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Almas F, Dasdelen MF, Seyhan Z, Sargolzaeimoghaddam M, Sarg A, Unlu O, Dasdelen ZB, Horuz R, Albayrak S, Kocak M, Laguna P, de la Rosette J. Reassessing Normal Voiding Standards: A Cross-Sectional Study Based on Medical Professionals' Evaluations with Portable Uroflowmetry and IPSS. J Clin Med 2024; 13:2857. [PMID: 38792399 PMCID: PMC11122113 DOI: 10.3390/jcm13102857] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/02/2024] [Revised: 04/24/2024] [Accepted: 05/10/2024] [Indexed: 05/26/2024] Open
Abstract
Background/Objectives: LUTS and voiding dysfunctions are prevalent in urology clinics, with uroflowmetry and IPSS as the prevailing diagnostic methods. Nevertheless, objective assessment can be constrained by age, gender, and variability in the test conditions. Portable (home) uroflowmetry addresses these limitations, allowing for more natural urinary flow recordings beyond clinic confines. This study aims to characterize spontaneous voiding patterns in healthcare professionals, exploring gender differences, variability in repeated measurements, and correlations among voiding parameters, IPSS, age, and BMI. Methods: This cross-sectional study was conducted during the SIU 43rd Congress in Istanbul using smart uroflow devices such as the Oruba Oruflow Uroflow Recorder, which were installed in public toilets. A total of 431 healthcare professionals participated by providing demographic information and completing the IPSS questionnaire. The data analysis included uroflowmetric parameters such as maximum flow rate (Qmax), average flow rate (Qave), and voided volume (VV), in addition to IPSS and demographic data to assess the possible associations with IPSS, age, BMI, and gender differences. Results: Of the participants, 76% were male and 24% female, with a higher prevalence of LUTS in women. Despite no significant gender difference in voided volume, men with lower volumes demonstrated more severe LUTS. Notably, women exhibited higher Qmax and Qave rates irrespective of their IPSS scores, contrasting with men whose flow rates declined with age and LUTS severity. In men, the total IPSS score was inversely associated with uroflowmetric performance, particularly impacting voiding symptoms over storage symptoms. Repeated measurements revealed noteworthy variability in Qmax and VV, without any influence from gender, BMI, age, or symptom severity. Conclusions: Our findings highlight the importance of gender-specific considerations in evaluating voiding complaints through uroflowmetry and IPSS. The significant variability observed in repeated uroflowmetry studies underlines the need for multiple measurements. Overall, this research emphasizes the significance of portable (home) uroflowmetry and calls for a reassessment of normal voiding standards in (non) clinical settings.
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Affiliation(s)
- Furkan Almas
- International School of Medicine, Istanbul Medipol University, 34810 Istanbul, Türkiye; (M.F.D.); (Z.S.); (O.U.); (Z.B.D.); (R.H.); (M.K.); (P.L.); (J.d.l.R.)
| | - Muhammed Furkan Dasdelen
- International School of Medicine, Istanbul Medipol University, 34810 Istanbul, Türkiye; (M.F.D.); (Z.S.); (O.U.); (Z.B.D.); (R.H.); (M.K.); (P.L.); (J.d.l.R.)
- Department of Biostatistics and Medical Informatics, Istanbul Medipol University, 34810 Istanbul, Türkiye
| | - Zuleyha Seyhan
- International School of Medicine, Istanbul Medipol University, 34810 Istanbul, Türkiye; (M.F.D.); (Z.S.); (O.U.); (Z.B.D.); (R.H.); (M.K.); (P.L.); (J.d.l.R.)
| | | | - Arya Sarg
- School of Medicine, Istanbul Medipol University, 34810 Istanbul, Türkiye; (M.S.); (A.S.); (S.A.)
| | - Omer Unlu
- International School of Medicine, Istanbul Medipol University, 34810 Istanbul, Türkiye; (M.F.D.); (Z.S.); (O.U.); (Z.B.D.); (R.H.); (M.K.); (P.L.); (J.d.l.R.)
| | - Zehra Betul Dasdelen
- International School of Medicine, Istanbul Medipol University, 34810 Istanbul, Türkiye; (M.F.D.); (Z.S.); (O.U.); (Z.B.D.); (R.H.); (M.K.); (P.L.); (J.d.l.R.)
| | - Rahim Horuz
- International School of Medicine, Istanbul Medipol University, 34810 Istanbul, Türkiye; (M.F.D.); (Z.S.); (O.U.); (Z.B.D.); (R.H.); (M.K.); (P.L.); (J.d.l.R.)
