John E. Speich, Ph.D.

Interim Chair and Professor, Department of Mechanical and Nuclear Engineering

  • Engineering East Hall, Room E3254, Richmond VA UNITED STATES
jespeich@vcu.edu

Engineering and program development expert with research focused on bladder biomechanics and robotics

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Biography

Professor of Mechanical Engineering since 2018
Director of Cooperative Education for the VCU School of Engineering since 2015
Associate Chair of the VCU Department of Mechanical & Nuclear Engineering since 2010
Director of Undergraduate Studies for Mechanical Engineering since 2007
Associate Professor of Mechanical Engineering 2007 - 2018
Assistant Professor of Mechanical Engineering 2001- 2007

Industry Expertise

Education/Learning
Research
Mechanical/Industrial Engineering
Medical Devices

Areas of Expertise

Cooperative Education
Engineering Education
Mechanical Engineering
Robotics
Medical Devices
Smooth muscle biomechanics
Bladder biomechanics and urodynamics
Expert Witness

Education

Vanderbilt University

Ph.D.

Mechanical Engineering

2001

Vanderbilt University

M.S.

Mechanical Engineering

1997

Tennessee Technological University

B.S.

Mechanical Engineering

1995

Affiliations

  • American Society of Mechanical Engineers (ASME)
  • Society of Urodynamics Female Pelvic Medicine & Urogenital Reconstruction (SUFU)
  • American Urological Association (AUA)
  • International Continence Society (ICS)

Patents

Split-Tube Flexure

US Patent No. 6,585,445

2003-07-01

Goldfarb, M. and Speich, J., “Split-Tube Flexure,” United States patent number 6,585,445, Issued July 1, 2003.

Research Grants

The Detrusor Tension Sensor: A Model for Novel Cystometrics in Overactive Bladder

NIH - NIDDK

2015-08-20

Urinary urgency is the key symptom in Overactive Bladder (OAB) that occurs during the filling phase of micturition, and increased detrusor wall tension is thought to be a critical factor in the pathophysiology of OAB. However, because pressure increases little during bladder filling and does not reflect changes in detrusor wall tension, true filling phase physiology cannot be evaluated during clinical cystometrics. Thus, objective assessments of OAB using standard clinical cystometric testing are difficult or impossible. Furthermore, evaluation of OAB using verbal sensory thresholds recommended by the International Continence Society are subjective and poorly defined. Thus, there is a pressing need for a mechanistically relevant diagnostic test of OAB that incorporates objective metrics for the direct evaluation of detrusor wall tension. Using a systems model of the filling phase of micturition, the detrusor smooth muscle and its in-series tension sensitive afferent nerves can be represented as a tension sensor with a definable input (volume), a continuously measurable output (urgency), and objectively measurable biomechanical parameters that affect the load on the tension sensor. Based on our previous investigations and the work of others, we have identified the following biomechanical parameters that can directly affect the load on the detrusor tension sensor during filling: bladder geometry, dynamic compliance, and spontaneous rhythmic contractions. In the current proposal, we will develop novel cystometric tests to identify 3 new tension-mediated OAB sub- categories (geometry-mediated, dynamic compliance-mediated, and spontaneous rhythmic contraction mediated) and a non-tension-medicated sub-category due to alterations in nervous system processing. Our new cystometrics will include 1) a sliding scale Urgency Meter that will allow patients to continuously record the tension sensor output of acute urgency, 2) two and three dimensional bladder ultrasonography to provide real- time measurements of bladder geometry that will be used to measure the effect of geometry and used for dynamic compliance calculations, and 3) Fast Fourier Transform (FFT) analysis to objectively measure filling phase spontaneous rhythmic contractions. These new metrics will provide a quantitative mechanistic link between OAB symptomatology and detrusor function, and we will use these new metrics to identify tension- mediated and non-tension mediated sub-groups of OAB.

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Courses

Engineering Courses

EGMN 201 Dynamics and Kinematics
EGMN 202 Mechanics of Deformables
EGMN 300 Mechanical Systems Design
EGMN 315 Process and Systems Dynamics
ENGR 395 Professional Development
ENGR 398 Cooperative Education Experience
EGMN 402/403 Senior Design Studio
EGMN 427 Robotics
EGMN 568 Robot Manipulators

Selected Articles

Comparison of 2D and 3D ultrasound methods to measure serial bladder volumes during filling: Steps toward development of non-invasive ultrasound urodynamics

Bladder

Nagle AS, Bernardo RJ, Varghese J, Carucci LR, Klausner AP, Speich JE.

