Systems and methods for detrusor pressure determination

Abstract

One or more computing devices, systems and / or methods are provided. In some examples, a vesical pressure signal may be received from a sensor of a urodynamic testing system. The sensor may be coupled to a catheter configured for insertion into a bladder of a patient. The sensor may be configured to measure a vesical pressure in a bladder of a patient. An abdominal electromyography (EMG) signal may be received from an EMG electrode of the urodynamic testing system. The EMG electrode may be configured to measure abdominal muscle activity of an abdomen of the patient. A detrusor pressure signal indicative of a detrusor pressure associated with the patient may be generated based upon the vesical pressure signal and the abdominal EMG signal. The detrusor pressure signal may be generated without receiving a signal, indicative of pressure measurements associated with the patient, from a second sensor coupled to a second catheter.

Description

SYSTEMS AND METHODS FOR DETRUSOR PRESSUREDETERMINATIONRELATED APPLICATION

[0001] This is an international patent application filed under 35 U.S.C.§363 claiming priority under 35 U.S.C. §120 to U.S. Provisional Patent Application No. 63 / 707,923, filed on October 16, 2024, entitled “Method and System for Detrusor Pressure Estimation,” which is incorporated herein by reference in its entirety.BACKGROUND

[0002] A urodynamic study (UDS) may be performed to evaluate how a bladder functions during filling and / or emptying. A UDS measures parameters such as bladder pressure and detrusor pressure, and may be performed for a patient with urinary incontinence, voiding dysfunction, and / or other conditions.SUMMARY

[0003] In accordance with the present disclosure, one or more computing devices, systems and / or methods are provided. In some examples, a vesical pressure signal may be received from a sensor of a urodynamic testing system. The sensor may be configured to measure a vesical pressure in a bladder of a patient. An abdominal electromyography (EMG) signal may be received from an EMG electrode of the urodynamic testing system. The EMG electrode may be configured to measure abdominal muscle activity of an abdomen of the patient. First vesical pressure data associated with one or more provocative maneuvers of the patient may be determined based upon the vesical pressure signal. First abdominal EMG data associated with the one or more provocative maneuvers of the patient may be determined based upon the abdominal EMG signal. Whether to implement a reconfiguration process for the urodynamic testing system or to implement a urodynamic testing procedure to be performed for the patient using the urodynamic testingsystem may be determined based upon a comparison of the first vesical pressure data with the first abdominal EMG data.

[0004] In some examples, a vesical pressure signal may be received from a sensor of a urodynamic testing system. The sensor may be configured to measure a vesical pressure in a bladder of a patient. An abdominal EMG signal may be received from an EMG electrode of the urodynamic testing system. The EMG electrode may be configured to measure abdominal muscle activity of an abdomen of the patient. A delay between the vesical pressure signal and the abdominal EMG signal may be determined. A detrusor pressure signal indicative of a detrusor pressure associated with the patient may be generated based upon the delay, the vesical pressure signal, and the abdominal EMG signal.

[0005] In some examples, a vesical pressure signal may be received from a sensor configured to measure a vesical pressure in a bladder of a patient. An abdominal EMG signal may be received from an EMG electrode configured to measure abdominal muscle activity of an abdomen of the patient. First vesical pressure data associated with one or more provocative maneuvers of the patient may be determined based upon the vesical pressure signal. First abdominal EMG data associated with the one or more provocative maneuvers of the patient may be determined based upon the abdominal EMG signal. A urodynamic testing procedure for the patient may be triggered based upon a comparison of the first vesical pressure data with the first abdominal EMG data. In response to triggering the urodynamic testing procedure, a detrusor pressure signal indicative of a detrusor pressure associated with the patient may be generated based upon the vesical pressure signal and the abdominal EMG signal.

[0006] In some examples, a vesical pressure signal may be received from a sensor of a urodynamic testing system. The sensor may be coupled to a catheter configured for insertion into a bladder of a patient. The sensor may be configured to measure a vesical pressure in the bladder. An abdominal EMG signal may be received from an EMG electrode of the urodynamic testing system. The EMG electrode may be configured to measure abdominal muscle activity of an abdomen of the patient. A detrusor pressure signalindicative of a detrusor pressure associated with the patient may be generated based upon the vesical pressure signal and the abdominal EMG signal. The detrusor pressure signal may be generated without receiving a signal, indicative of pressure measurements associated with the patient, from a second sensor coupled to a second catheter.DESCRIPTION OF THE DRAWINGS

[0007] While the techniques presented herein may be embodied in alternative forms, the particular embodiments illustrated in the drawings are only a few examples that are supplemental of the description provided herein. These embodiments are not to be interpreted in a limiting manner, such as limiting the claims appended hereto.

[0008] Fig. 1 is an illustration of a scenario involving various examples of networks that may connect servers and clients.

[0009] Fig. 2 is an illustration of a scenario involving an example configuration of a server that may utilize and / or implement at least a portion of the techniques presented herein.

[0010] Fig. 3 is an illustration of a scenario involving an example configuration of a client device that may utilize and / or implement at least a portion of the techniques presented herein.

[0011] Fig. 4 is a flow chart illustrating an example method, in accordance with some embodiments.

[0012] Fig. 5A is a component block diagram illustrating acquisition of an electromyography (EMG) signal and a vesical pressure signal and determination of whether to implement a reconfiguration process or to implement a urodynamic testing procedure, in accordance with some embodiments.

[0013] Fig. 5B is a component block diagram illustrating processing of an EMG signal and a vesical pressure signal, in accordance with some embodiments.

[0014] Fig. 5C illustrates an EMG signal, a vesical pressure signal, and a correlation data structure, in accordance with some embodiments.

[0015] Fig. 5D illustrates a magnified view of an EMG signal and a vesical pressure signal, in accordance with some embodiments.

[0016] Fig. 5E illustrates a magnified view of an EMG signal and a vesical pressure signal, in accordance with some embodiments.

[0017] Fig. 5F illustrates synchronized signals including an EMG signal and a vesical pressure signal, in accordance with some embodiments.

[0018] Fig. 5G illustrates a data structure indicative of an EMG signal and a data structure indicative of a vesical pressure signal, in accordance with some embodiments.

[0019] Fig. 5H is a component block diagram illustrating determination of a detrusor pressure, in accordance with some embodiments.

[0020] Fig. 5I illustrates a group of data structures associated with a urodynamic testing procedure, in accordance with some embodiments.

[0021] Fig. 5J illustrates a group of data structures associated with a urodynamic testing procedure, in accordance with some embodiments.

[0022] Fig. 5K illustrates data structures associated with an EMG signal and a filtered EMG signal, in accordance with some embodiments.

[0023] Fig. 6 is a flow chart illustrating an example method, in accordance with some embodiments.

[0024] Fig. 7 is a flow chart illustrating an example method, in accordance with some embodiments.

[0025] Fig. 8 is a flow chart illustrating an example method, in accordance with some embodiments.

[0026] Fig. 9 is an illustration of a scenario featuring an example non- transitory machine readable medium in accordance with one or more of the provisions set forth herein.DETAILED DESCRIPTION

[0027] Subject matter will now be described more fully hereinafter with reference to the accompanying drawings, which form a part hereof, and which show, by way of illustration, specific example embodiments. This description is not intended as an extensive or detailed discussion of known concepts. Details that are known generally to those of ordinary skill in the relevant art may have been omitted, or may be handled in summary fashion.

[0028] The following subject matter may be embodied in a variety of different forms, such as methods, devices, components, and / or systems. Accordingly, this subject matter is not intended to be construed as limited to any example embodiments set forth herein. Rather, example embodiments are provided merely to be illustrative. Such embodiments may, for example, take the form of hardware, software, firmware, medicine, clothing design, or any combination thereof.

[0029] Fig. 1 is an interaction diagram of a scenario 100 illustrating a service 102 provided by a set of servers 104 to a set of client devices 110 via various types of networks. The servers 104 and / or client devices 1 10 may be capable of transmitting, receiving, processing, and / or storing many types of signals, such as in memory as physical memory states.

[0030] In the scenario 100 of Fig. 1 , the service 102 may be accessed via a wide area network 108 (WAN) by a user 112 of one or more client devices 110, such as a portable media player (e.g., an electronic text reader, an audio device, or a portable gaming, exercise, or navigation device); a portable communication device (e.g., a camera, a phone, a wearable or a text chatting device); a workstation; and / or a laptop form factor computer. The respective client devices 110 may communicate with the service 102 via various connections to the wide area network 108.

[0031] One or more client devices 1 10 may comprise a cellular communicator and may communicate with the service 102 by connecting to the wide area network 108 via a wireless local area network 106 (LAN) provided by a cellular provider.

[0032] Alternatively and / or additionally, one or more client devices 110 may communicate with the service 102 by connecting to the wide areanetwork 108 via a wireless local area network 106 provided by a location such as the user’s home or workplace. The wireless local area network 106 may, for example, be a WiFi (Institute of Electrical and Electronics Engineers (IEEE) Standard 802.11) network or a Bluetooth (IEEE Standard 802.15.1) personal area network.

[0033] It may be appreciated that the servers 104 and the client devices 110 may communicate over various types of networks. Exemplary types of networks that may be accessed by the servers 104 and / or client devices 110 include mass storage, such as network attached storage (NAS), a storage area network (SAN), or other forms of computer or machine readable media.

[0034] The servers 104 of the service 102 may be interconnected directly, or through one or more other networking devices, such as routers, switches, and / or repeaters. The servers 104 may utilize a variety of physical networking protocols, such as Ethernet and / or Fiber Channel, and / or logical networking protocols, such as variants of an Internet Protocol (IP), a Transmission Control Protocol (TCP), and / or a User Datagram Protocol (UDP).

[0035] The servers 104 of the service 102 may be internally connected via a local area network 106. The local area network 106 may be organized according to one or more network architectures, such as server / client, peer- to-peer, and / or mesh architectures, and / or a variety of roles, such as administrative servers, authentication servers, security monitor servers, data stores for objects such as files and databases, business logic servers, time synchronization servers, and / or front-end servers providing a user-facing interface for the service 102.

[0036] The local area network 106 may be a wired network where network adapters on the respective servers 104 are interconnected via cables (e.g., coaxial and / or fiber optic cabling), and may be connected in various topologies (e.g., buses, token rings, meshes, and / or trees). The local area network 106 may include, e.g., analog telephone lines, such as a twisted wire pair, a coaxial cable, full or fractional digital lines including T1 , T2, T3, or T4 type lines, Integrated Services Digital Networks (ISDNs), Digital Subscriber Lines (DSLs), wireless links including satellite links, or other communication links or channels, such as may be known to those skilled in the art.

[0037] Alternatively and / or additionally, the local area network 106 may comprise one or more sub-networks, such as may employ differing architectures, may be compliant or compatible with differing protocols and / or may interoperate within the local area network 106. Additionally, a variety of local area networks 106 may be interconnected; e.g., a router may provide a link between otherwise separate and independent local area networks 106.

[0038] In the scenario 100 of Fig. 1 , the local area network 106 of the service 102 is connected to a wide area network 108 that allows the service 102 to exchange data with other services 102 and / or client devices 1 10. The wide area network 108 may encompass various combinations of devices with varying levels of distribution and exposure, such as a public wide-area network (e.g., the Internet) and / or a private network (e.g., a virtual private network (VPN) of a distributed enterprise).

[0039] Fig. 2 presents a schematic architecture diagram 200 of a server 104 that may utilize at least a portion of the techniques provided herein. Such a server 104 may vary widely in configuration or capabilities, alone or in conjunction with other servers, in order to provide a service such as the service 102.

[0040] The server 104 may comprise a variety of peripheral components, such as a wired and / or wireless network adapter 214 connectible to a local area network and / or wide area network; one or more storage components 216, such as a hard disk drive, a solid-state storage device (SSD), a flash memory device, and / or a magnetic and / or optical disk reader.

[0041] The server 104 may comprise memory 202 storing various forms of applications, such as an operating system 204; one or more server applications 206, such as a hypertext transport protocol (HTTP) server, a file transfer protocol (FTP) server, or a simple mail transport protocol (SMTP) server; and / or various forms of data, such as a database 208 or a file system.

[0042] The server 104 may comprise one or more processors 210 that process instructions. The one or more processors 210 may optionally include a plurality of cores; one or more coprocessors, such as a mathematicscoprocessor or an integrated graphical processing unit (GPU); and / or one or more layers of local cache memory.

[0043] The server 104 may comprise a mainboard featuring one or more communication buses 212 that interconnect the processor 210, the memory 202, and various peripherals, using a variety of bus technologies, such as a variant of a serial or parallel AT Attachment (ATA) bus protocol; a Uniform Serial Bus (USB) protocol; and / or Small Computer System Interface (SCI) bus protocol. In a multibus scenario, a communication bus 212 may interconnect the server 104 with at least one other server.

[0044] The server 104 may operate in various physical enclosures, such as a desktop or tower, and / or may be integrated with a display as an “all-in- one” device. The server 104 may be mounted horizontally and / or in a cabinet or rack, and / or may simply comprise an interconnected set of components.

[0045] The server 104 may provide power to and / or receive power from another server and / or other devices. The server 104 may comprise a dedicated and / or shared power supply 218 that supplies and / or regulates power for the other components. The server 104 may comprise a shared and / or dedicated climate control unit 220 that regulates climate properties, such as temperature, humidity, and / or airflow.

[0046] The server 104 may include one or more other components that are not shown in the schematic diagram 200 of Fig. 2, such as a display; a display adapter, such as a graphical processing unit (GPU); input peripherals, such as a keyboard and / or mouse; and a flash memory device that may store a basic input / output system (BIOS) routine that facilitates booting the server 104 to a state of readiness. A plurality of such servers 104 may be configured and / or adapted to utilize at least a portion of the techniques presented herein.

[0047] Fig. 3 presents a schematic architecture diagram 300 of a client device 110 whereupon at least a portion of the techniques presented herein may be implemented. Such a client device 110 may vary widely in configuration or capabilities, in order to provide a variety of functionality to a user such as the user 112.

[0048] The client device 110 may comprise memory 301 storing various forms of applications, such as an operating system 303; one or more user applications 302, such as document applications, media applications, file and / or data access applications, communication applications such as web browsers and / or email clients, utilities, and / or games; and / or drivers for various peripherals.

[0049] In some examples, as a user 112 interacts with a software application on a client device 110 (e.g., an instant messenger and / or electronic mail application), descriptive content in the form of signals or stored physical states within memory (e.g., an email address, instant messenger identifier, phone number, postal address, message content, date, and / or time) may be identified.

[0050] In such examples, descriptive content may be stored, typically along with contextual content. For example, the source of an email address (e.g., a communication received from another user via an instant messenger application) may be stored as contextual content associated with the email address. Contextual content, therefore, may identify circumstances surrounding receipt of an email address (e.g., the date or time that the email address was received), and may be associated with descriptive content. Contextual content, may, for example, be used to subsequently search for associated descriptive content. For example, a search for email addresses received from specific individuals, received via an instant messenger application or at a given date or time, may be initiated.

