Scottsdale, AZ (UroToday.com) Sphincteric incompetence is a common problem in Urology. Precision Medical Devices (PMD) has developed a new telemetric compressive device. The Politano-Sayet-Sutherland Flow Control Device (PSS-FCD) has undergone 6 previous prototypes. The current working model is composed of 3 elements:1) Control/Battery Pack (CBP) 2) Valve assembly with an Anvil/Cap piece; 3) Remote Master Control Module- blue tooth technology).
The CBP consists of an electronic and drives component. A printed circuit board, stepper motor, and a lithium cell array are contained in the fully, hermetically-sealed waterproof titanium casing. The valve assembly consists of a cable link, a plunger, and two shell halves. The cable link connects the cuff and plunger to the CBP. The CBP opens and closes the plunger via the drive assembly and has the ability to adjust the magnitude of closure force with 10 different settings based on commands made to the CBP - Closure pressure of the FCD was determined from the device clamp force measured using a strain gauge load cell and amplifier in a benchtop test stand. The typical closure pressure of a healthy human urethra ranges from 75 to 100 cm of water. and the external size is approximately 24Fr or an 8mm diameter. The PSS-FCD has a clamp pad with two flexible silicone ridges of 4mm in width resulting in a total clamping area at urethra closure of 75mm2. The FCD produced an average clamp force of 3.67N resulting in a closure pressure of 0.057N/mm2 or ~584 cm of water at the PSS-FCD clamp stroke setting of 08. The clamp force can be adjusted: a range of 04 to 10 as required to occlude fluid flow.
The authors report that the successful Phase I, Phase IIa and Phase IIb implants (and bench tests) have allowed the development of the newest Bluetooth telemetrically controlled AUS/valve. We have demonstrated biologic tissue compatibility without urethral trauma or erosion in all animals during survival experiments lasting more than 1 year.
The authors demonstrated the easy feasibility of performing full FCD replacement on 4 animals without complications and they concluded that the development of a remotely controlled circumferential compressive device that allows for post-implant adjustable settings and remote telemonitoring is possible.
Angelo Gousse, MD1, Christopher Gomez, MD2, Chris Ross3, Peter Sayet4
1. Bladder Health & Reconstructive Urology Institute
2. Baptist Hospital
3. Engineering Resources Group
4. Precision Medical Devices
Written by: Bilal Farhan, MD, Assistant Professor, Division of Urology, University of Texas, Medical Branch, Texas; @BilalfarhanMD, @UTMBUrology at the Society of Urodynamics, Female Pelvic Medicine & Urogenital Reconstruction Winter Meeting, SUFU 2020, February 25 - 29, 2020, Scottsdale, AZ