Systems, devices and methods for assessment of body cavity pressures

Abstract

Systems, devices and methods that can be used to obtain objective pressure measurements in a body cavity using one or more monitoring bladders mounted on a catheter. The monitoring bladders may be adapted to connect or be connected to a system capable of providing objective pressure measurements indicative of the compressive forces acting on the one or more monitoring bladder in the body cavity. The body cavity may include, for example, the rectum, esophagus, stomach, intestine, colon, reproductive tract, urethra, oronasopharnygeal tract, etc.

1 . A body cavity pressure measurement system comprising:
 a pressure measuring device that comprises:
 a catheter comprising a proximal end and a distal end, wherein a longitudinal axis extends along the catheter through the proximal end and the distal end; 
 a distention device mounted on the catheter proximate the distal end of the catheter, wherein the distention device is expandable and collapsible between a collapsed configuration and a distended configuration; 
 a monitoring bladder mounted on the catheter at a location proximal to the distention device, wherein the monitoring bladder is movable along the catheter between a first position proximate the distention device and a second position located proximal of the first position; and 
 a monitoring lumen extending proximally through at least a portion of the catheter from the monitoring bladder towards the proximal end of the catheter, wherein the monitoring lumen is in fluid communication with an interior of the monitoring bladder such that a fluid pressure in the monitoring bladder is communicated through the monitoring lumen; and 
   pressure monitoring apparatus operably connected to the monitoring bladder of the pressure measuring device through the monitoring lumen, wherein the pressure monitoring apparatus is configured to determine the fluid pressure in the monitoring bladder by measuring fluid pressure in the monitoring lumen at a proximal end of the monitoring lumen.   
     
     
         2 . A system according to  claim 1 , wherein the distention device is mounted at a fixed position on the catheter. 
     
     
         3 . A system according to  claim 1 , wherein, in the distended configuration, the distention device comprises a maximum transverse dimension that is larger than a maximum transverse dimension of the pressure measuring device in the length occupied by the monitoring bladder, wherein the maximum transverse dimensions are measured transverse to the longitudinal axis. 
     
     
         4 . A system according to  claim 1 , wherein the distention device comprises an inflatable chamber that is inflated to expand the distention device to the distended configuration and wherein the inflatable chamber is deflated to collapse the distention device to the collapsed configuration. 
     
     
         5 . A system according to  claim 4 , further comprising a distention lumen extending proximally through at least a portion of the catheter from the distention device towards the proximal end of the catheter, wherein the distention lumen is in fluid communication with the inflatable chamber. 
     
     
         6 . A system according to  claim 1 , wherein the catheter comprises a movable sleeve positioned proximal of the distention device, wherein the monitoring bladder is mounted on the movable sleeve, and wherein the movable sleeve moves along the catheter when the monitoring bladder moves along the catheter between the first position proximate the distention device and the second position located proximal of the first position of the catheter. 
     
     
         7 . A system according to  claim 1 , further comprising an inflation lumen extending proximally through at least a portion of the catheter from the monitoring bladder towards the proximal end of the catheter, wherein the inflation lumen is in fluid communication with the interior of the monitoring bladder fluid can be delivered to the monitoring bladder through the inflation lumen. 
     
     
         8 . A system according to  claim 7 , wherein the inflation lumen and the monitoring lumen are different lumens. 
     
     
         9 . (canceled) 
     
     
         10 . A system according to  claim 1 , wherein the pressure measuring device comprises two or more monitoring bladders and two or more monitoring lumens;
 wherein each monitoring bladder of the two or more monitoring bladders is mounted on the catheter at a location proximal to the distention device, wherein each monitoring bladder is movable along the catheter between a first position proximate the distention device and a second position located proximal of the first position; and   wherein each monitoring lumen of the two or more monitoring lumens extends proximally through at least a portion of the catheter from the monitoring bladder towards the proximal end of the catheter, wherein each monitoring lumen is in fluid communication with an interior of one monitoring bladder such that a fluid pressure in the one monitoring bladder is communicated through the monitoring lumen.   
     
     
         11 . A system according to  claim 10 , wherein the two or more monitoring bladders are positioned about a periphery of the catheter at the same longitudinal position, wherein each monitoring bladder occupies only a portion of the periphery of the catheter. 
     
     
         12 . A system according to  claim 1 , wherein the system further comprises:
 a medical electrode mounted on the catheter proximate the monitoring bladder;   an electrical lead operably connected to the medical electrode and extending proximally through at least a portion of the catheter; and   electrical monitoring apparatus operably connected to the medical electrode through the electrical lead, wherein the electrical monitoring apparatus is configured to detect electrical activity in tissue contacting the medical lead.   
     
     
         13 . A system according to  claim 12 , wherein the medical electrode is attached to an expandable support that is expandable and collapsible between a collapsed configuration and an expanded configuration, wherein the medical electrode is closer to the catheter when the expandable support is in the collapsed configuration than when the expandable support is in the expanded configuration. 
     