[0051] The client device 110 may comprise one or more processors 310 that process instructions. The one or more processors 310 may optionally include a plurality of cores; one or more coprocessors, such as a mathematics coprocessor or an integrated graphical processing unit (GPU); and / or one or more layers of local cache memory.

[0052] The client device 110 may comprise a dedicated and / or shared power supply 318 that supplies and / or regulates power for other components, and / or a battery 304 that stores power for use while the client device 110 is not connected to a power source via the power supply 318. The client device 110 may provide power to and / or receive power from other client devices.

[0053] The client device 110 may comprise a variety of peripheral components, such as a wired and / or wireless network adapter 306 connectible to a local area network and / or wide area network; one or more output components, such as a display 308 coupled with a display adapter (optionally including a graphical processing unit (GPU)), a sound adapter coupled with a speaker, and / or a printer; input devices for receiving input from the user, such as a keyboard 311 , a mouse, a microphone, a camera, and / or a touch-sensitive component of the display 308; and / or environmental sensors, such as a global positioning system (GPS) receiver 319 that detects the location, velocity, and / or acceleration of the client device 110, a compass, accelerometer, and / or gyroscope that detects a physical orientation of the client device 110.

[0054] The client device 110 may comprise a mainboard featuring one or more communication buses 312 that interconnect the processor 310, the memory 301 , and various peripherals, using a variety of bus technologies, such as a variant of a serial or parallel AT Attachment (ATA) bus protocol; the Uniform Serial Bus (USB) protocol; and / or the Small Computer System Interface (SCI) bus protocol.

[0055] The client device 110 may include one or more other components that are not shown in the schematic architecture diagram 300 of Fig. 3, such as one or more storage components, such as a hard disk drive, a solid-state storage device (SSD), a flash memory device, and / or a magnetic and / or optical disk reader; and / or a flash memory device that may store a basic input / output system (BIOS) routine that facilitates booting the client device 110 to a state of readiness. In some examples, the client device 110 may include a climate control unit that regulates climate properties, such as temperature, humidity, and airflow.

[0056] The client device 110 may include one or more servers that may locally serve the client device 110 and / or other client devices of the user 1 12 and / or other individuals. For example, a locally installed webserver may provide web content in response to locally submitted web requests. Many such client devices 110 may be configured and / or adapted to utilize at least a portion of the techniques presented herein.

[0057] The client device 110 may serve the user in a variety of roles, such as a workstation, kiosk, media player, gaming device, and / or appliance. The client device 110 may therefore be provided in a variety of form factors, such as a desktop or tower workstation; an “all-in-one” device integrated with a display 308; a laptop, tablet, convertible tablet, or palmtop device; a wearable device mountable in a headset, eyeglass, earpiece, and / or wristwatch, and / or integrated with an article of clothing; and / or a component of a piece of furniture, such as a tabletop, and / or of another device, such as a vehicle or residence.

[0058] One or more devices and / or techniques for implementing a urodynamic testing procedure for a patient and / or determining a detrusor pressure (e.g., bladder pressure) of the patient are provided. A vesical pressure signal may be received from a sensor of a urodynamic testing system. The sensor may be coupled to a catheter in a bladder of the patient and / or may be configured to measure a vesical pressure in the bladder. An abdominal EMG signal may be received from an EMG electrode of the urodynamic testing system. The EMG electrode may be configured to measure abdominal muscle activity of an abdomen of the patient. The patient may be prompted to perform one or more provocative maneuvers. Vesical pressure data and abdominal EMG data associated with the one or more provocative maneuvers may be derived from the signal vesical pressure and the EMG signal, respectively. The vesical pressure data and the abdominal EMG data may be compared to determine whether to implement a reconfiguration process for the urodynamic testing system or to implement a urodynamic testing procedure for the patient using the urodynamic testing system. During the urodynamic testing procedure, a detrusor pressure signal indicative of a detrusor pressure associated with the patient may be generated based upon the vesical pressure signal and the abdominal EMG signal. The detrusor pressure signal may be generated without receiving a signal, indicative of pressure measurements associated with the patient, from a second sensor coupled to a second catheter, which may provide for improved comfort and / or convenience, reduced risk of infection, and / or other benefits as compared with some systems that rely upon the second sensorcoupled to the second catheter (e.g., a rectal and / or vaginal catheter) to determine the detrusor pressure.

[0059] An embodiment of evaluating determining whether to implementing a urodynamic testing procedure using a urodynamic testing system is illustrated by an example method 400 of Fig. 4, and is further described in conjunction with a system 501 of Figs. 5A-5K. At 402 of Fig. 4, a vesical pressure signal 532 (shown in Fig. 5A) may be received from a sensor 534 of a urodynamic testing system. The vesical pressure signal 532 may be received by an acquisition module 536 of the urodynamic testing system. The sensor 534 may be configured to measure a vesical pressure in a bladder of a patient. It may be appreciated that the patient may be a person (undergoing medical treatment, for example), an animal (undergoing veterinary treatment, for example), etc. In some examples, the sensor 534 may be coupled to a catheter 502 (e.g., a transurethral catheter) inserted into a bladder 510 of the patient. The catheter 502 may comprise an air-charged catheter and / or other suitable catheter. The sensor 534 may be configured to measure a vesical pressure in the bladder 510 of the patient. The sensor 534 may comprise a pressure transducer and / or other suitable sensor for measuring the vesical pressure in the bladder 510. The vesical pressure signal 532 may be indicative of vesical pressure values measured by the sensor 534 and / or the catheter 502. Measurements indicative of vesical pressure values associated with the bladder 510 may be sampled using the sensor 534 and / or the acquisition module 536 at a first sampling frequency to generate the vesical pressure signal 532. In some examples, the first sampling frequency may be about 1 ,000 Hz and / or may between about 500 Hz to about 1 ,500 Hz. In some examples, the urodynamic testing system may comprise a fluid reservoir 514 comprising a fluid, a pump 516 configured to transfer the fluid from the fluid reservoir 514 into the bladder 510 via the catheter 502, and / or an EMG electrode 504 (e.g., an abdominal EMG electrode).

[0060] At 404, an EMG signal 530 (shown in Fig. 5A) may be received from the EMG electrode 504 of the urodynamic testing system. The EMG signal 530 may be received by the acquisition module 536. In some examples, the EMG electrode 504 is placed on and / or adhered to (using anadhesive, for example) a surface of the patient’s abdomen (e.g., belly). The EMG electrode 504 may be configured to measure abdominal muscle activity of the abdomen of the patient. Measurements (e.g., voltage measurements) indicative of electrical activity associated with abdominal muscle activity of the abdomen may be sampled using the EMG electrode 504 and / or the acquisition module 536 at a second sampling frequency to generate the EMG signal 530. In some examples, the second sampling frequency may be about 1 ,000 Hz and / or may between about 500 Hz to about 1 ,500 Hz. In some examples, the second sampling frequency may be about equal to the first sampling frequency. The EMG electrode 504 may comprise an array of electrodes. The EMG electrode 504 may be placed at a position, of the surface of the abdomen, that is about two inches lateral to the patient’s naval and / or about two inches inferior to the patient’s naval.

[0061] Fig. 5A illustrates the vesical pressure signal 532 and the EMG signal 530 being used to determine whether to implement a reconfiguration process for the urodynamic testing system or to implement a urodynamic testing procedure (e.g., a urodynamic study (UDS)) for the patient using the urodynamic testing system. In some examples, the vesical pressure signal 532 and / or the EMG signal 530 may be provided to a preprocessing module 520. The preprocessing module 520 may generate a processed vesical pressure signal 582 (shown in Fig. 5B) based upon the vesical pressure signal 532 and / or provide the processed vesical pressure signal 582 to a configuration check module 522. The preprocessing module 520 may generate a processed EMG signal 584 (shown in Fig. 5B) based upon the EMG signal 530 and / or provide the processed EMG signal 584 to the configuration check module 522.

[0062] In some examples, the configuration check module 522 may comprise a provocative maneuver prompting module 524 for prompting the patient to perform one or more first provocative maneuvers. In some examples, the one or more first provocative maneuvers may comprise one or more types of provocative maneuvers, such as a cough (associated with an abdominal contraction, for example), a Valsalva event (associated with an extended abdominal push, for example), and / or one or more other types ofprovocative maneuvers. In some examples, the one or more first provocative maneuvers may correspond to a defined sequence of provocative maneuvers. In an exemplary scenario, the defined sequence of provocative maneuvers may be cough-cough-Valsalva event (e.g., the patient may be prompted to cough twice then perform a Valsalva event). In an exemplary scenario, the defined sequence of provocative maneuvers may be cough-Valsalva eventcough (e.g., the patient may be prompted to cough, then perform a Valsalva event, then cough again). In some examples, the provocative maneuver prompting module 524 may output provocative maneuver instructions for performing the one or more first provocative maneuvers via a display and / or via a speaker. For example, the provocative maneuver instructions may be indicative of the defined sequence of provocative maneuvers, one or more techniques for performing the one or more first provocative maneuvers, a time to start performing the one or more first provocative maneuvers, and / or other information that may inform the patient and / or a healthcare professional of how to appropriately perform the one or more first provocative maneuvers.

[0063] In some examples, prior to the patient performing the one or more first provocative maneuvers (and / or prior to the provocative maneuver prompting module 524 outputting the provocative maneuver instructions to prompt the patient to perform the one or more first provocative maneuvers), a first defined amount of fluid from the fluid reservoir 514 may be infused into the bladder 510. For example, the first defined amount of fluid may be transferred to the bladder by activating the pump 516 to infuse the first defined amount of fluid into the bladder 510. In some examples, the fluid in the fluid reservoir 514 comprises saline, sterile water, and / or other suitable fluid. In some examples, the first defined amount of fluid may be about 50 ml_ and / or may between about 25 ml_ to about 75 ml_. In some examples, the provocative maneuver prompting module 524 outputs the provocative maneuver instructions to prompt the patient to perform the one or more first provocative maneuvers in response to infusing the first defined amount of fluid into the bladder 510.

[0064] At 406 of Fig. 4, first vesical pressure data associated with the one or more first provocative maneuvers of the patient may be determined basedupon the vesical pressure signal 532. For example, the first vesical pressure data may be determined using the configuration check module 522 based upon the processed vesical pressure signal 582 (generated by the preprocessing module 522 based upon the vesical pressure signal 532, for example). In some examples, the first vesical pressure data may comprise normalized vesical pressure data 586 (shown in Fig. 5B) generated based upon the processed vesical pressure signal 582.

[0065] At 408 of Fig. 4, first abdominal EMG data associated with the one or more first provocative maneuvers of the patient may be determined based upon the EMG signal 530. For example, the first abdominal EMG data may be determined using the configuration check module 522 based upon the processed EMG signal 584 (generated by the preprocessing module 522 based upon from the EMG signal 530, for example). In some examples, the first abdominal EMG data may comprise normalized abdominal EMG data 588 (shown in Fig. 5B) generated based upon the processed EMG signal 584.

[0066] At 410 of Fig. 4, the configuration check module 522 may determine whether to implement a reconfiguration process for the urodynamic testing system or to implement a urodynamic testing procedure for the patient using the urodynamic testing system based upon a comparison of the first vesical pressure data (e.g., the normalized vesical pressure data 586) with the first abdominal EMG data (e.g., the normalized abdominal EMG data 588). In some examples, the configuration check module 522 may output a reconfiguration process initiation signal 526 indicative of performing the reconfiguration process in response to determining to implement the reconfiguration process. Alternatively and / or additionally, the configuration check module 522 may output a testing procedure initiation signal 528 indicative of performing the urodynamic testing procedure in response to determining to implement the urodynamic testing procedure.

[0067] Fig. 5B illustrates use of the preprocessing module 522 to generate the processed vesical pressure signal 582 and / or the processed EMG signal 584. The processed vesical pressure signal 582 and / or the processed EMG signal 584 may be provided to the configuration check module 522. The configuration check module 522 may determine the normalized vesicalpressure data 586, determine the normalized EMG data 588, determine an EMG signal quality metric 580 (e.g., signal to noise ratio), and / or determine whether to implement the reconfiguration process for the urodynamic testing system or to implement the urodynamic testing procedure based upon the EMG signal quality metric 580 and / or a comparison 566 of the normalized vesical pressure data 586 with the normalized EMG data 588.

[0068] In some examples, the preprocessing module 520 may buffer 538 the vesical pressure signal 532 to collect a first defined quantity of vesical pressure measurement samples (e.g., 4,000 samples or other quantity of samples). In some examples, the preprocessing module 520 may downsample 540 the buffered data by a first defined down-sampling factor (e.g., a factor of 10 or other factor) to generate a down-sampled vesical pressure signal. In some examples, the preprocessing module 520 may perform one or more first filtering operations 542 on the down-sampled vesical pressure signal to generate a first filtered vesical pressure signal. The one or more first filtering operations 542 may comprise applying a 10th-order finite impulse response (FIR) band-pass filter with a bandwidth ranging from 10 to 200 Hz and / or a stop band attenuation of 30 dB. In some examples, the one or more first filtering operations 542 may isolate desired frequency range relevant to bladder pressure dynamics and / or may attenuate undesired frequencies (e.g., frequencies that are not relevant to bladder pressure dynamics) in the first filtered vesical pressure signal.

[0069] In some examples, the preprocessing module 520 may perform one or more second filtering operations 544 (including one or more outlier removal operations, for example) on the first filtered vesical pressure signal to generate a second filtered vesical pressure signal. The one or more second filtering operations 544 may comprise applying a 3rd order Savitzky-Golay smoother which may utilize convolutional linear least squares (CLS) to fit successive adjacent data points with a polynomial (e.g., a low-degree polynomial, such as a 2nd or 3rd degree polynomial or other polynomial). Embodiments are contemplated in which the one or more second filtering operations 544 comprise applying a different polynomial smoothing filter other than (and / or in addition to) the 3rd order Savitzky-Golay smoother. In someexamples, the second filtering operation may refine the first filtered vesical pressure signal, remove outliers from the first filtered vesical pressure signal, and / or reduce artifact amplitude to generate the second filtered vesical pressure signal. It may be appreciated that using the 3rd order Savitzky- Golay smoother preserves data features in the second filtered vesical pressure signal with improved accuracy as compared with other smoothing techniques (such as moving average filter). In some examples, the second filtered vesical pressure signal may be provided to a delay detection and / or synchronization module 546.

