to recreate a patient’s symptoms while simultaneously acquiring various measurements (bladder pressures, abdominal pressures, urine flow rates, etc), which help clinicians evaluate the lower urinary tract. Therefore, to enable accurate measurements, UDS should be performed in the natural posture the patient uses when urinating.
In the Western world, most UDS tests involve specialized chairs, which enable measurements while allowing female patients to empty their bladders in the customary “Western-toilet” posture. However, in Africa, where the fistula epidemic is most prevalent, women urinate in a relaxed squatting posture. Currently available UDS toilets do not accommodate this posture making testing difficult and less accurate. In fact, many patients are unable to urinate using currently available UDS equipment.
Recently, GIRHL completed the design of a culturally compliant UDS toilet that is lightweight, disinfectable, and easily assembled and disassembled. In April, we presented our design at the Innovating for Continence Conference (The Simon Foundation for Continence) in Chicago, IL, and we are field testing our prototype this Fall. The validation of this design will allow us to undertake clinical studies utilizing UDS that will help determine the cause of incontinence and allow for more appropriate treatment and cure.