     
         14 - 15 . (canceled) 
     
     
         16 . A body cavity pressure measuring device that comprises:
 a catheter comprising a proximal end and a distal end;   a distention device mounted on the catheter proximate the distal end of the catheter, wherein the distention device is expandable and collapsible between a collapsed configuration and a distended configuration;   a monitoring bladder mounted on the catheter at a location proximal to the distention device, wherein the monitoring bladder is movable along the catheter between a first position proximate the distention device and a second position located proximal of the first position; and   a monitoring lumen extending proximally through at least a portion of the catheter from the monitoring bladder towards the proximal end of the catheter, wherein the monitoring lumen is in fluid communication with an interior of the monitoring bladder such that a fluid pressure in the monitoring bladder is communicated through the monitoring lumen.   
     
     
         17 . A device according to  claim 16 , wherein the distention device is mounted at a fixed position on the catheter. 
     
     
         18 . A device according to according to  claim 16 , wherein, in the distended configuration, the distention device comprises a maximum transverse dimension that is larger than a maximum transverse dimension of the pressure measuring device in the length occupied by the monitoring bladder, wherein the maximum transverse dimensions are measured transverse to the longitudinal axis. 
     
     
         19 . A device according to according to  claim 16 , wherein the distention device comprises an inflatable chamber that is inflated to expand the distention device to the distended configuration and wherein the inflatable chamber is deflated to collapse the distention device to the collapsed configuration. 
     
     
         20 . A device according to  claim 19 , further comprising a distention lumen extending proximally through at least a portion of the catheter from the distention device towards the proximal end of the catheter, wherein the distention lumen is in fluid communication with the inflatable chamber. 
     
     
         21 . A device according to according to  claim 16 , wherein the catheter comprises a movable sleeve positioned proximal of the distention device, wherein the monitoring bladder is mounted on the movable sleeve, and wherein the movable sleeve moves along the catheter when the monitoring bladder moves along the catheter between the first position proximate the distention device and the second position located proximal of the first position of the catheter. 
     
     
         22 . A device according to  claim 16 , further comprising an inflation lumen extending proximally through at least a portion of the catheter from the monitoring bladder towards the proximal end of the catheter, wherein the inflation lumen is in fluid communication with the interior of the monitoring bladder fluid can be delivered to the monitoring bladder through the inflation lumen. 
     
     
         23 . A device according to  claim 22 , wherein the inflation lumen and the monitoring lumen are different lumens. 
     
     
         24 . (canceled) 
     
     
         25 . A device according to according to  claim 16 , wherein the device comprises two or more monitoring bladders and two or more monitoring lumens;
 wherein each monitoring bladder of the two or more monitoring bladders is mounted on the catheter at a location proximal to the distention device, wherein each monitoring bladder is movable along the catheter between a first position proximate the distention device and a second position located proximal of the first position; and   wherein each monitoring lumen of the two or more monitoring lumens extends proximally through at least a portion of the catheter from the monitoring bladder towards the proximal end of the catheter, wherein each monitoring lumen is in fluid communication with an interior of one monitoring bladder such that a fluid pressure in the one monitoring bladder is communicated through the monitoring lumen.   
     
     
         26 . A device according to  claim 25 , wherein the two or more monitoring bladders are positioned about a periphery of the catheter at the same longitudinal position, wherein each monitoring bladder occupies only a portion of the periphery of the catheter. 
     
     
         27 . A device according to according to  claim 16 , wherein the device further comprises:
 a medical electrode mounted on the catheter proximate the monitoring bladder; and   an electrical lead operably connected to the medical electrode and extending proximally through at least a portion of the catheter.   
     
     
         28 . A device according to  claim 27 , wherein the medical electrode is attached to an expandable support that is expandable and collapsible between a collapsed configuration and an expanded configuration, wherein the medical electrode is closer to the catheter when the expandable support is in the collapsed configuration than when the expandable support is in the expanded configuration. 
     
     
         29 - 30 . (canceled) 
     
     
         31 . A method of monitoring internal body cavity pressures comprising:
 locating a device in a body cavity, wherein the device comprises:
 a catheter comprising a proximal end and a distal end; 
 a distention device mounted on the catheter proximate the distal end of the catheter, wherein the distention device is expandable and collapsible between a collapsed configuration and a distended configuration; 
 a monitoring bladder mounted on the catheter at a location proximal to the distention device, wherein the monitoring bladder is movable along the catheter between a first position proximate the distention device and a second position located proximal of the first position; and 
 a monitoring lumen extending proximally through at least a portion of the catheter from the monitoring bladder towards the proximal end of the catheter, wherein the monitoring lumen is in fluid communication with an interior of the monitoring bladder such that a fluid pressure in the monitoring bladder is communicated through the monitoring lumen; 
   expanding the distention device;   monitoring pressure exerted on the monitoring bladder by the body cavity; and   moving the monitoring bladder relative to the distention device to monitor pressure exerted on the monitoring bladder at two or more locations relative to the body cavity while holding the distention device stationary relative to the body cavity.