[0070] In some examples, the preprocessing module 520 may buffer 548 the EMG signal 530 to collect a second defined quantity of abdominal EMG samples (e.g., 4,000 samples or other quantity of samples). In some examples, the second defined quantity is about equal to the first defined quantity. In some examples, the preprocessing module 520 may downsample 550 the buffered data by a second defined down-sampling factor (e.g., a factor of 10 or other factor) to generate a down-sampled EMG signal. In some examples, the second defined down-sampling factor is about equal to the first defined down-sampling factor. In some examples, the preprocessing module 520 may perform one or more third filtering operations 552 on the down-sampled EMG signal to generate a first filtered EMG signal. The one or more third filtering operations 552 may comprise applying 0.1 -Hz low-pass filter (LPF). In some examples, the one or more third filtering operations 552 may mitigate and / or eliminate high-frequency activity from the down-sampled EMG signal to generate the first filtered EMG signal.

[0071] In some examples the preprocessing module 520 may rectify 554 the first filtered EMG signal (via absolute value, for example) to generate a rectified EMG signal, which may transform a bipolar waveform indicated by the first filtered EMG signal to a unipolar representation in the rectified EMG signal. In some examples, the preprocessing module 520 may perform envelope detection 556 on the rectified EMG signal to generate an EMG envelope signal which capture a dynamic amplitude of EMG signals and / or may be indicative of muscle contractions and / or relaxations associated with the abdomen of the patient. In some examples, the envelope detection 556 isperformed using a Hilbert filter (e.g., 300-tap Hilbert filter) to compute an upper envelope of the rectified EMG signal and / or to generate the EMG envelope signal indicative of the upper envelope. In some examples, the EMG envelope signal may be provided to the delay detection and / or synchronization module 546. Alternatively and / or additionally, a moving average filter with a window size of 50 samples (or other window size) may be applied to the EMG envelope signal to generate a smoothened version of the EMG envelope signal, and / or the smoothened version of the EMG envelope signal may be provided to the delay detection and / or synchronization module 546.

[0072] In some examples, the delay detection and / or synchronization module 546 may determine a first delay (e.g., a phase difference) between the second filtered vesical pressure signal and the EMG envelope signal (e.g., the smoothened version of the EMG envelope signal). In some examples, the first delay may be a patient-specific delay that may differ from other delays for other patients. In some examples, the delay detection and / or synchronization module 546 may determine a correlation (e.g., cross-correlation) between the second filtered vesical pressure signal and the EMG envelope signal as a function of lag between the second filtered vesical pressure signal and the EMG envelope signal, and / or may determine the first delay based upon the correlation. The correlation may quantify a similarity between the second filtered vesical pressure signal and the EMG envelope signal (as a function of the lag, for example). In some examples, the correlation may be determined based upon respective segments, of the second filtered vesical pressure signal and the EMG envelope signal, that correspond to a time period during and / or after at least one provocative maneuver of the one or more first provocative maneuvers (since abdominal pressures reflected by the second filtered vesical pressure signal is assumed to strongly correlate to the EMG envelope signal in the time segment during a provocative maneuver of the one or more first provocative maneuvers, for example). The correlation may be analyzed to identify a maximum correlation (e.g., peak correlation). The first delay may be determined to correspond to a lag at which the correlation reaches the maximum. In some examples, the correlation between thesecond filtered vesical pressure signal (x) and the EMG envelope signal (y) may be Rxy(k~) =+ k~), where N corresponds to a number of samples, and / or k corresponds to the lag.

[0073] Fig. 50 illustrates a data structure 511 comprising a normalized EMG signal 513 (e.g., the EMG envelope signal and / or a normalized version of the EMG envelope signal) and a vesical pressure signal 515 (e.g., the second filtered vesical pressure signal and / or a normalized version of the second filtered vesical pressure signal), and a correlation data structure 517 comprising a correlation curve indicative of the correlation between the vesical pressure signal 515 and the EMG signal 513. The data structure 511 may comprise a first segment 523 associated with a first provocative maneuver (e.g., cough) of the one or more first provocative maneuvers and / or a second segment 525 associated with a second provocative maneuver (e.g., Valsalva event) of the one or more first provocative maneuvers. Fig. 5D illustrates a magnified view of the first segment 523 of the data structure 511. Fig. 5E illustrates a magnified view of the second segment 525 of the data structure 511.

[0074] In some examples, the delay detection and / or synchronization module 546 may analyze the correlation data structure 517 to identify the maximum correlation (shown with reference number 521 in Fig. 5C). The first delay may be determined based upon (and / or may be determined to be equal to) a lag 519 corresponding to the maximum correlation 521 . In some examples, the lag 519 may be converted from quantity of samples to a duration of time to determine the first delay (e.g., the first delay may be in units of time).

[0075] In some examples, the delay detection and / or synchronization module 546 may determine a synchronized set of signals by applying the first delay to the EMG signal 513 to generate a synchronized EMG signal 527 (shown in Fig. 5F) that is synchronized with the vesical pressure signal 515, where the vesical pressure signal 515 remains stationary, for example. For example, the synchronized EMG signal 527 may correspond to the processed EMG signal 584 (shown in Fig. 5B) and / or the vesical pressure signal 515 may correspond to the processed vesical pressure signal 582.

[0076] Fig. 5F illustrates a synchronization data structure indicative of the synchronized set of signals. In some examples, the EMG signal 513 is shifted by the first delay to generate the synchronized EMG signal 527. In some examples, the delay detection and / or synchronization module 546 may determine the synchronized set of signals by applying the first delay to the vesical pressure signal 515 to generate a synchronized vesical pressure signal (e.g., the processed vesical pressure signal 582) and / or the EMG signal 513 (e.g., the processed EMG signal 584) may remain stationary. In some examples, the delay detection and / or synchronization module 546 may determine the synchronized set of signals by applying a first portion of the first delay to the vesical pressure signal 515 to generate a synchronized vesical pressure signal (e.g., the processed vesical pressure signal 582) and / or a second portion of the first delay to the EMG signal 513 to generate a synchronized EMG signal (e.g., the processed EMG signal 584).

[0077] In some examples, a feature extraction module 570 (shown in Fig. 5B) may determine provocative feature information 574 comprising vesical pressure feature information associated with one, some, or all provocative maneuvers of the one or more first provocative maneuvers and / or EMG feature information associated with one, some, or all provocative maneuvers of the one or more first provocative maneuvers. Fig. 5G illustrates a vesical pressure data structure 529 comprising a vesical pressure signal (e.g., the second filtered vesical pressure signal and / or a normalized version of the second filtered vesical pressure signal) indicative of vesical pressure over a provocative maneuver time period in which the one or more first provocative maneuvers are performed and an EMG data structure 531 comprising an EMG signal (e.g., the EMG envelope signal and / or a normalized version of the EMG envelope signal) indicative of abdominal muscle activity over the provocative maneuver time period.

[0078] In some examples, the vesical pressure signal of the vesical pressure data structure 529 may be analyzed to identify pressure events associated with the one or more first provocative maneuvers. For example, the pressure events may comprise Pci (e.g., a first cough), Pc2 (e.g., a second cough), Pcs (e.g., a third cough), Ppi (e.g., a Valsalva event), Pc4(e.g., a fourth cough), and / or Pcs (e.g., a fifth cough). In some examples, the vesical pressure signal may be compared with a vesical pressure threshold 533 to identify the pressure events. In some examples, the vesical pressure threshold 533 may be determined based upon a maximum amplitude of the vesical pressure signal during the provocative maneuver time period. For example, the vesical pressure threshold 533 may be determined by multiplying the maximum amplitude by a first predefined factor. In some examples, the first predefined factor may be about 50% and / or may be between about 40% to about 60%. In some examples, peaks of the vesical pressure signal may be identified, and / or the peaks may be determined to correspond to an event of the pressure events based upon a determination that the peak is greater than the vesical pressure threshold 533. In some examples, for each of the pressure events, the vesical pressure feature information may be generated to include at least one of a timestamp of the pressure event (e.g., at least one of a start time, an end time, a time at which the vesical pressure signal intersects with the vesical pressure threshold 533, etc.), a width of the pressure event (e.g., a distance between points where the vesical pressure signal crosses the vesical pressure threshold 533), an amplitude (e.g., maximum amplitude) of the pressure event, and / or other information associated with the pressure event. In some examples, a width 537 of the Valsalva event Ppi may be determined by identifying points 539 and 541 where the vesical pressure signal crosses the vesical pressure threshold 533, and / or determining the distance between the points 539 and 541 . The width 537 of the Valsalva event Ppi, a timestamp indicating a time 553 associated with the Valsalva event Ppi, and / or an amplitude 535 (e.g., a maximum amplitude) of the Valsalva event Ppi may be included in the vesical pressure feature information. In some examples, the vesical pressure feature information may comprise a vesical pressure vector comprising vp=denote timestamps associated with the ith cough and Valsalva event (e.g., push), respectively, and wciand wpidenote widths associated with the ith cough and Valsalva event, respectively.

[0079] In some examples, the EMG signal of the EMG data structure 531 may be analyzed to identify EMG events associated with the one or more first provocative maneuvers. For example, the EMG events may comprise Eci (e.g., the first cough), Ec2 (e.g., the second cough), Ecs (e.g., the third cough), Epi (e.g., the Valsalva event), Ec4 (e.g., the fourth cough), and / or Ecs (e.g., the fifth cough). In some examples, the EMG signal may be compared with an EMG threshold 543 to identify the EMG events. In some examples, the EMG threshold 543 may be determined based upon a maximum amplitude of the EMG signal during the provocative maneuver time period. For example, the EMG threshold 543 may be determined by multiplying the maximum amplitude by a second predefined factor. In some examples, the second predefined factor may be about 30% and / or may be between about 20% to about 40%. In some examples, peaks of the EMG signal may be identified, and / or the peaks may be determined to correspond to an event of the EMG events based upon a determination that the peak is greater than the EMG threshold 543. In some examples, for each of the EMG events, the EMG feature information may be generated to include at least one of a timestamp of the EMG event (e.g., at least one of a start time, an end time, a time at which the EMG signal intersects with the EMG threshold 543, etc.), a width of the EMG event (e.g., a distance between points where the EMG signal crosses the EMG threshold 543), an amplitude (e.g., maximum amplitude) of the EMG event, and / or other information associated with the EMG event. In some examples, a width 547 of the Valsalva event Epi may be determined by identifying points 549 and 551 where the EMG signal crosses the EMG threshold 543, and / or determining the distance between the points 549 and 551 . The width 547 of the Valsalva event Epi, a timestamp indicating a time 555 associated with the Valsalva event Epi, and / or an amplitude 545 (e.g., a maximum amplitude) of the Valsalva event Epi may be included in the EMG feature information. In some examples, the EMG feature information may comprise an EMG vector comprising ve=[tcltc2tcpl... tcn, wcl, wc2, ... , wpl, wcn], where tciand tpidenote timestamps associated with the ith cough and Valsalva event, respectively, and wciand wpidenote widths associated with the ith cough and Valsalva event, respectively.

[0080] In some examples, a wavelet gain determination module 572 may determine wavelet level gains 576 (e.g., least square gains) based upon a vesical pressure signal (e.g., the second filtered vesical pressure signal and / or a normalized version of the second filtered vesical pressure signal) indicative of vesical pressure over the provocative maneuver time period in which the one or more first provocative maneuvers are performed and / or an EMG signal (e.g., the EMG envelope signal and / or a normalized version of the EMG envelope signal) indicative of abdominal muscle activity over the provocative maneuver time period. In some examples, the wavelet level gains 576 may be determined using least mean square method and / or other techniques. In some examples, the wavelet level gains 576 and / or the provocative feature information 574 (e.g., the vesical pressure feature information and / or the EMG feature information) may be included in a patient profile 578 associated with the patient, which may be stored in a patient data store and / or used in a urodynamic testing procedure for the patient.

[0081] In some examples, the processed vesical pressure signal 582 and / or the processed EMG signal 584 (of the synchronized set of signals, for example) may be provided (by the delay detection and / or synchronization module 546, for example) to the configuration check module 522. In some examples, the configuration check module 522 may normalize 558 the processed vesical pressure signal 582 to generate the normalized vesical pressure data 586 (e.g., a normalized vesical pressure signal indicative of vesical pressure values between 0 and 1 ), which may comprise vesical pressure data indicative of vesical pressure over the provocative maneuver time period. In some examples, the configuration check module 522 may normalize 560 the processed EMG signal 584 to generate the normalized EMG data 588 (e.g., a normalized EMG signal indicative of abdominal pressure values between 0 and 1), which may comprise abdominal EMG data indicative of abdominal muscle activity over the provocative maneuver time period.

[0082] In some examples, the comparison 566 of the normalized vesical pressure data 586 with the normalized EMG data 588 may comprise determining a correlation score associated with a correlation between thenormalized vesical pressure data 586 with the normalized EMG data 588. In some examples, the correlation score may be based upon one or more correlation values of the correlation data structure 517. The correlation score may be an average of correlation values of the correlation data structure 517. The correlation score may be equal to the maximum correlation 521 . In some examples, the correlation score may be determined using one or more of the techniques and / or functions provided herein with respect to determining the correlation data structure 517, values of the correlation Rxy(k~), and / or the maximum correlation 521 . In some examples, the correlation score may be compared with a threshold correlation score (e.g., 0.85 or other threshold). In some examples, the configuration check module 522 may determine to implement the reconfiguration process for the urodynamic testing system (and / or may output the reconfiguration process initiation signal 526) based upon a determination that the correlation score does not meet the threshold correlation score (e.g., the correlation score is less than the threshold correlation score). In some examples, the configuration check module 522 may determine to implement the urodynamic testing procedure (and / or may output the testing procedure initiation signal 528) based upon a determination that the correlation score meets the threshold correlation score (e.g., the correlation score exceeds the threshold correlation score).

[0083] In some examples, the comparison 566 of the normalized vesical pressure data 586 with the normalized EMG data 588 may comprise generating, based upon the normalized vesical pressure data 586 and the normalized EMG data 588, estimated detrusor pressure data indicative of an estimated detrusor pressure (of the patient) over the provocative maneuver time period associated with the one or more first provocative maneuvers. In some examples, a start time of the provocative maneuver time period may be determined based upon a time of an initial provocative maneuver of the one or more first provocative maneuvers and / or a first predefined duration of time (e.g., a duration of three to five seconds). For example, the first predefined duration of time may be subtracted from the time of the initial provocative maneuver to determine the start time of the provocative maneuver time period. In some examples, an end time of the provocative maneuver timeperiod may be determined based upon a time of a last provocative maneuver of the one or more first provocative maneuvers and / or a second predefined duration of time (e.g., a duration of three to five seconds). For example, the second predefined duration of time may summed with the time of the last provocative maneuver to determine the end time of the provocative maneuver time period.

[0084] In some examples, the estimated detrusor pressure data may comprise an estimated detrusor pressure signal generated based upon the normalized vesical pressure data 586 and the normalized EMG data 588. In some examples, the normalized EMG data 588 may comprise an abdominal pressure signal indicative of an abdominal pressure of the patient over the provocative maneuver time period associated with the one or more first provocative maneuvers. An estimated detrusor pressure value (corresponding to a first point in time during the provocative maneuver time period) indicated by the estimated detrusor pressure data may be determined based upon a vesical pressure value (corresponding to the first point in time, for example) indicated by the normalized vesical pressure data 586 and / or an abdominal pressure value (corresponding to the first point in time, for example) indicated by the normalized EMG data 588. For example, the estimated detrusor pressure value may be determined by subtracting the abdominal pressure value from the vesical pressure value.

