Continuous Monitoring of Bladder Dysfunction in People With Multiple Sclerosis: Wearables for the Bladder.

Background: Bladder dysfunction affects over 85% of people with multiple sclerosis (PwMS), yet current assessment methods are limited to periodic in-clinic evaluations or subjective patient reports, failing to capture real-world symptom fluctuations.

Objectives: To evaluate the feasibility and validity of using a novel remote bladder ultrasound device for home monitoring of bladder dysfunction in PwMS, comparing remote measurements with standard clinical assessments.

Methods: Twenty-two women with MS participated in this 3-month pilot study. Participants were asked to use the wearable ultrasound device at home for at least 3-5 days a month. Remote device measurements were compared with standard clinical data for post-void residual (rPVR vs. cPVR) and urinary frequency (rFrequency vs. 3-day bladder diary frequency). Agreement between measures was assessed using Bland-Altman analyses and correlation coefficients.

Results: Participants were middle-aged (mean 51.5 years; SD 9.3) with mild-moderate disability (median EDSS 4.0) and mostly relapsing MS (72.7%). Study retention was high (86.4%; 19/22), with mean device utilization of 14.1 days. Good agreement was seen between rPVR and cPVR (mean difference = 32.1 mL, SD = 38.6; 95% limits of agreement: -43.6, 107.9). The rFrequency measure also demonstrated a strong correlation with patient-reported frequency (ICC = 0.81, Pearson's r = 0.793, p = 0.002). Visualization of remote monitoring data revealed substantial day-to-day variability in bladder symptoms not captured by traditional assessments.

Conclusion: This pilot study demonstrates the feasibility and preliminary validity of using wearable ultrasound technology for remote monitoring of bladder dysfunction in PwMS. The ability to capture real-world symptom variations could transform assessment and management approaches, enabling more personalized and responsive care strategies.