Unfortunately, there is a large number of women that for various reasons are unable to empty their bladder independently. This problem can be caused by neurological afflictions, such as multiple sclerosis (MS) or spinal injury. It can also occur after extremely prolonged labor, or when the bladder, by whatever cause, is not emptied (urinary retention). Unfortunately, some patients require a permanent indwelling urinary catheter which often causes significant discomfort and complications, such as infections. Others can solve the problem with intermittent self-catheterization; emptying the bladder at regular intervals during the day. This method is much less burdensome and is known to cause fewer complications. To make self-catheterization as easy as possible, MMID, on the initiative of Martin Bucx, anesthesiologist at Radboud University Medical Center developed a tool that is far more effective than previously available. This tool ensures more women are eligible for self-catheterization, and it provides them with the option to catheterize outside the home, for instance in a public restroom. This helps the user to keep their independence and to experience only minor limitations in their social activities.
Picture by Marlou Pulles
Self-catheterization isn’t necessarily easy to do; it requires a proper view of the urethral opening and excellent dexterity. This could cause issues, particularly for women with poor eyesight, limited motor skills, and older women. Martin Bucx noticed this when his mother, after an operation, became reliant on self-catheterization for the rest of her life. “The problem was that my mother just couldn’t see what she was doing. I searched everywhere for an effective tool, but unfortunately, it just didn’t exist yet.”
He realized the ideal tool had to have a mirror that could be placed on the seat of an average toilet and it had to have a lamp, to help the user see what exactly she is doing. That will give her a stable and good view, and she will have both hands free to insert the catheter. He assembled a prototype using a shaving mirror and bicycle lamp bought at the HEMA (a Dutch home goods retail store) and material found at a DIY store. This prototype proved both simple and effective. “After I came into contact with MMID, we detailed this idea together. It took some time, but now there finally is a product on the market that will help people like my mother.”
Usable everywhere and always
Tijs Driessen, Producibility Designer at MMID, was closely involved with the development of Bright Mirror. “We translated Martin Bucx’s idea to a simple and user-friendly product. The user can easily clamp the product to the toilet seat, and the light goes on when the product is flipped open, giving the user a better view of what they are doing. The product can be cleaned under the tap after use because it is splash proof. The device also has a micro USB port for easy charging. We deliberately chose to use a Li-ion battery. Normal alkaline batteries grow steadily weaker, leaving you to wonder when to change them, as you don’t want to throw out half empty batteries, but need the light to shine at full strength. Batteries tend to give issues after you drop or knock them, as they lose electrical contact. Just think of your tv’s remote control. That’s not what the user wants. And they certainly don’t want that, if that means they need a screwdriver to pry open the cover. That may be doable at home, but it would be very irritating in a public toilet. The rechargeable battery is soldered in place and will not lose contact after a fall or knock. A fully charged Bright lasts about 1 or 2 weeks and can be charged in an electrical outlet at the user’s convenience. These kinds of deliberate choices make this a highly user-friendly product.”
Focus on the User
The internal client was Caspar Steenhuijsen, CEO and owner of MMID: “User-friendliness was our central focus during the development process. Every design choice we have made is fully tailored to the user. We have done an incredible amount of user tests with the help of patients at Radboudumc. We even recruited two graduates from Sweden to help with the testing phase, and this resulted in many new insights. The first prototype we tested proved much too complex, and that is why we simplified the design considerably. We also made sure the design has a modern and fresh look and feel, instead of a stigmatizing appearance.”
Other important technical challenges, besides effectiveness, were waterproofness and hygiene, since the product contains electronics that drive the lighting and the user must be able to clean the product easily. Tijs explains, “We separated the design into three elements, namely the part containing the mirror and electronics, a clamp that attaches to the toilet seat, and a flexible watertight cover for the USB port. Each part easily clicks together, no screws are required. The mirror is glued to the casing with waterproof tape, which not only makes the product easy to use but also quick to assemble. We have truly considered every stakeholder in this project.”
Last week, we delivered the first products to Astellas, a forward-thinking company that introduces innovative pharmaceutical products worldwide. Tijs says, “I think it’s remarkable that MMID did not take on this project for the financial gain. It’ll probably take years before we will recoup the investment. Helping people like Martin’s mum was the primary goal. During one of the many user tests, we gave the mirror to a 16-year-old girl. Up till then, she hadn’t succeeded in catheterizing herself. Using our product she succeeded on the first try and was so elated, she didn’t want to return it to us. What an amazing way to learn you have developed a great product! Of course, we presented her with the first product. To me, this is precisely what MMID stands for: achieving value together”.