[0085] The estimated detrusor pressure data may be analyzed to determine (and / or identify and / or select) one or more sets of detrusor pressure data associated with one, some, or all of the one or more first provocative maneuvers. The one or more sets of detrusor pressure data may comprise a first set of detrusor pressure data associated with a first provocative maneuver (e.g., at least one of a cough, a push, etc.) of the one or more first provocative maneuvers, a second set of detrusor pressure data associated with a second provocative maneuver (e.g., at least one of a cough, a push, etc.) of the one or more first provocative maneuvers, and / or one or more other sets of detrusor pressure data associated with one or more other provocative maneuvers of the one or more first provocative maneuvers. For example, the first set of detrusor pressure data may comprise a first segment,of the estimated detrusor pressure signal, indicative of an estimated detrusor pressure of the patient over a first time period, of the provocative maneuver time period, during which the first provocative maneuver is performed (by the patient). In some examples, an event start time of the first time period associated with the first provocative maneuver may be determined based upon a start time associated with the first provocative maneuver (which may be determined to be a time that precedes a timestamp associated with the first provocative maneuver by the first predefined duration of time, for example) and / or a third predefined duration of time (e.g., a duration of 0.2 seconds). For example, the third predefined duration of time may be subtracted from the start time associated with the first provocative maneuver to determine the event start time of the first time period. In some examples, an event end time of the first time period associated with the first provocative maneuver may be determined based upon an end time associated with the first provocative maneuver (which may be determined to be a time that follows a timestamp associated with the first provocative maneuver by the second predefined duration of time, for example) and / or a fourth predefined duration of time (e.g., a duration of 0.2 seconds). For example, the fourth predefined duration of time may be summed with the end time associated with the first provocative maneuver to determine the event end time.

[0086] In some examples, a first confidence score (indicative of a confidence level of 0%-100%, for example) associated with the first provocative maneuver and / or the first set of detrusor pressure data may be determined. In some examples, the first confidence score may be determined based upon the first set of detrusor pressure data and / or a first set of abdominal pressure data indicative of an abdominal pressure of the patient over the first time period associated with the first provocative maneuver. The normalized EMG data 588 may be analyzed to determine (and / or identify and / or select) the first set of abdominal pressure data. For example, the first set of abdominal pressure data may comprise a first segment, of the normalized EMG data 588, corresponding to the first time period. In some examples, the first confidence score may be determined based upon a first detrusor pressure event energy value associated with the first provocativemaneuver and / or a first abdominal pressure event energy value associated with the first provocative maneuver.

[0087] In some examples, the first detrusor pressure event energy value associated with the first provocative maneuver may be determined based upon a start detrusor pressure value (indicated by the estimated detrusor pressure data) associated with the event start time of the first time period, an end detrusor pressure value (indicated by the estimated detrusor pressure data) associated with the event end time of the first time period, and / or a first detrusor pressure event baseline value associated with the first provocative maneuver. In some examples, the first detrusor pressure event baseline value may correspond to an average detrusor pressure value of a baseline time period (e.g., a period of 0.5 seconds) before the event start time of the first time period. In some examples, the first detrusor pressure event energy value may be determined by calculating a sum of squares of the first detrusor pressure event baseline value and a difference between the start detrusor pressure value and the end detrusor pressure value.

[0088] In some examples, the first abdominal pressure event energy value associated with the first provocative maneuver may be determined based upon a start abdominal pressure value (indicated by the first set of abdominal pressure data, for example) associated with the event start time of the first time period, an end abdominal pressure value (indicated by the first set of abdominal pressure data, for example) associated with the event end time of the first time period, and / or a first abdominal pressure event baseline value associated with the first provocative maneuver. In some examples, the first abdominal pressure event baseline value may correspond to an average abdominal pressure value of the baseline time period (e.g., a period of 0.5 seconds) before the event start time of the first time period. In some examples, the first abdominal pressure event energy value may be determined by calculating a sum of squares of the first abdominal pressure event baseline value and a difference between the start abdominal pressure value and the end abdominal pressure value.

[0089] In some examples, the first provocative maneuver may be a cough and / or a Valsalva event that is expected to primarily impact abdominalpressure (e.g., most or all energy of the first provocative maneuver is expected to be in abdominal pressure and little to no energy of the first provocative maneuver is expected to be in detrusor pressure). In some examples, the first confidence score may be increased based upon an increase of the first abdominal pressure event energy value or a decrease of the first detrusor pressure event energy value. In some examples, the first confidence score may be decreased based upon a decrease of the first abdominal pressure event energy value or an increase of the first detrusor pressure event energy value.

[0090] In some examples, the first confidence score may be compared with a first threshold confidence score (e.g., 95% or other threshold). In some examples, the configuration check module 522 may determine to implement the reconfiguration process for the urodynamic testing system (and / or may output the reconfiguration process initiation signal 526) based upon a determination that the first confidence score does not meet the first threshold confidence score (e.g., the first confidence score is less than the first threshold confidence score). In some examples, the configuration check module 522 may determine to implement the urodynamic testing procedure (and / or may output the testing procedure initiation signal 528) based upon a determination that the first confidence score meets the first threshold confidence score (e.g., the first confidence score exceeds the first threshold confidence score).

[0091] In some examples, a plurality of confidence scores (comprising the first confidence score) associated with some or all provocative maneuvers of the one or more first provocative maneuvers may be determined, and a combined confidence score may be determined based upon (e.g., by combining) the plurality of confidence scores. For example, the combined confidence score may be an average of the plurality of confidence scores. In some examples, the plurality of confidence scores may comprise a second confidence score (indicative of a confidence level of 0%-100%, for example) associated with the second provocative maneuver and / or one or more other confidence scores associated with one or more other provocative maneuvers.

[0092] In some examples, the combined confidence score may be compared with the first threshold confidence score (e.g., 95% or other threshold). In some examples, the configuration check module 522 may determine to implement the reconfiguration process for the urodynamic testing system (and / or may output the reconfiguration process initiation signal 526) based upon a determination that the combined confidence score does not meet the first threshold confidence score (e.g., the combined confidence score is less than the first threshold confidence score). In some examples, the configuration check module 522 may determine to implement the urodynamic testing procedure (and / or may output the testing procedure initiation signal 528) based upon a determination that the combined confidence score meets the first threshold confidence score (e.g., the combined confidence score exceeds the first threshold confidence score).

[0093] In some examples, the second confidence score may be determined based upon the second set of detrusor pressure data and / or a second set of abdominal pressure data indicative of an abdominal pressure of the patient over the second time period associated with the second provocative maneuver. The normalized EMG data 588 may be analyzed to determine (and / or identify and / or select) the second set of abdominal pressure data. For example, the second set of abdominal pressure data may comprise a second segment, of the normalized EMG data 588, corresponding to the second time period. In some examples, the second confidence score may be determined based upon a second detrusor pressure event energy value associated with the second provocative maneuver and / or a second abdominal pressure event energy value associated with the second provocative maneuver. The second detrusor pressure event energy value may be determined using one or more of the techniques provided herein with respect to determining the first detrusor pressure event energy value. The second abdominal pressure event energy value may be determined using one or more of the techniques provided herein with respect to determining the first abdominal pressure event energy value. In some examples, the second confidence score may be increased based upon an increase of the second abdominal pressure event energy value or a decrease of the second detrusorpressure event energy value. In some examples, the second confidence score may be decreased based upon a decrease of the second abdominal pressure event energy value or an increase of the second detrusor pressure event energy value.

[0094] In some examples, the comparison 566 of the normalized vesical pressure data 586 with the normalized EMG data 588 may comprise generating a first attribute vector based upon the normalized vesical pressure data 586, generating a second attribute vector based upon the normalized EMG data 588, and / or determining a distance (e.g., Euclidean distance) between the first attribute vector and the second attribute vector. In some examples, the distance may be compared with a threshold distance (e.g., 0.15 or other threshold). In some examples, the configuration check module 522 may determine to implement the urodynamic testing procedure (and / or may output the testing procedure initiation signal 528) based upon a determination that the distance does not meet the threshold distance (e.g., the distance is less than the threshold distance). In some examples, the configuration check module 522 may determine to implement the reconfiguration process for the urodynamic testing system (and / or may output the reconfiguration process initiation signal 526) based upon a determination that the distance meets the threshold distance (e.g., the distance exceeds the threshold distance).

[0095] The normalized vesical pressure data 586 may be analyzed to determine (and / or identify and / or select) one or more sets of vesical pressure data associated with one, some, or all of the one or more first provocative maneuvers. The one or more sets of vesical pressure data may comprise a first set of vesical pressure data associated with the first provocative maneuver of the one or more first provocative maneuvers, a second set of vesical pressure data associated with the second provocative maneuver of the one or more first provocative maneuvers, and / or one or more other sets of vesical pressure data associated with one or more other provocative maneuvers of the one or more first provocative maneuvers. For example, the first set of vesical pressure data may comprise a first segment, of a normalized vesical pressure signal indicated by the normalized vesical pressure data 586, indicative of a vesical pressure of the patient over the firsttime period during which the first provocative maneuver is performed (by the patient). One or more first attributes of the first set of vesical pressure data may be determined. For example, the one or more first attributes may comprise a first amplitude (e.g., a first peak) and / or a first width of a waveform of the first set of vesical pressure data. For example, the first amplitude may correspond to the amplitude 535 (shown in Fig. 5G) of the Valsalva event Ppi and / or the first width may correspond to the width 537 of the Valsalva event Ppi. One or more second attributes of the second set of vesical pressure data may be determined. For example, the one or more second attributes may comprise a second amplitude (e.g., a second peak) and / or a second width of a waveform of the second set of vesical pressure data. In some examples, the first attribute vector may be generated based upon attributes comprising the one or more first attributes, the one or more second attributes, and / or one or more other attributes associated with one or more other provocative maneuvers. For example, the first attribute vector may comprise amplitude to width ratios (e.g., peak to width ratios) determined based upon the attributes (e.g., the amplitude to width ratios may comprise at least one of a ratio of the first amplitude to the first width, a ratio of the second amplitude to the second width, etc.).

[0096] The normalized EMG data 588 may be analyzed to identify one or more sets of abdominal pressure data associated with one, some, or all of the one or more first provocative maneuvers. The one or more sets of abdominal pressure data may comprise the first set of abdominal pressure data associated with the first provocative maneuver of the one or more first provocative maneuvers, the second set of abdominal pressure data associated with the second provocative maneuver of the one or more first provocative maneuvers, and / or one or more other sets of abdominal pressure data associated with one or more other provocative maneuvers of the one or more first provocative maneuvers. One or more third attributes of the first set of abdominal pressure data may be determined. For example, the one or more third attributes may comprise a third amplitude (e.g., a third peak) and / or a third width of a waveform of the first set of abdominal pressure data. For example, the third amplitude may correspond to the amplitude 545 (shown inFig. 5G) of the Valsalva event Epi and / or the third width may correspond to the width 547 of the Valsalva event Epi. One or more fourth attributes of the second set of abdominal pressure data may be determined. For example, the one or more fourth attributes may comprise a fourth amplitude (e.g., a fourth peak) and / or a fourth width of a waveform of the second set of abdominal pressure data. In some examples, the second attribute vector may be generated based upon attributes comprising the one or more third attributes, the one or more fourth attributes, and / or one or more other attributes associated with one or more other provocative maneuvers. For example, the second attribute vector may comprise amplitude to width ratios (e.g., peak to width ratios) determined based upon the attributes (e.g., the amplitude to width ratios may comprise at least one of a ratio of the third amplitude to the third width, a ratio of the second amplitude to the second width, etc.).

[0097] In some examples, the EMG signal quality metric 580 may be determined based upon the EMG envelope signal (and / or other EMG signal such as the EMG signal 530 or a signal derived from the EMG signal 530) using a signal quality determination module 557 (shown in Fig. 5B). The EMG signal quality metric 580 may comprise and / or may be based upon a signal to noise ratio and / or other type of signal quality metric. In some examples, the EMG signal quality metric 568 (e.g., the signal to noise ratio) may be determined based upon (and / or to be equal to) a variance in the EMG envelope signal (and / or other EMG signal such as the EMG signal 530 or a signal derived from the EMG signal 530) in a period of no pressure activity (and / or less than a threshold amount of pressure activity) relative to an amplitude change in the EMG envelope signal (and / or the other EMG signal) that is captured during pressure activity. The EMG signal quality metric 568 may be compared 568 with a threshold signal quality metric (e.g., -1 .4 dB or other threshold), such as a threshold signal to noise ratio. In some examples, the configuration check module 522 may determine to implement the reconfiguration process for the urodynamic testing system (and / or may output the reconfiguration process initiation signal 526) based upon a determination that the EMG signal quality metric 580 does not meet the threshold signal quality metric (e.g., the EMG signal quality metric 580 is less than thethreshold signal quality metric). In some examples, the configuration check module 522 may determine to implement the urodynamic testing procedure (and / or may output the testing procedure initiation signal 528) based upon a determination that the EMG signal quality metric 580 meets the threshold signal quality metric (e.g., the EMG signal quality metric 580 exceeds the threshold signal quality metric).

[0098] In some examples, the configuration check module 522 may determine to implement the reconfiguration process for the urodynamic testing system (and / or may output the reconfiguration process initiation signal 526) based upon a determination that at least one of the EMG signal quality metric 580 does not meet the threshold signal quality metric (e.g., the EMG signal quality metric 580 is less than the threshold signal quality metric) or the normalized vesical pressure data 586 and / or the normalized EMG data 588 are not sufficiently coherent. The configuration check module 522 may determine that the normalized vesical pressure data 586 and / or the normalized EMG data 588 are not sufficiently coherent based upon a determination that at least one of the correlation score does not meet the threshold correlation score (e.g., the correlation score is less than the threshold correlation score), the first confidence score does not meet the first threshold confidence score (e.g., the first confidence score is less than the first threshold confidence score), the combined confidence score does not meet the first threshold confidence score (e.g., the combined confidence score is less than the first threshold confidence score), and / or the distance meets the threshold distance (e.g., the distance exceeds the threshold distance).

[0099] In some examples, the configuration check module 522 may determine to implement the urodynamic testing procedure (and / or may output the testing procedure initiation signal 528) based upon a determination that both the EMG signal quality metric 580 meets the threshold signal quality metric (e.g., the EMG signal quality metric 580 exceeds the threshold signal quality metric) and the normalized vesical pressure data 586 and / or the normalized EMG data 588 are sufficiently coherent. The configuration check module 522 may determine that the normalized vesical pressure data 586and / or the normalized EMG data 588 are sufficiently coherent based upon a determination that at least one of the correlation score meets the threshold correlation score (e.g., the correlation score exceeds the threshold correlation score), the first confidence score meets the first threshold confidence score (e.g., the first confidence score exceeds the first threshold confidence score), the combined confidence score meets the first threshold confidence score (e.g., the combined confidence score exceeds the first threshold confidence score), and / or the distance does not meet the threshold distance (e.g., the distance is less than the threshold distance).

