JMIR Publications

ABSTRACT

Background:

Accurate assessment of voiding patterns before and after surgery for lower urinary symptoms are critical in patient care, but generate heavy tolls on both the patient and the clinic. While methods for telemedicine have been devised, no technology for acoustic assessment for urinary patterns have been prospectively evaluated for clinical use.

Objective:

To assess the precision of a mobile application-based uroflowmetry (UFM) and compare it to inpatient UFM measurements for the management of patients undergoing surgical treatment for benign prostatic hyperplasia (BPH).

Methods:

A total of 46 patients without prior treatment within 4 weeks of their initial outpatient clinic visit were prospectively enrolled from three tertiary centers. After diagnosis, participants with BPH conducted subsequent UFM measurements using a sound-based mobile application proudP® for at least 4 days during the pre-treatment period, followed by transurethral resection of prostate (TURP). Additional measurements were taken at pre-operative visit and 4-day periods after 2, 6, and 12 weeks of treatment initiation, with concurrent in-office measurements. UFM parameters, including maximum flow rate (Qmax) and voided volume (VV), were compared. Patient satisfaction was evaluated using a 0-10 scale at the end of the 12-week study.

Results:

TURP resulted in mean Qmax improvement of 7.2mL/sec at conventional UFM, which correlated with mean improvement of 5.1 mL/sec when measured by application. A statistically significant correlation (p<0.05) was observed between the two methods. The application-based UFM effectively reflected the improvement in voiding symptoms over time subsequent to the initiation of medical treatment, with statistically significant improvement in total IPSS (-4.7), IPSS obstructive (-5.7), IPSS irritative (-2.6), and quality of life (-5.9) (all p<0.05). Overall, the participants reported a high level of satisfaction, with a mean score of 9.5±0.8 points at the conclusion of the study

Conclusions:

The findings of this study demonstrate that application-based UFM (proudP®) measurements serve as an accurate and reliable indicator of perioperative surveillance in patients undergoing TURP for BPH. By enabling a personalized and portable UFM, clinicians can easily monitor treatment response as well as observe risk of postoperative AUR.