[Outpatient urodynamic monitoring in patients with BPH: world and russian experience].

Outpatient urodynamic monitoring (AUM) - registration of the patients urination parameters for a certain time (for example, during the day), which is carried out in natural conditions for him. Monitoring allows you to identify hidden or periodically occurring (circadian) changes, which are not always possible to record with a single study. The research was searched in the PubMed and Elibrary.ru databases using the keywords "home uroflowmetry", "outpatient urodynamic examination", "outpatient urodynamic monitoring", "outpatient uroflowmetric monitoring". The difficulties in performing AUM lie not only in the hardware (the presence of a portable device, minimally invasive or non-invasive research, software that guarantees the storage and transmission of data), but also the difficulties associated with teaching patients and overcoming conservatism on the part of medical personnel. Today, there are several urodynamic devices and uroflowmeters designed for research at home. Outpatient (home) urodynamic monitoring is one of the most promising studies for implementation in everyday clinical practice in the provision of medical care to patients with urination disorders on the background of benign prostatic hyperplasia. The integration of home uroflowmetric monitoring into the eHealth system, of course, remains an inevitable trend in the development of modern healthcare.

The value of home-uroflowmetry in evaluation of voiding function in children with overactive bladder.

INTRODUCTION: Overactive bladder (OAB) in children is clinically common and seriously affects the physical and mental health of children. The voiding frequency (VF) is an important basis for the diagnosis of OAB. The emergence of home-uroflowmetry (HUF) has allowed the patients to record the VF while recording the uroflowmetry at home, and the voiding at home can show the real voiding situation. However, the use of HUF to assess OAB in children and its clinical significance has not been reported in the literature. Thus, this study investigate the value of HUF in evaluation of voiding function in children with OAB and survey the VF of healthy children in Mainland China. MATERIALS AND METHODS: From May 2021 to July 2023, 52 children with OAB aged 7-10 years, 48 age-matched volunteers (control group) accepted HUF. Daytime VF and nighttime VF, voided volume (VV) per time, 24-h voided volume (24h-VV), maximum flow rate (Qmax), voiding time (VT), and uroflow pattern were recorded and compute corrected maximum urine flow rate (cQmax). VF in 600 health pupils (7-10 years) from five primary schools in Henan Province China were selected for questionnaire survey by cross-sectional survey and multi-stage sampling methods. RESULTS: 52 children with OAB and 48 healthy children completed the available 48-h HUF recordings. 24-hour, daytime, and nighttime VF, and cQmax were higher in the OAB group than in the control group (P < 0.05). However, average VV, Qmax, and VT were lower in the OAB group than in the control group (P < 0.05). There was no significant difference in 24h-VV between two groups (P > 0.05). A total of 502 questionnaires qualified for statistical analysis, and the 24h-VF was 6.3 ± 0.95 times, daytime VF was 5.6 ± 0.89 times, and nighttime VF was 0.7 ± 0.59 times. There was no significant difference in the comparison of 24-h, daytime, and nighttime VF between boys and girls and in the comparison of VF by age (P > 0.05). Compared with the results of the questionnaire, the difference of VF in HUF control group was not statistically significant (P > 0.05). CONCLUSIONS: The VF in children is similar to that of adults and the HUF is a useful tool with the ability to more realistically record changes in voiding function in children with OAB.

A Novel Low-Cost Uroflowmetry for Patient Telemonitoring.

Uroflowmetry (UF) is a crucial guideline-recommended tool for men with benign prostatic obstruction (BPO). Moreover, UF is a helpful decision-making tool for the management of patients with lower urinary tract symptoms (LUTS) and benign prostatic hyperplasia (BPH). In the last few years, telemedicine and telehealth have increased exponentially as cost-effective treatment options for both patients and physicians. Telemedicine and telehealth have been well positioned during the COVID-19 pandemic to prevent healthcare system overload and to ensure adequate management of patients through screening, diagnosis, and follow-up at home. In the present manuscript, the main characteristics and performance of a novel and low-cost device for home-based UF have been analyzed. The simple weight-transducer method has been applied to perform UF. An inexpensive load cell connected to a 24 bit analogic digital converter (ADC) sends data to a cloud server via SIM card or home Wi-Fi. Data are processed and shown in graphics with both volume and flow rate as a function of time, allowing for measurement of average flow rate, maximum flow rate, voided volume, and voiding time. A numerical algorithm allows for filtering of the dynamic effect due to the urine gravity acceleration and for removing the funnel to simplify the home measurement procedure. Through an online platform, the physician can see and compare each UF data. The device's reliability has been validated in a first laboratory setting and showed excellent performance. This approach based on domiciliary tests and an online platform can revolutionize the urologic clinic landscape by offering a constant patient cost-effective follow-up, eliminating the time wasted waiting in the office setting.

First-Year Experience of Managing Urology Patients With Home Uroflowmetry: Descriptive Retrospective Analysis.

BACKGROUND: Lower urinary tract symptoms affect a large number of people of all ages and sexes. The clinical assessment typically involves a bladder diary and uroflowmetry test. Conventional paper-based diaries are affected by low patient compliance, whereas in-clinic uroflowmetry measurement face challenges such as patient stress and inconvenience factors. Home uroflowmetry and automated bladder diaries are believed to overcome these limitations. OBJECTIVE: In this study, we present our first-year experience of managing urological patients using Minze homeflow, which combines home uroflowmetry and automated bladder diaries. Our objective was 2-fold: first, to provide a description of the reasons for using homeflow and second, to compare the data obtained from homeflow with the data obtained from in-clinic uroflowmetry (hospiflow). METHODS: A descriptive retrospective analysis was conducted using Minze homeflow between July 2019 and July 2020 at a tertiary university hospital. The device comprises a Bluetooth-connected gravimetric uroflowmeter, a patient smartphone app, and a cloud-based clinician portal. Descriptive statistics, Bland-Altman plots, the McNemar test, and the Wilcoxon signed rank test were used for data analysis. RESULTS: The device was offered to 166 patients, including 91 pediatric and 75 adult patients. In total, 3214 homeflows and 129 hospiflows were recorded. Homeflow proved valuable for diagnosis, particularly in cases where hospiflow was unreliable or unsuccessful, especially in young children. It confirmed or excluded abnormal hospiflow results and provided comprehensive data with multiple measurements taken at various bladder volumes, urge levels, and times of the day. As a result, we found that approximately one-fourth of the patients with abnormal flow curves in the clinic had normal bell-shaped flow curves at home. Furthermore, homeflow offers the advantage of providing an individual's plot of maximum flow rate (Q-max) versus voided volume as well as an average or median result. Our findings revealed that a considerable percentage of patients (22/76, 29% for pediatric patients and 24/50, 48% for adult patients) had a Q-max measurement from hospiflow falling outside the range of homeflow measurements. This discrepancy may be attributed to the unnatural nature of the hospiflow test, resulting in nonrepresentative uroflow curves and an underestimation of Q-max, as confirmed by the Bland-Altman plot analysis. The mean difference for Q-max was -3.1 mL/s (with an upper limit of agreement of 13 mL/s and a lower limit of agreement of -19.2 mL/s), which was statistically significant (Wilcoxon signed rank test: V=2019.5; P<.001). Given its enhanced reliability, homeflow serves as a valuable tool not only for diagnosis but also for follow-up, allowing for the evaluation of treatment effectiveness and home monitoring of postoperative and recurrent interventions. CONCLUSIONS: Our first-year experience with Minze homeflow demonstrated its feasibility and usefulness in the diagnosis and follow-up of various patient categories. Homeflow provided more reliable and comprehensive voiding data compared with hospiflow.