[0100] In some examples, in response to determining to implement the reconfiguration process (and / or outputting the reconfiguration process initiation signal 526), an alert (e.g., at least one of an audio alert to be output via a speaker, a graphical object to be displayed on a display, etc.) indicative of the reconfiguration process may be output via an alert element (e.g., a speaker, a display, etc.) of the urodynamic testing system. In some examples, the alert may comprise one or more instructions for performing the reconfiguration process, which may guide a healthcare professional and / or the patient on one or more actions to perform to perform the reconfiguration process. In some examples, the reconfiguration process may comprise adjusting (e.g., repositioning, reconnecting, and / or reconfiguring) at least one of the sensor 534, the catheter 502, the EMG electrode 504, a connection between the sensor 534 and the catheter 502, a connection between the sensor 534 and the acquisition module 536, a connection between the EMG electrode 504 and the acquisition module 536, or one or more other components of the urodynamic testing system.

[0101] In some examples, in response to performing the reconfiguration process, the patient may be prompted (by the provocative maneuver prompting module 524, for example) to perform one or more second provocative maneuvers, and / or the configuration check module 522 may determine, based upon an EMG signal and / or a vesical pressure signal received (from the EMG electrode 504 and / or the sensor 534, for example) in association the one or more second provocative maneuvers, whether to implement a second reconfiguration process or to implement the urodynamictesting procedure. For example, the configuration check module 522 may determine whether to implement the second reconfiguration process or to implement the urodynamic testing procedure using one or more of the techniques provided herein with respect to determining whether to perform the reconfiguration process or the urodynamic testing procedure based upon the EMG signal 530 and / or the vesical pressure signal 532 associated with the one or more first provocative maneuvers.

[0102] In some examples, the urodynamic testing procedure may comprise a bladder filling phase during which the bladder 510 of the patient is at least partially filled retrograde through the catheter 502 with fluid from the fluid reservoir 514. The urodynamic testing procedure may comprise a voiding phase during which the bladder 510 of the patient is at least partially emptied. In some examples, during the bladder filling phase and / or the voiding phase (and / or one or more other phases of the urodynamic testing procedure), one or more parameters associated with the patient are measured and / or monitored using the EMG signal 530 and / or the vesical pressure signal 532. In some examples, the one or more parameters associated with the patient may comprise a vesical pressure (e.g., bladder pressure) of the patient (determined based upon the vesical pressure signal 532, for example), an abdominal pressure of the patient (determined based upon the EMG signal 530, for example), and / or a detrusor pressure (e.g., estimated detrusor pressure determined based upon the vesical pressure signal 532 and / or the EMG signal 530). In some examples, during the urodynamic testing procedure, one, some, or all of the one or more parameters (e.g., the vesical pressure, the abdominal pressure, and / or the detrusor pressure) may be displayed in real time or in near real time (with a 1 second delay, for example) via a display. In some examples, the one or more parameters (e.g., the vesical pressure, the abdominal pressure, and / or the detrusor pressure) may be determined using the EMG signal 530 and / or the vesical pressure signal 532 without receiving a signal, indicative of pressure measurements associated with the patient, from a second sensor coupled to a second catheter (e.g., a rectal and / or vaginal catheter), which may provide for improved comfort and / or convenience, reduced risk of infection, and / or otherbenefits as compared with some systems that rely upon the second sensor coupled to the second catheter (which may be inserted inside an abdominal region 512 of the patient, for example) to gather pressure measurements.

[0103] Fig. 5H illustrates determining the detrusor pressure (shown with reference number 581 ) associated with the patient (during the urodynamic testing procedure, for example). In some examples, the vesical pressure signal 532 and / or the EMG signal 530 may be provided to a processing module 571 , which may process the vesical pressure signal 532 and / or the EMG signal 530 to generate processed signals 573 comprising a processed vesical pressure signal and / or a processed EMG signal. In some examples, the processing module 571 may comprise the preprocessing module 520 (shown in Figs. 5A and 5B) and / or may generate the processed signals 573 by performing one, some, or all of the operations provided herein with respect to using the preprocessing module 520 to generate the processed vesical pressure signal 582 and / or the processed EMG signal 584. The processing module 571 may generate the processed signals 573 based upon the first delay (and / or based upon an updated delay between the vesical pressure signal 532 and the EMG signal 530 determined by the processing module 571 ) such that the processed signals 573 are synchronized (e.g., aligned with each other). In some examples, the processing module 571 may hold the vesical pressure signal 532 and / or the EMG signal 530 in a buffer of data for a duration of time (e.g., 4 seconds, which may correspond to 4,000 samples of recorded data for each signal, or other duration of time), and / or may perform filtering to smooth the buffered data to generate the processed signals 573.

[0104] In some examples, the processed signals 573 are provided to a wavelet decomposer 575, which may determine wavelet information 577 based upon the processed signals 573. In some examples, the wavelet information 577 may be provided to a detrusor pressure determination module 579, which may determine the detrusor pressure 581 based upon the wavelet information 577 and / or the patient profile 578 (retrieved from the patient data store, for example). For example the wavelet level gains 576 and / or the provocative feature information 574 indicated by the patient profile 578 may be used to determine the detrusor pressure 581 .

[0105] In some examples, the wavelet decomposer 575 may decompose the processed signals 573 into frequency components (e.g., fundamental frequency components) and / or include the frequency components in the wavelet information 577. In some examples, the wavelet decomposer 575 may comprise a wavelet multiresolution analyzer (MRA) configured to decompose the processed signals 573 into the frequency components. In some examples, the MRA may perform discrete wavelet transform (DWT) to decompose the processed signals 573 into the frequency components. The MRA and / or the DWT may preserve time-domain information and / or frequency-domain information in the frequency components and / or the wavelet information 577.

[0106] In some examples, the MRA is augmented with a tunable weight vector WL, where i G [1,2, ...j is the wavelet resolution level. In some examples, the weight vector provides a flexible method of determining (e.g., estimating) the detrusor pressure 581 using a weighted sum. In some examples, with Wsz=320, the 320-sample frame may be decomposed into five frames representing the window component at 1 , 2, 3, 5, and 1 ,000 Hz. In some examples, due to decimation at each stage of the transform, the final level of the transform may yield a single approximation coefficient (e.g., only a single approximation coefficient). In some examples, a sampling frequency and / or a mother wavelet for the MRA may be selected for determining (e.g., estimating) the detrusor pressure 581 .

[0107] In some examples, an output (comprising at least a portion of the wavelet information 577, for example) of the wavelet decomposer 575 may be definedmay be the window resolution at level i, ip may be the mother wavelet function, and / or N = log2( z)G Kmay be the depth of decomposition. In some examples, the vector wszmay be predefined and / or selected to capture a slowest event of interest. Alternatively and / or additionally, the mother wavelet may be varied with a unity weighted vector value, then a Wszvalue may be determined with a static mother wavelet function via least mean square (LMS) fitting.

[0108] In some examples, event detection may be performed on the processed signals 573 to detect a set of events (e.g., a set of one or more events). For example, the set of events may comprise at least one of an abdominal event, a cough (e.g., short abdominal contraction), a Valsalva event (e.g., an extended abdominal push), a non-voiding bladder contraction (e.g., bladder contraction without void), a voiding bladder contraction (e.g., bladder contraction with void), a voiding bladder contraction with abdominal contribution (e.g., bladder contraction with abdominal push), a bladder compliance event (e.g., passive increase in bladder pressure during filling phase), a baseline (e.g., a concatenation of some or all periods, in the urodynamic testing procedure, in which there are no other events), an artifact (e.g., an artifact on the vesical pressure with little to no abdominal and / or detrusor activity), and / or one other events.

[0109] In some examples, an event of the set of events may be detected based upon the provocative feature information 574. For example, the event may be determined to be a cough based upon the event being associated with one or more features (e.g., at least one of width of a waveform, amplitude of a waveform, etc.) that matches and / or is similar to one or more features indicated by the provocative feature information 574. In some examples, reconstruction weights wtmay be selected based upon the event, which may provide for improved accuracy of the wavelet information 577 and / or the detrusor pressure 581 , such as due, at least in part, to the reconstruction weights W(being event-dependent. Alternatively and / or additionally, the event may be determined based upon a frequency of a signal of the processed signals 573. For example, an abdominal event of the set of events may be identified based upon a determination that a signal of the processed signals 573 has elements with frequencies greater than a threshold frequency. In some examples, based upon detecting the abdominal event, the weighting vector for windows during the abdominal event may deemphasize one or more scales (e.g., one or more initial scales) of the DWT. In some examples, the reconstruction weights wz;may be adaptively calculated (such that reconstruction weights the capture the recent history of activity in the data, for example, which may enable a more robust detectionscheme). In some examples, one or more statistical features may be used to adaptively scale the reconstruction weights W). In some examples, statistical features of the window may serve as an alternative abstract representation of the window and / or a strong indicator of contraction onset and / or termination of an event of the set of events.

[0110] In some examples, an event span of an event of the set of events (e.g., a time difference between onset time and termination time of the event) may be determined. In some examples, in response to identifying the termination time of the event, the detrusor pressure 581 may be determined (more accurately, for example) via DWT approximation coefficients. In some examples, coughs may be determined to have event spans within a first range of event spans (e.g., between about 0.9 seconds to about 1 .9 seconds), and / or Valsalva events may be determined to have event spans within a second range of event spans (e.g., between about 2 seconds to about 3 seconds). In some examples, a window (e.g., fixed window) of 320 samples may capture Valsalva events with at most two consecutive windows. In some examples, an event ending flag may be added to the event detection kernel to enable detection of events (of the set of events) spanning more than one window.

[0111] In some examples, event detection may be performed (on the processed signals 573 and / or other signals, for example) to identify a vector of threshold values for event onset and / or termination. In some examples, a kernel of an event detection algorithm (for detecting events of the set of events using a sliding window, for example) may be(e.g., the vector of threshold values), a may be the local window standard deviation, n may be the arithmetic mean, 8 may be the maximum value of local gradient, f may be the rate of signal zero crossing, Fgmay be a flag set at onset and cleared at termination, and / or Tmand Trmay be tuning parameters. In some examples, the vector of threshold values, the kernel and / or the event detection algorithm may be used (by the wavelet decomposer 575 and / or the detrusor pressure determination module 579, forexample) to detect one or more events of the set of events based upon the processed signals 573.

[0112] In some examples, the detrusor pressure 581 may be determined (e.g., estimated) based upon one or more events (detected by the wavelet decomposer 575 and / or the detrusor pressure determination module 579, for example) of the set of events. In some examples, the detrusor pressure 581 may be calculated by mitigating and / or eliminating the one or more detected events from the detrusor pressure 581 (based upon a determination that the one or more detected events are abdominal events that primarily impact abdominal pressure and / or have little to no impact on detrusor pressure, such as at least one of a cough, a Valsalva event, etc., for example). For example, the dutrosor pressure 581 (e.g., PDET) may be< P rfki = 1 calculated as PDET(W, wsz, p, <r, 8, = _ ,IP — p otherwise

[0113] Fig. 5I illustrates a first group of data structures associated with a first scenario in which the urodynamic testing procedure is performed. The first group of data structures comprise a first data structure 182 indicative of the vesical pressure (e.g., bladder pressure) associated with the patient during the provocative maneuver time period and / or the urodynamic testing procedure (as indicated by and / or determined based upon the processed vesical pressure signal of the processed signals 573, for example). The first group of data structures comprise a second data structure 184 indicative of an abdominal pressure (labeled “Pabd” in Fig. 5I) associated with the patient during the provocative maneuver time period and / or the urodynamic testing procedure (as indicated by and / or determined based upon the processed EMG signal of the processed signals 573, for example) and a reference abdominal pressure (labeled “Pabd ref” in Fig. 5I). The reference abdominal pressure may be determined via an invasive manner using the second catheter and / or the second sensor. It may be appreciated that the abdominal pressure (determined without the second sensor and / or the second catheter) exhibits a strong correlation to the reference abdominal pressure (determined with the second sensor and / or the second catheter), thereby removing the need for the second sensor and / or the second catheter to (accurately)determine the abdominal pressure. The first group of data structures comprise a third data structure 186 indicative of an abdominal EMG signal (e.g., the processed EMG signal of the processed signals 573) associated with the patient during the provocative maneuver time period and / or the urodynamic testing procedure. The first group of data structures comprise a fourth data structure 188 indicative of the detrusor pressure 581 (labeled “Pdet” in Fig. 5I) associated with the patient during the provocative maneuver time period and / or the urodynamic testing procedure and a reference detrusor pressure (labeled “Pdet ref” in Fig. 5I). The reference detrusor pressure may be determined via an invasive manner using the second catheter and / or the second sensor, such as by subtracting the reference abdominal pressure (indicated by the second data structure 184) from the vesical pressure (indicated by the first data structure 182). It may be appreciated that the detrusor pressure (determined without the second sensor and / or the second catheter) exhibits a strong correlation to the reference detrusor pressure (determined with the second sensor and / or the second catheter), thereby removing the need for the second sensor and / or the second catheter to (accurately) determine the detrusor pressure.

[0114] Fig. 5I illustrates an indication 190 of the provocative maneuver time period and / or event spans associated with events of the set of events identified via event detection, such as an event span 192 of a cough event (labeled “COU” in Fig. 5I), an event span 194 of a Valsalva event (labeled “Push” in Fig. 5I), an event span 196 of a bladder contraction event (labeled “BC” in Fig. 5I), an event span 198 of a voiding bladder contraction event (labeled “VO” in Fig. 5I), and / or an event span 180, within the event span 198, of a voiding bladder contraction event with abdominal contribution (e.g., abdominal push).

[0115] In some examples, the vesical pressure signal indicated by the first data structure 182 may be analyzed to identify a waveform 176, which may comprise a spike. The spike may correspond to a vesical pressure signal strength value that exceeds an average vesical pressure signal strength value (e.g., an average of at least a portion of the vesical pressure signal prior to and / or following the waveform 176) by at least a threshold valueand / or at least a threshold proportion. In some examples, the waveform 176 may be determined to be associated with an abdominal event (e.g., the cough event associated with the event span 192) based upon the abdominal EMG signal and / or the vesical pressure (e.g., bladder pressure) associated with the patient. A portion 178 of the detrusor pressure 581 may be determined based upon the abdominal event, such as by mitigating and / or eliminating the abdominal event from the detrusor pressure 581 (since the abdominal event primarily impacts abdominal pressure with little to no impact on the detrusor pressure 581 , for example). In some examples, the portion 178 of the detrusor pressure 581 may be determined based upon (and / or may be set to be equal to) an average (and / or a rolling average) of the detrusor pressure 581 during a period of time before the abdominal event. In some examples, the portion 178 of the detrusor pressure 581 may be determined with increased accuracy as compared to the reference detrusor pressure (determined using the second sensor and / or the second catheter), where a corresponding portion of the reference detrusor pressure may comprise an artifact (e.g., spikes shown in Fig. 5I) due to not identifying, mitigating, and / or eliminating the abdominal event in the reference detrusor pressure.