- Department of Urology, Istanbul Medipol University, 34810 Istanbul, Türkiye
| | - Selami Albayrak
- School of Medicine, Istanbul Medipol University, 34810 Istanbul, Türkiye; (M.S.); (A.S.); (S.A.)
- Department of Urology, Istanbul Medipol University, 34810 Istanbul, Türkiye
| | - Mehmet Kocak
- International School of Medicine, Istanbul Medipol University, 34810 Istanbul, Türkiye; (M.F.D.); (Z.S.); (O.U.); (Z.B.D.); (R.H.); (M.K.); (P.L.); (J.d.l.R.)
- Department of Biostatistics and Medical Informatics, Istanbul Medipol University, 34810 Istanbul, Türkiye
| | - Pilar Laguna
- International School of Medicine, Istanbul Medipol University, 34810 Istanbul, Türkiye; (M.F.D.); (Z.S.); (O.U.); (Z.B.D.); (R.H.); (M.K.); (P.L.); (J.d.l.R.)
- Department of Urology, Istanbul Medipol University, 34810 Istanbul, Türkiye
| | - Jean de la Rosette
- International School of Medicine, Istanbul Medipol University, 34810 Istanbul, Türkiye; (M.F.D.); (Z.S.); (O.U.); (Z.B.D.); (R.H.); (M.K.); (P.L.); (J.d.l.R.)
- Department of Urology, Istanbul Medipol University, 34810 Istanbul, Türkiye
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Takeshima Y, Yamada Y, Takemura K, Kimura N, Hakozaki Y, Miyakawa J, Taguchi S, Akiyama Y, Sato Y, Kawai T, Yamada D, Fujimura T, Kume H. The association between the parameters of uroflowmetry and lower urinary tract symptoms in prostate cancer patients after robot-assisted radical prostatectomy. PLoS One 2022; 17:e0275069. [PMID: 36201466 PMCID: PMC9536545 DOI: 10.1371/journal.pone.0275069] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2022] [Accepted: 09/09/2022] [Indexed: 11/07/2022] Open
Abstract
OBJECTIVE To investigate changes in uroflowmetry parameters in men undergoing robot-assisted radical prostatectomy (RARP) for prostate cancer. MATERIALS AND METHODS Four hundred and twenty-eight patients received uroflowmetry testing before and after RARP from November 2011 to December 2018. Clinicopathological data, including age, initial prostate-specific antigen (PSA), prostate volume, clinical stage, body mass index (BMI), uroflowmetry parameters, and core lower urinary tract symptom scores (CLSS) were retrospectively obtained from clinical records. Changes in uroflowmetry parameters were analyzed for statistical predictors and effects on post-operative outcomes. RESULTS A significant increase in maximum flow rate (MFR) and decreases in voided volume (VV) and post-void residual urine (PVR) were seen. In multivariate analysis, age was a negative predictor of MFR increase, while prostate volume was a positive predictor of PVR decrease and MFR increase. VV decrease led to worse incontinence symptoms, while PVR decrease and MFR increase led to improvement in voiding symptoms such as slow stream and straining. Continence recovery curves showed that VV decrease were associated with a delay in continence recovery. CONCLUSIONS Significant changes were seen in uroflowmetry results after RARP, each parameter directly related to urinary symptoms. In particular, VV decrease was associated with a worsening of incontinence symptoms and continence recovery.
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Affiliation(s)
- Yuta Takeshima
- Division of Innovative Cancer Therapy, Advanced Research Center, The Institute of Medical Science, The University of Tokyo, Tokyo, Japan
| | - Yuta Yamada
- Department of Urology, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
- * E-mail:
| | - Kotaro Takemura
- Department of Urology, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
| | - Naoki Kimura
- Department of Urology, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
| | - Yuji Hakozaki
- Department of Urology, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
| | - Jimpei Miyakawa
- Department of Urology, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
| | - Satoru Taguchi
- Department of Urology, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
| | - Yoshiyuki Akiyama
- Department of Urology, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
| | - Yusuke Sato
- Department of Urology, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
| | - Taketo Kawai
- Department of Urology, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
| | - Daisuke Yamada
- Department of Urology, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
| | | | - Haruki Kume
- Department of Urology, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
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