2018-01-04

Non-invasive methods to objectively characterize overactive bladder (OAB) and other forms of voiding dysfunction using real-time ultrasound are currently under development but require accurate and precise serial measurements of bladder volumes during filling. This study’s objective was to determine the most accurate and precise ultrasound-based method of quantifying serial bladder volumes during urodynamics (UD). Twelve female participants with OAB completed an extended UD procedure with the addition of serial bladder ultrasound images captured once per minute. Bladder volume was measured using three ultrasound methods: (1) Vspheroid: two-dimensional (2D) method calculated assuming spheroid geometry; (2) Vbih: 2D correction method obtained by multiplying Vspheroid by a previously derived correction factor of 1.375; and (3) V3D: three-dimensional (3D) method obtained by manually tracing the bladder outline in six planes automatically reconstructed into a solid rendered volume. These volumes were compared to a control (Vcontrol) obtained by adding UD infused volume and the volume of estimated urine production. Based on linear regression analysis, both Vbih and V3D were fairly accurate estimators of Vcontrol, but V3D was more precise. Vspheroid significantly underestimated Vcontrol. Although the Vbih and V3D methods were more accurate than the more-commonly used Vspheroid method for measuring bladder volumes during UD, the V3D method was the most precise and could best account for non-uniform bladder geometries. Therefore, the V3D method may represent the best tool required for the continued development of non-invasive methods to diagnose OAB and other forms of voiding dysfunction.

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Quantification of bladder wall biomechanics during urodynamics: A methodologic investigation using ultrasound

Journal of Biomechanics

Anna S. Nagle, Adam P. Klausner, Jary Varghese, Rachel J. Bernardo, Andrew F. Colhoun, Robert W. Barbee, Laura R. Carucci, John E. Speich

2017-08-11

Overactive bladder is often characterized by biomechanical changes in the bladder wall, but there is no established method to measure these changes in vivo. The goal of this study was to develop a novel method to determine detrusor wall biomechanical parameters during urodynamics through the incorporation of transabdominal ultrasound imaging. Individuals with overactive bladder (OAB) underwent ultrasound imaging during filling. The fill rate was 10% of the cystometric capacity per minute as determined by an initial fill. Transabdominal ultrasound images were captured in the midsagittal and transverse planes at 1 min intervals. Using image data and Pves, detrusor wall tension, stress, and compliance were calculated. From each cross − sectional image, luminal and wall areas along with inner perimeters were measured. In the sagittal and transverse planes, wall tension was calculated as Pves ∗ luminal area, wall stress as tension/wall area, and strain as the change in perimeter normalized to the perimeter at 10% capacity. Elastic modulus was calculated as stress/strain in the medial–lateral and cranial-caudal directions. Patient-reported fullness sensation was continuously recorded. Data from five individuals with OAB showed that detrusor wall tension, volume, and strain had the highest correlations to continuous bladder sensation of all quantities measured. This study demonstrates how detrusor wall tension, stress, strain, and elastic modulus can be quantified by adding ultrasound imaging to standard urodynamics. This technique may be useful in diagnosing and better understanding the biomechanics involved in OAB and other bladder disorders.

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Effects of vesical & perfusion pressure on perfusate flow, & flow on vesical pressure, in the isolated perfused working pig bladder reveal a potential mechanism for regulation of detrusor compliance

Neurourology and Urodynamics

Vince, R., Tracey, A., Deebel, N., Barbee, R., Speich, J., Klausner, A. and Ratz, P.

2017-07-26

Although there is evidence that deficits in bladder blood flow negatively impact bladder function, the effects of vesical, and perfusion pressures on bladder perfusion (perfusate flow), and of perfusate flow on vesical pressure, remain poorly understood. The present study used the isolated perfused working pig bladder model to examine the relationships between blood flow, and vesical and perfusion pressures. Vesical arteries of pig bladders obtained from a local slaughterhouse were cannulated and perfused with Krebs-Henseleit solution at different pressures, and with carbachol to cause bladder contraction. The urethra of each bladder was cannulated to permit filling (10 mL/min), isovolumetric contraction and emptying. A ureter was cannulated with a pressure sensor to monitor vesical pressure. When at rest (50 mL vesical volume), bladder vesical pressure was 8.06 ± 1.5 mmHg and perfusate flow driven by a pressure gradient of 105 mmHg was 22.5 ± 2 mL/min (58.9 ± 7.8 mL/min-100 g). During filling, vesical pressure increased and flow decreased, but not necessarily in-parallel. Perfusate flow decreased transiently during isovolumetric contraction, and flow increased during emptying. A reduction in perfusion pressure from ∼105 to ∼40 mmHg reduced flow from ∼70 to ∼20 mL/min-100g, and reduced flow correlated with reduced vesical pressure. Perfusate flow is dependent on bladder perfusion pressure, and not necessarily reciprocally dependent on vesical pressure. Vesical pressure is highly sensitive to the level of perfusate flow, which supports the hypothesis that vesical pressure is dependent on the level of detrusor smooth muscle contractile activity (tone), and that compliance is dependent on bladder perfusion.

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