[0116] In some examples, the vesical pressure signal indicated by the first data structure 182 may be analyzed to identify a waveform 172, which may comprise a spike (e.g., a vesical pressure signal strength value that exceeds an average vesical pressure signal strength value by at least the threshold value and / or at least the threshold proportion). In some examples, the waveform 172 may be determined to be associated with an abdominal event (e.g., the Valsalva event associated with the event span 194) based upon the abdominal EMG signal and / or the vesical pressure (e.g., bladder pressure) associated with the patient. A portion 174 of the detrusor pressure 581 may be determined based upon the abdominal event, such as by mitigating and / or eliminating the abdominal event from the detrusor pressure 581 (since the abdominal event primarily impacts abdominal pressure with little to no impact on the detrusor pressure 581 , for example). In some examples, the portion 174 of the detrusor pressure 581 may be determined based upon (and / or may be set to be equal to) an average (and / or a rollingaverage) of the detrusor pressure 581 during a period of time before the abdominal event.

[0117] In some examples, the vesical pressure signal indicated by the first data structure 182 may be analyzed to identify a waveform 168, which may comprise a spike (e.g., a vesical pressure signal strength value that exceeds an average vesical pressure signal strength value by at least the threshold value and / or at least the threshold proportion). In some examples, the waveform 168 may be determined to be associated with an abdominal event (e.g., the voiding bladder contraction event with abdominal contribution associated with the event span 180) based upon the abdominal EMG signal and / or the vesical pressure (e.g., bladder pressure) associated with the patient. A portion 170 of the detrusor pressure 581 may be determined based upon the abdominal event, such as by mitigating and / or eliminating the abdominal event from the detrusor pressure 581 (since the abdominal event primarily impacts abdominal pressure with little to no impact on the detrusor pressure 581 , for example). In some examples, the portion 170 of the detrusor pressure 581 may be determined based upon (and / or may be set to be equal to) an average (and / or a rolling average) of the detrusor pressure 581 during a period of time before the abdominal event.

[0118] Fig. 5J illustrates a second group of data structures associated with a second scenario in which the urodynamic testing procedure is performed. The second group of data structures comprise a fifth data structure 183 indicative of the vesical pressure (e.g., bladder pressure) associated with the patient during the provocative maneuver time period and / or the urodynamic testing procedure (as indicated by and / or determined based upon the processed vesical pressure signal of the processed signals 573, for example). The second group of data structures comprise a sixth data structure 185 indicative of an abdominal pressure (labeled “Pabd” in Fig. 5J) associated with the patient during the provocative maneuver time period and / or the urodynamic testing procedure (as indicated by and / or determined based upon the processed EMG signal of the processed signals 573, for example) and a reference abdominal pressure (labeled “Pabd ref” in Fig. 5J). The reference abdominal pressure may be determined via an invasivemanner using the second catheter and / or the second sensor. The second group of data structures comprise a seventh data structure 187 indicative of an abdominal EMG signal (e.g., the processed EMG signal of the processed signals 573) associated with the patient during the provocative maneuver time period and / or the urodynamic testing procedure. The second group of data structures comprise an eighth data structure 189 indicative of the detrusor pressure 581 (labeled “Pdet” in Fig. 5J) associated with the patient during the provocative maneuver time period and / or the urodynamic testing procedure and a reference detrusor pressure (labeled “Pdet ref” in Fig. 5J). The reference detrusor pressure may be determined via an invasive manner using the second catheter and / or the second sensor, such as by subtracting the reference abdominal pressure (indicated by the sixth data structure 185) from the vesical pressure (indicated by the fifth data structure 183).

[0119] Fig. 5J illustrates an indication 191 of the provocative maneuver time period and / or event spans associated with events of the set of events identified via event detection, such as an event span 195 of a cough event (labeled “GOLI” in Fig. 5J), an event span 197 of a bladder contraction event (labeled “BC” in Fig. 5J), and / or an event span 199 of a voiding bladder contraction event (labeled “VO ” in Fig. 5J). In some examples, the reference abdominal pressure (Pabd ref) indicated by the sixth data structure 185 may comprise an artifact 181 (e.g., an error), which may comprise an abdominal pressure increase without an increase of bladder pressure, such as due to at least one of a catheter movement, a bowel contraction, etc. In some examples, a portion 179 of the reference detrusor pressure (Pdet ref) may be incorrectly determined to have a negative spike based upon the artifact 181 , whereas a corresponding portion of the detrusor pressure 581 (Pdet) may be (correctly) determined not to have the negative spike, thereby providing for improved accuracy of the detrusor pressure 581 determined using one or more of the techniques provided herein without the second catheter and / or the second sensor.

[0120] Fig. 5K illustrates data structures associated with processing an abdominal EMG signal. The data structures include an EMG signal data structure 583 indicative of an input abdominal EMG signal (e.g., the EMGsignal 530), a filtered EMG signal data structure 585 indicative of a filtered EMG signal (generated by performing the one or more third filtering operations 552 shown in Fig. 5B, for example), a power spectral density (PSD) data structure 587 indicative of a PSD of the input abdominal EMG signal, and / or a PSD data structure 589 indicative of a PSD of the filtered EMG signal.

[0121] In some examples, a treatment plan may be generated based upon the one or more parameters determined via the urodynamic testing procedure (e.g., the vesical pressure, the abdominal pressure, and / or the detrusor pressure 581 ) and / or based upon information submitted by a healthcare professional administering and / or overseeing the urodynamic testing procedure. In some examples, the one or more parameters may be evaluated to determine a condition of the patient, and / or may generate the treatment plan to comprise an indication of the condition. For example, the condition may comprise detrusor overactivity, overactive bladder, neurogenic detrusor overactivity, detrusor underactivity, underactive bladder, detrusor areflexia, bladder outlet obstruction, stress urinary incontinence, poor bladder compliance, and / or other condition. Alternatively and / or additionally, the treatment plan may be indicative of one or more treatments for the patient, which may be determined based upon the one or more parameters and / or the condition. For example, the one or more treatments may comprise a behavioral treatment, pharmacologic treatment, surgical treatment, catheterization, pelvic floor therapy, and / or other treatment. In some examples, the pharmacologic treatment may be indicative of a medicine and / or a dose of the medicine. For example, the medicine may comprise at least one of antimuscarinics (e.g., oxybutynin and / or tolterodine), 3-agonists (e.g., mirabegron), cholinergic agents (e.g., bethanechol), a-blockers (e.g., tamsulosin and / or alfuzosin), 5a-reductase inhibitors (e.g., finasteride), etc. In some examples, based upon the treatment plan, the medicine may be administered to the patient according to the dose.

[0122] In some examples, the one or more parameters determined via the urodynamic testing procedure may be evaluated (after the urodynamic testing procedure is completed, for example) to determine confidence scoresassociated with the set of events (determined via event detection, for example). In some examples, the detrusor pressure 581 may be validated and / or updated based upon the evaluation and / or the confidence scores.

[0123] In some examples, a confidence score associated with a cough and / or a Valsalva event may be determined using one or more of the techniques provided herein with respect to determining the first confidence score (indicative of the confidence level of 0%-100%, for example) associated with the first provocative maneuver and / or the first set of detrusor pressure data.

[0124] In some examples, for a bladder compliance event of the set of events, a filling start time and filling end time may be determined from a report and / or record of events, and / or a slope of the detrusor pressure 581 over the filling time may be obtained to determine compliance (in units of cmH2O / minute, for example). A comparison of compliance from a reference detrusor pressure (determined using the second sensor and / or the second catheter, for example) to the detrusor pressure 581 may be undertaken which may be indicative of a distance between the reference detrusor pressure and the detrusor pressure 581 . In order to calculate bladder compliance, one or more acts may be performed. The one or more acts may comprise evaluating the urodynamic testing procedure to determine a timestamp for “Start Infusion” and a timestamp for “End Infusion”, and / or determining a slope of the detrusor pressure 581 for the infusion period such that the detrusor pressure 581 has a compliance calculation that is reported (in units of cmH2O / minute, for example).

[0125] In some examples, for a baseline event of the set of events, a level of activity of the detrusor pressure 581 during non-activity periods may be determined. The level of activity may be compared with baseline performance of the detrusor pressure 581 . In some examples, a baseline score (e.g., confidence score for the baseline event and / or the detrusor pressure 581 ) may be determined by performing one or more acts. The one or more acts may comprise identifying each event that is baseline, which may comprise time periods between other events of the set of events, and / or assessing a quietness of each of the baseline events using measures ofstability of each of the baseline periods for the detrusor pressure 581 . Median Absolute Deviation (MAD) and / or other parameters may be used to assess the quietness. The MAD parameter may provide for an unbiased assessment of quietness, may reflect baseline changes in the detrusor pressure 581 , and / or may reflect a variability and / or deviation of values within a given range from their central tendency (e.g., median). In some examples, the MAD parameter may be a median of the absolute differences between each value in a defined range and the median value of the range. The one or more acts may comprise producing (in response to determining the MAD parameter, for example) a baseline score (e.g., confidence score) for each baseline period as a weighted average of each of the baseline periods (such that longer baseline periods are weighted higher than shorter baseline periods, for example).

[0126] In some examples, one or more acts may be performed to determine a confidence score for a voiding bladder contraction and / or a nonvoiding bladder contraction, which may be performed in relation to event detection using static thresholding, for example. The one or more acts may comprise zeroing an EMG signal (e.g., the processed EMG signal of the processed signals 573) (to remove an offset, for example), removing a redundancy from the output signal by defining a minimum contraction time (of 2 seconds or other duration), and / or assigning the vesical pressure to a slowest dilation of wavelet decomposition of the vesical pressure, slide over the vesical pressure and the EMG signal using a window size of 3 seconds (or other duration) to capture changes that signify contraction (aiming to distinguish a voiding bladder contraction event and / or a non-voiding bladder contraction from Valsalva maneuvers accompanied by noise, which could potentially yield false indications of detrusor contraction, for example). The one or more acts may comprise detecting a detrusor contraction event based upon a determination that a summation of a vesical pressure signal (e.g., the processed vesical pressure signal of the processed signals 573) during the event period exceeds a first threshold, and / or that a summation of the EMG signal during the event period is less than a second threshold. In some examples, the first threshold and / or the second threshold may be determinedusing adaptive thresholding, such as adaptive thresholding performed using a Context Aware Thresholding (CAT) algorithm. Alternatively and / or additionally, widths and / or amplitudes (e.g., peaks) associated with a cough event and / or a Valsalva event during the one or more first provocative maneuvers may be determined. The first threshold may be determined based upon (and / or to be equal to) an area under the Valsalva event (which may be determined based upon a width and / or an amplitude of the Valsalva event). The second threshold may be determined based upon (and / or to be equal to) half of an average normalized cough area in the EMG signal. In some examples, a detrusor contraction may be detected in the vesical pressure signal and / or the EMG signal based upon the first threshold and / or the second threshold (from a fixed window size of a previous 3 seconds or other duration from a current sample, for example). A peak-to-peak distance may be used as a condition to exclude the detected detrusor contraction. In some examples, a peak-to-width parameter may be used to determine that the detected portions have little to no abdominal activity.

[0127] In some examples, a voiding bladder contraction with abdominal contribution event may integrate elements from Valsalva event type and / or voiding bladder contraction event type. In some examples, a confidence score associated with the voiding bladder contraction with abdominal contribution event may be determined by performing one or more acts. The one or more acts may comprise identifying a start time and end time of the event, defining Event Start as 0.2 seconds (or other duration) before the start time, defining Event End as 0.2 seconds after the end time, calculate event baseline and / or event energy for abdominal pressure and detrusor pressure contributions, and / or applying a scoring function to assess energy contributions from the abdominal pressure and the detrusor pressure, such as using one or more of the techniques provided herein with respect to determining the first detrusor pressure event energy value associated with the first provocative maneuver and / or the first abdominal pressure event energy value associated with the first provocative maneuver.

[0128] In some examples, event detection may be performed in a defined sequence to detect and / or evaluate the set of events and / ordetermine confidence scores associated with the set of events. In some examples, one or more first event types (e.g., event types that are relatively easier to detect) may be detected prior to detecting one or more second event types (e.g., event types that are relatively more difficult to detect). In some examples, one or more acts may be performed to isolate event portions sequentially to allow evaluation of each event (individually, for example). In some examples, the one or more acts may comprise detecting, on the EMG signal and / or the vesical pressure signal, baseline event portions (such as by identifying baseline event start times and end times). The one or more acts may comprise evaluating a portion, of the EMG signal and / or the vesical pressure signal, that excludes the baseline event portions, to identify one or more Valsalva events and / or one or more cough events. Start times and / or end times of the one or more Valsalva events and / or one or more cough events may be extracted, such as by identifying a start time of a Valsalva event or a cough event based upon a slope of a rise edge of the event exceeding a threshold slope (e.g., 70% or other threshold slope) and / or identifying an end time of the event based upon a magnitude of a slope of a falling edge of the event being greater than the threshold slope and / or a second threshold slope. In some examples, the one or more acts may comprise evaluating a portion, of the EMG signal and / or the vesical pressure signal, that excludes baseline event portions, Valsalva event portions and / or cough event portions to identify voiding and / or non-voiding bladder contraction events, such as by applying a wavelet decomposition (e.g., a 5- level wavelet decomposition) to the portion of the vesical pressure signal to extract a relatively slow (e.g., slowest) dilation (e.g., 5th level). In some examples, a window may be shifted along the 5-level wavelet decompositions of the vesical pressure signal and / or the EMG signal to detect one or more bladder contraction events, such as using the first threshold, the second threshold, and / or one or more of the techniques provided herein for detecting a voiding bladder contraction event and / or a non-voiding bladder contraction event. In some examples, a voiding event may be detected (during postprocessing after the urodynamic testing procedure is complete, for example). For example, the voiding event may be detected by evaluating a portion, of the EMG signal and / or the vesical pressure signal, that excludesbaseline event portions, Valsalva event portions, cough event portions, and / or voiding and / or non-voiding bladder contraction event portions. In some examples, a relatively slow dilation (e.g., slowest dilation) of the vesical pressure may be detected to identify a start of the voiding event, which may be characterized by (and / or detected by identifying) a relatively gradual rise with a slope less exceeding 0.6 cmH20 / min (and / or other slope). In some examples, an end of the voiding event may be determined by detecting a point in which the vesical pressure reaches at least 10 cmH2O (or other value) above baseline and / or exhibits a negative slope. In some examples, bladder contractions occurring between the identified voiding event start and the voiding event end may be classified as voiding bladder contractions, while bladder contractions occurring outside the voiding event period may be classified as non-voiding bladder contractions.

[0129] An embodiment of determining a detrusor pressure associated with a patient is illustrated by an example method 600 of Fig. 6. At 602, a vesical pressure signal (e.g., the vesical pressure signal 532) may be received from a sensor (e.g., the sensor 534) of a urodynamic testing system. The sensor may be coupled to a catheter (e.g., the catheter 502) configured for insertion into a bladder of a patient. The sensor may be configured to measure a vesical pressure in the bladder. At 604, an abdominal EMG signal (e.g., the EMG signal 530) may be received from an EMG electrode (e.g., the EMG electrode 504) of the urodynamic testing system. The EMG electrode may be configured to measure abdominal muscle activity of an abdomen of the patient. At 606, a detrusor pressure signal indicative of a detrusor pressure (e.g., the detrusor pressure 581 ) associated with the patient may be generated based upon the vesical pressure signal and the EMG signal. The detrusor pressure signal may be generated without receiving a signal, indicative of pressure measurements associated with the patient, from a second sensor coupled to a second catheter.

[0130] An embodiment of determining a detrusor pressure associated with a patient is illustrated by an example method 700 of Fig. 7. At 702, a vesical pressure signal (e.g., the vesical pressure signal 532) may be received from a sensor (e.g., the sensor 534) of a urodynamic testing system.The sensor may be configured to measure a vesical pressure in the bladder. At 704, an abdominal EMG signal (e.g., the EMG signal 530) may be received from an EMG electrode (e.g., the EMG electrode 504) of the urodynamic testing system. The EMG electrode may be configured to measure abdominal muscle activity of an abdomen of the patient. At 706, a delay (e.g., the first delay) between the vesical pressure signal and the abdominal EMG signal may be determined. At 708, a detrusor pressure signal indicative of a detrusor pressure (e.g., the detrusor pressure 581 ) associated with the patient may be generated based upon the delay, the vesical pressure signal and the EMG signal. For example, a synchronized set of signals (e.g., the processed signals 573 and / or signals output by the delay detection and / or synchronization module 546) may be generated based upon the delay (e.g., the synchronized set of signals may comprise a vesical pressure signal and / or an EMG signal that are aligned with each other). The detrusor pressure signal may be generated based upon the synchronized set of signals. The detrusor pressure signal may be generated without receiving a signal, indicative of pressure measurements associated with the patient, from a second sensor coupled to a second catheter.

[0131] An embodiment of determining a detrusor pressure associated with a patient is illustrated by an example method 800 of Fig. 8. At 802, a vesical pressure signal (e.g., the vesical pressure signal 532) may be received from a sensor (e.g., the sensor 534) configured to measure a vesical pressure in a bladder of a patient. At 804, an abdominal EMG signal (e.g., the EMG signal 530) may be received from an EMG electrode (e.g., the EMG electrode 504) configured to measure abdominal muscle activity of an abdomen of the patient. At 806, first vesical pressure data (e.g., the normalized vesical pressure data 586) associated with one or more provocative maneuvers of the patient may be determined based upon the vesical pressure signal. At 808, first abdominal EMG data (e.g., the normalized abdominal EMG data 588) associated with the one or more provocative maneuvers of the patient may be determined based upon the EMG signal. At 810, a urodynamic testing procedure for the patient may be triggered based upon a comparison of the first vesical pressure data with thefirst abdominal EMG data. For example, the urodynamic testing procedure for the patient may be triggered by outputting the testing procedure initiation signal 528. At 812, in response to triggering the urodynamic testing procedure, a detrusor pressure signal indicative of a detrusor pressure (e.g., the detrusor pressure 581 ) associated with the patient may be generated based upon the vesical pressure signal and / or the EMG signal. The detrusor pressure signal may be generated without receiving a signal, indicative of pressure measurements associated with the patient, from a second sensor coupled to a second catheter.

[0132] According to some embodiments, a method is provided. The method includes receiving a vesical pressure signal from a sensor of a urodynamic testing system, wherein the sensor is configured to measure a vesical pressure in a bladder of a patient; receiving an abdominal electromyography (EMG) signal from an EMG electrode of the urodynamic testing system, wherein the EMG electrode is configured to measure abdominal muscle activity of an abdomen of the patient; determining, based upon the vesical pressure signal, first vesical pressure data associated with one or more provocative maneuvers of the patient; determining, based upon the abdominal EMG signal, first abdominal EMG data associated with the one or more provocative maneuvers of the patient; and determining, based upon a comparison of the first vesical pressure data with the first abdominal EMG data, whether to implement a reconfiguration process for the urodynamic testing system or to implement a urodynamic testing procedure to be performed for the patient using the urodynamic testing system.

[0133] According to some embodiments, the method includes generating, based upon the first vesical pressure data and the first abdominal EMG data, estimated detrusor pressure data indicative of an estimated detrusor pressure over a first time period associated with the one or more provocative maneuvers; analyzing the estimated detrusor pressure data to identify a first set of data, of the estimated detrusor pressure data, associated with a first provocative maneuver of the one or more provocative maneuvers; and determining a first confidence score associated with the first set of data, wherein determining whether to implement the reconfiguration process or toimplement the urodynamic testing procedure is performed based upon the first confidence score.

[0134] According to some embodiments, the method includes implementing the urodynamic testing procedure based upon at least one of the first confidence score meeting a threshold confidence score; or a second confidence score, determined based upon the first confidence score, meeting the threshold confidence score.

[0135] According to some embodiments, the method includes implementing the reconfiguration process based upon at least one of the first confidence score not meeting a threshold confidence score; or a second confidence score, determined based upon the first confidence score, not meeting the threshold confidence score.

[0136] According to some embodiments, the method includes analyzing the first abdominal EMG data to identify a set of abdominal EMG data associated with a first provocative maneuver of the one or more provocative maneuvers; determining one or more first attributes of the set of abdominal EMG data; generating a first attribute vector based upon the one or more first attributes; analyzing the first vesical pressure data to identify a set of vesical pressure data associated with the first provocative maneuver; determining one or more second attributes from the set of vesical pressure data; generating a second attribute vector based upon the one or more second attributes; and determining a distance between the first attribute vector and the second attribute vector.

[0137] According to some embodiments, the one or more first attributes include at least one of a first amplitude or a first width of a waveform of the set of abdominal EMG data; and the one or more second attributes include at least one of a second amplitude or a second width of a waveform of the set of vesical pressure data.

[0138] According to some embodiments, the method includes implementing the urodynamic testing procedure based upon the distance not meeting a threshold distance.

[0139] According to some embodiments, the method includes implementing the reconfiguration process based upon the distance meeting a threshold distance.

[0140] According to some embodiments, the method includes determining a correlation score associated with a correlation between the first vesical pressure data and the first abdominal EMG data, wherein determining whether to implement the reconfiguration process or to implement the urodynamic testing procedure is performed based upon the correlation score.

[0141] According to some embodiments, the method includes implementing the urodynamic testing procedure based upon the correlation score meeting a threshold correlation score.

[0142] According to some embodiments, the method includes implementing the reconfiguration process based upon the correlation score not meeting a threshold correlation score.

[0143] According to some embodiments, the method includes determining a signal quality metric associated with the abdominal EMG signal, wherein determining whether to implement the reconfiguration process or to implement the urodynamic testing procedure is performed based upon the signal quality metric.

[0144] According to some embodiments, the method includes implementing the urodynamic testing procedure based upon the signal quality metric meeting a threshold signal quality metric.

[0145] According to some embodiments, the method includes implementing the reconfiguration process based upon the signal quality metric not meeting a threshold signal quality metric.

[0146] According to some embodiments, the method includes implementing the reconfiguration process based upon the comparison, wherein implementing the reconfiguration process includes outputting an alert indicative of the reconfiguration process via an alert element of the urodynamic testing system.

[0147] According to some embodiments, the method includes implementing the reconfiguration process based upon the comparison, wherein implementing the reconfiguration process includes adjusting at least one of the sensor, a catheter to which the sensor is coupled, a connection between the sensor and the catheter, a connection between the sensor and an acquisition module, the EMG electrode, or a connection between the EMG electrode and the acquisition module.

[0148] According to some embodiments, the method includes implementing the urodynamic testing procedure based upon the comparison, wherein implementing the urodynamic testing procedure includes generating a detrusor pressure signal indicative of a detrusor pressure associated with the patient based upon the vesical pressure signal and the abdominal EMG signal.

[0149] According to some embodiments, the sensor is coupled to a catheter configured for insertion into a bladder region of the patient; and generating the detrusor pressure signal is performed without receiving a signal, indicative of pressure measurements associated with the patient, from a second sensor coupled to a second catheter.

[0150] According to some embodiments, generating the detrusor pressure signal includes analyzing at least one of the vesical pressure signal or the abdominal EMG signal to detect an abdominal event; and generating the detrusor pressure signal based upon the abdominal event.

[0151] According to some embodiments, generating the detrusor pressure signal includes analyzing the vesical pressure signal to identify a waveform including a vesical pressure signal strength value that exceeds an average vesical pressure signal strength by at least a threshold value; determining, based upon the abdominal EMG signal, that the waveform is associated with an abdominal event; and generating the detrusor pressure signal based upon the abdominal event.

[0152] According to some embodiments, the sensor is coupled to a catheter configured for insertion into a bladder region of the patient.

[0153] According to some embodiments, a non-transitory computer- readable medium is provided. The non-transitory computer-readable medium stores instructions that when executed perform operations including receiving a vesical pressure signal from a sensor of a urodynamic testing system, wherein the sensor is configured to measure a vesical pressure in a bladder of a patient; receiving an abdominal electromyography (EMG) signal from an EMG electrode of the urodynamic testing system, wherein the EMG electrode is configured to measure abdominal muscle activity of an abdomen of the patient; determining a delay between the vesical pressure signal and the abdominal EMG signal; and generating a detrusor pressure signal indicative of a detrusor pressure associated with the patient based upon the delay, the vesical pressure signal, and the abdominal EMG signal.

[0154] According to some embodiments, the operations include analyzing at least one of the vesical pressure signal or the abdominal EMG signal to detect an abdominal event; and generating the detrusor pressure signal based upon the abdominal event.

[0155] According to some embodiments, the operations include analyzing the vesical pressure signal to identify a waveform; determining, based upon the abdominal EMG signal, that the waveform is associated with an abdominal event; and generating the detrusor pressure signal based upon the abdominal event.

[0156] According to some embodiments, the operations include analyzing the vesical pressure signal to identify a waveform; determining, based upon the abdominal EMG signal, that the waveform is associated with an abdominal event; and generating the detrusor pressure signal based upon the abdominal event.

[0157] According to some embodiments, the sensor is coupled to a catheter configured for insertion into the bladder.

[0158] According to some embodiments, generating the detrusor pressure signal is performed without receiving a signal, indicative of pressure measurements associated with the patient, from a second sensor coupled to a second catheter.

[0159] According to some embodiments, a computing device is provided. The computing device includes a processor and memory including processor-executable instructions that when executed by the processor cause performance of operations, the operations including receiving a vesical pressure signal from a sensor, wherein the sensor is configured to measure a vesical pressure in a bladder of a patient; receiving an abdominal electromyography (EMG) signal from an EMG electrode, wherein the EMG electrode is configured to measure abdominal muscle activity of an abdomen of the patient; determining, based upon the vesical pressure signal, first vesical pressure data associated with one or more provocative maneuvers of the patient; determining, based upon the abdominal EMG signal, first abdominal EMG data associated with the one or more provocative maneuvers of the patient; triggering a urodynamic testing procedure for the patient based upon a comparison of the first vesical pressure data with the first abdominal EMG data; and in response to triggering the urodynamic testing procedure, generating a detrusor pressure signal indicative of a detrusor pressure associated with the patient based upon the vesical pressure signal and the abdominal EMG signal.

[0160] According to some embodiments, generating the detrusor pressure signal includes analyzing at least one of the vesical pressure signal or the abdominal EMG signal to detect an abdominal event; and generating the detrusor pressure signal based upon the abdominal event.

[0161] According to some embodiments, generating the detrusor pressure signal includes analyzing the vesical pressure signal to identify a waveform; determining, based upon the abdominal EMG signal, that the waveform is associated with an abdominal event; and generating the detrusor pressure signal based upon the abdominal event.

[0162] According to some embodiments, generating the detrusor pressure signal includes analyzing the vesical pressure signal to identify a waveform; determining, based upon the abdominal EMG signal, that the waveform is associated with an abdominal event; and generating the detrusor pressure signal based upon the abdominal event.

[0163] According to some embodiments, the sensor is coupled to a catheter configured for insertion into the bladder.

[0164] According to some embodiments, generating the detrusor pressure signal is performed without receiving a signal, indicative of pressure measurements associated with the patient, from a second sensor coupled to a second catheter.

[0165] According to some embodiments, a method is provided. The method includes receiving a vesical pressure signal from a sensor of a urodynamic testing system, wherein: the sensor is coupled to a catheter configured for insertion into a bladder of a patient, and the sensor is configured to measure a vesical pressure in the bladder; receiving an abdominal electromyography (EMG) signal from an EMG electrode of the urodynamic testing system, wherein the EMG electrode is configured to measure abdominal muscle activity of an abdomen of the patient; and generating a detrusor pressure signal indicative of a detrusor pressure associated with the patient based upon the vesical pressure signal and the abdominal EMG signal, wherein generating the detrusor pressure signal is performed without receiving a signal, indicative of pressure measurements associated with the patient, from a second sensor coupled to a second catheter.

[0166] According to some embodiments, the method includes analyzing at least one of the vesical pressure signal or the abdominal EMG signal to detect an abdominal event; and generating the detrusor pressure signal based upon the abdominal event.

[0167] According to some embodiments, the method includes analyzing the vesical pressure signal to identify a waveform; determining, based upon the abdominal EMG signal, that the waveform is associated with an abdominal event; and generating the detrusor pressure signal based upon the abdominal event.

[0168] According to some embodiments, the method includes analyzing the vesical pressure signal to identify a waveform; determining, based upon the abdominal EMG signal, that the waveform is associated with anabdominal event; and generating the detrusor pressure signal based upon the abdominal event.

[0169] According to some embodiments, a method is provided which includes at least one aspect as described in the present disclosure and / or shown in the figures.

[0170] According to some embodiments, a method is provided which includes plural aspects as described in the present disclosure and / or shown in the figures.

[0171] According to some embodiments, a system is provided which includes at least one aspect as described in the present disclosure and / or shown in the figures.

[0172] According to some embodiments, a system is provided which includes plural aspects as described in the present disclosure and / or shown in the figures.

[0173] Fig. 9 is an illustration of a scenario 900 involving an example non-transitory machine readable medium 902. The non-transitory machine readable medium 902 may comprise processor-executable instructions 912 that when executed by a processor 916 cause performance (e.g., by the processor 916) of at least some of the provisions herein (e.g., embodiment 914).

[0174] The non-transitory machine readable medium 902 may comprise a memory semiconductor (e.g., a semiconductor utilizing static random access memory (SRAM), dynamic random access memory (DRAM), and / or synchronous dynamic random access memory (SDRAM) technologies), a platter of a hard disk drive, a flash memory device, or a magnetic or optical disc (such as a compact disc (CD), digital versatile disc (DVD), or floppy disk).

[0175] The example non-transitory machine readable medium 902 stores computer-readable data 904 that, when subjected to reading 906 by a reader 910 of a device 908 (e.g., a read head of a hard disk drive, or a read operation invoked on a solid-state storage device), express the processorexecutable instructions 912.

[0176] In some embodiments, the processor-executable instructions 912, when executed, cause performance of operations, such as at least some of the example method 400 of Fig. 4, at least some of the example method 600 of Fig. 6, at least some of the example method 700 of Fig. 7, and / or at least some of the example method 800 of Fig. 8, for example. In some embodiments, the processor-executable instructions 912 are configured to cause implementation of a system, such as at least some of the example system 501 of Figs. 5A-5K, for example.

[0177] As used in this application, "component," "module," "system", "interface", and / or the like are generally intended to refer to a computer- related entity, either hardware, a combination of hardware and software, software, or software in execution. For example, a component may be, but is not limited to being, a process running on a processor, a processor, an object, an executable, a thread of execution, a program, and / or a computer. By way of illustration, both an application running on a controller and the controller can be a component. One or more components may reside within a process and / or thread of execution and a component may be localized on one computer and / or distributed between two or more computers.

[0178] Unless specified otherwise, “first,” “second,” and / or the like are not intended to imply a temporal aspect, a spatial aspect, an ordering, etc. Rather, such terms are merely used as identifiers, names, etc. for features, elements, items, etc. For example, a first object and a second object generally correspond to object A and object B or two different or two identical objects or the same object.

[0179] Moreover, "example" is used herein to mean serving as an instance, illustration, etc., and not necessarily as advantageous. As used herein, "or" is intended to mean an inclusive "or" rather than an exclusive "or". In addition, "a" and "an" as used in this application are generally be construed to mean "one or more" unless specified otherwise or clear from context to be directed to a singular form. Also, at least one of A and B and / or the like generally means A or B or both A and B. Furthermore, to the extent that "includes", "having", "has", "with", and / or variants thereof are used in eitherthe detailed description or the claims, such terms are intended to be inclusive in a manner similar to the term "comprising”.

[0180] Although the subject matter has been described in language specific to structural features and / or methodological acts, it is to be understood that the subject matter defined in the appended claims is not necessarily limited to the specific features or acts described above. Rather, the specific features and acts described above are disclosed as example forms of implementing at least some of the claims.

[0181] Furthermore, the claimed subject matter may be implemented as a method, apparatus, or article of manufacture using standard programming and / or engineering techniques to produce software, firmware, hardware, or any combination thereof to control a computer to implement the disclosed subject matter. The term "article of manufacture" as used herein is intended to encompass a computer program accessible from any computer- readable device, carrier, or media. Of course, many modifications may be made to this configuration without departing from the scope or spirit of the claimed subject matter.

[0182] Various operations of embodiments are provided herein. In an embodiment, one or more of the operations described may constitute computer readable instructions stored on one or more computer and / or machine readable media, which if executed will cause the operations to be performed. The order in which some or all of the operations are described should not be construed as to imply that these operations are necessarily order dependent. Alternative ordering will be appreciated by one skilled in the art having the benefit of this description. Further, it will be understood that not all operations are necessarily present in each embodiment provided herein. Also, it will be understood that not all operations are necessary in some embodiments.

[0183] Also, although the disclosure has been shown and described with respect to one or more implementations, equivalent alterations and modifications will occur to others skilled in the art based upon a reading and understanding of this specification and the annexed drawings. The disclosure includes all such modifications and alterations and is limited only by the scopeof the following claims. In particular regard to the various functions performed by the above described components (e.g., elements, resources, etc.), the terms used to describe such components are intended to correspond, unless otherwise indicated, to any component which performs the specified function of the described component (e.g., that is functionally equivalent), even though not structurally equivalent to the disclosed structure. In addition, while a particular feature of the disclosure may have been disclosed with respect to only one of several implementations, such feature may be combined with one or more other features of the other implementations as may be desired and advantageous for any given or particular application.

Claims

CLAIMSWhat is claimed is:1 . A method, comprising: receiving a vesical pressure signal from a sensor of a urodynamic testing system, wherein the sensor is configured to measure a vesical pressure in a bladder of a patient; receiving an abdominal electromyography (EMG) signal from an EMG electrode of the urodynamic testing system, wherein the EMG electrode is configured to measure abdominal muscle activity of an abdomen of the patient; determining, based upon the vesical pressure signal, first vesical pressure data associated with one or more provocative maneuvers of the patient; determining, based upon the abdominal EMG signal, first abdominal EMG data associated with the one or more provocative maneuvers of the patient; and determining, based upon a comparison of the first vesical pressure data with the first abdominal EMG data, whether to implement a reconfiguration process for the urodynamic testing system or to implement a urodynamic testing procedure to be performed for the patient using the urodynamic testing system.

2. The method of claim 1 , comprising: generating, based upon the first vesical pressure data and the first abdominal EMG data, estimated detrusor pressure data indicative of an estimated detrusor pressure over a first time period associated with the one or more provocative maneuvers; analyzing the estimated detrusor pressure data to identify a first set of data, of the estimated detrusor pressure data, associated with a first provocative maneuver of the one or more provocative maneuvers; and determining a first confidence score associated with the first set of data, wherein determining whether to implement the reconfiguration process63or to implement the urodynamic testing procedure is performed based upon the first confidence score.

3. The method of claim 2, comprising: implementing the urodynamic testing procedure based upon at least one of: the first confidence score meeting a threshold confidence score; or a second confidence score, determined based upon the first confidence score, meeting the threshold confidence score.

4. The method of claim 2, comprising: implementing the reconfiguration process based upon at least one of: the first confidence score not meeting a threshold confidence score; or a second confidence score, determined based upon the first confidence score, not meeting the threshold confidence score.

5. The method of claim 1 , comprising: analyzing the first abdominal EMG data to identify a set of abdominal EMG data associated with a first provocative maneuver of the one or more provocative maneuvers; determining one or more first attributes of the set of abdominal EMG data; generating a first attribute vector based upon the one or more first attributes; analyzing the first vesical pressure data to identify a set of vesical pressure data associated with the first provocative maneuver; determining one or more second attributes from the set of vesical pressure data; generating a second attribute vector based upon the one or more second attributes; and determining a distance between the first attribute vector and the second attribute vector.

646. The method of claim 5, wherein: the one or more first attributes comprise at least one of a first amplitude or a first width of a waveform of the set of abdominal EMG data; and the one or more second attributes comprise at least one of a second amplitude or a second width of a waveform of the set of vesical pressure data.

7. The method of claim 5, comprising: implementing the urodynamic testing procedure based upon the distance not meeting a threshold distance.

8. The method of claim 5, comprising: implementing the reconfiguration process based upon the distance meeting a threshold distance.

9. The method of claim 1 , comprising: determining a correlation score associated with a correlation between the first vesical pressure data and the first abdominal EMG data, wherein determining whether to implement the reconfiguration process or to implement the urodynamic testing procedure is performed based upon the correlation score.

10. The method of claim 9, comprising: implementing the urodynamic testing procedure based upon the correlation score meeting a threshold correlation score.11 . The method of claim 9, comprising: implementing the reconfiguration process based upon the correlation score not meeting a threshold correlation score.

12. The method of claim 1 , comprising: determining a signal quality metric associated with the abdominal EMG signal, wherein determining whether to implement the reconfiguration process65or to implement the urodynamic testing procedure is performed based upon the signal quality metric.

13. The method of claim 12, comprising: implementing the urodynamic testing procedure based upon the signal quality metric meeting a threshold signal quality metric.

14. The method of claim 1 , comprising: implementing the reconfiguration process based upon the signal quality metric not meeting a threshold signal quality metric.

15. The method of claim 1 , comprising: implementing the reconfiguration process based upon the comparison, wherein implementing the reconfiguration process comprises outputting an alert indicative of the reconfiguration process via an alert element of the urodynamic testing system.

16. The method of claim 1 , comprising: implementing the reconfiguration process based upon the comparison, wherein implementing the reconfiguration process comprises adjusting at least one of the sensor, a catheter to which the sensor is coupled, a connection between the sensor and the catheter, a connection between the sensor and an acquisition module, the EMG electrode, or a connection between the EMG electrode and the acquisition module.

17. The method of claim 1 , comprising: implementing the urodynamic testing procedure based upon the comparison, wherein implementing the urodynamic testing procedure comprises generating a detrusor pressure signal indicative of a detrusor pressure associated with the patient based upon the vesical pressure signal and the abdominal EMG signal.

18. The method of claim 17, wherein:66the sensor is coupled to a catheter configured for insertion into a bladder region of the patient; and generating the detrusor pressure signal is performed without receiving a signal, indicative of pressure measurements associated with the patient, from a second sensor coupled to a second catheter.

19. The method of claim 17, wherein generating the detrusor pressure signal comprises: analyzing at least one of the vesical pressure signal or the abdominal EMG signal to detect an abdominal event; and generating the detrusor pressure signal based upon the abdominal event.

20. The method of claim 17, wherein generating the detrusor pressure signal comprises: analyzing the vesical pressure signal to identify a waveform comprising a vesical pressure signal strength value that exceeds an average vesical pressure signal strength by at least a threshold value; determining, based upon the abdominal EMG signal, that the waveform is associated with an abdominal event; and generating the detrusor pressure signal based upon the abdominal event.21 . The method of claim 1 , wherein: the sensor is coupled to a catheter configured for insertion into a bladder region of the patient.

22. A non-transitory computer-readable medium storing instructions that when executed perform operations comprising: receiving a vesical pressure signal from a sensor of a urodynamic testing system, wherein the sensor is configured to measure a vesical pressure in a bladder of a patient; receiving an abdominal electromyography (EMG) signal from an EMG electrode of the urodynamic testing system, wherein the EMG electrode is67configured to measure abdominal muscle activity of an abdomen of the patient; determining a delay between the vesical pressure signal and the abdominal EMG signal; and generating a detrusor pressure signal indicative of a detrusor pressure associated with the patient based upon the delay, the vesical pressure signal, and the abdominal EMG signal.

23. The non-transitory computer-readable medium of claim 22, the operations comprising: analyzing at least one of the vesical pressure signal or the abdominal EMG signal to detect an abdominal event; and generating the detrusor pressure signal based upon the abdominal event.

24. The non-transitory computer-readable medium of claim 22, the operations comprising: analyzing the vesical pressure signal to identify a waveform; determining, based upon the abdominal EMG signal, that the waveform is associated with an abdominal event; and generating the detrusor pressure signal based upon the abdominal event.

25. The non-transitory computer-readable medium of claim 22, the operations comprising: analyzing the vesical pressure signal to identify a waveform; determining, based upon the abdominal EMG signal, that the waveform is associated with an abdominal event; and generating the detrusor pressure signal based upon the abdominal event.

26. The non-transitory computer-readable medium of claim 22, wherein: the sensor is coupled to a catheter configured for insertion into the bladder.

27. The non-transitory computer-readable medium of claim 26, wherein: generating the detrusor pressure signal is performed without receiving a signal, indicative of pressure measurements associated with the patient, from a second sensor coupled to a second catheter.

28. A computing device comprising: a processor; and memory comprising processor-executable instructions that when executed by the processor cause performance of operations, the operations comprising: receiving a vesical pressure signal from a sensor, wherein the sensor is configured to measure a vesical pressure in a bladder of a patient; receiving an abdominal electromyography (EMG) signal from an EMG electrode, wherein the EMG electrode is configured to measure abdominal muscle activity of an abdomen of the patient; determining, based upon the vesical pressure signal, first vesical pressure data associated with one or more provocative maneuvers of the patient; determining, based upon the abdominal EMG signal, first abdominal EMG data associated with the one or more provocative maneuvers of the patient; triggering a urodynamic testing procedure for the patient based upon a comparison of the first vesical pressure data with the first abdominal EMG data; and in response to triggering the urodynamic testing procedure, generating a detrusor pressure signal indicative of a detrusor pressure associated with the patient based upon the vesical pressure signal and the abdominal EMG signal.

29. The computing device of claim 28, wherein generating the detrusor pressure signal comprises: analyzing at least one of the vesical pressure signal or the abdominal EMG signal to detect an abdominal event; andgenerating the detrusor pressure signal based upon the abdominal event.

30. The computing device of claim 28, wherein generating the detrusor pressure signal comprises: analyzing the vesical pressure signal to identify a waveform; determining, based upon the abdominal EMG signal, that the waveform is associated with an abdominal event; and generating the detrusor pressure signal based upon the abdominal event.31 . The computing device of claim 28, wherein generating the detrusor pressure signal comprises: analyzing the vesical pressure signal to identify a waveform; determining, based upon the abdominal EMG signal, that the waveform is associated with an abdominal event; and generating the detrusor pressure signal based upon the abdominal event.

32. The computing device of claim 28, wherein: the sensor is coupled to a catheter configured for insertion into the bladder.

33. The computing device of claim 32, wherein: generating the detrusor pressure signal is performed without receiving a signal, indicative of pressure measurements associated with the patient, from a second sensor coupled to a second catheter.

34. A method, comprising: receiving a vesical pressure signal from a sensor of a urodynamic testing system, wherein: the sensor is coupled to a catheter configured for insertion into a bladder of a patient; andthe sensor is configured to measure a vesical pressure in the bladder; receiving an abdominal electromyography (EMG) signal from an EMG electrode of the urodynamic testing system, wherein the EMG electrode is configured to measure abdominal muscle activity of an abdomen of the patient; and generating a detrusor pressure signal indicative of a detrusor pressure associated with the patient based upon the vesical pressure signal and the abdominal EMG signal, wherein generating the detrusor pressure signal is performed without receiving a signal, indicative of pressure measurements associated with the patient, from a second sensor coupled to a second catheter.

35. The method of claim 34, comprising: analyzing at least one of the vesical pressure signal or the abdominal EMG signal to detect an abdominal event; and generating the detrusor pressure signal based upon the abdominal event.

36. The method of claim 34, comprising: analyzing the vesical pressure signal to identify a waveform; determining, based upon the abdominal EMG signal, that the waveform is associated with an abdominal event; and generating the detrusor pressure signal based upon the abdominal event.

37. The method of claim 34, comprising: analyzing the vesical pressure signal to identify a waveform; determining, based upon the abdominal EMG signal, that the waveform is associated with an abdominal event; and generating the detrusor pressure signal based upon the abdominal event.

38. A method, comprising:71at least one aspect as described in any one of the preceding claims.72

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