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Liu X, Meng L, Wang J, Ma T, Shi B, Huang H, Wang Q, Chen M, Liao L, Shen H, Wei Z, Xiao Y, Pan T, Ren J, Zhang P, Tian X, Zhang Y. A multicenter uroflowmetry study of healthy women in China. Chin Med J (Engl) 2024; 137:1225-1227. [PMID: 38602088 PMCID: PMC11101221 DOI: 10.1097/cm9.0000000000003100] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/09/2023] [Indexed: 04/12/2024] Open
Affiliation(s)
- Xiaodong Liu
- Department of Urology, Beijing Hospital, National Center of Gerontology, Institute of Geriatric Medicine, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing 100730, China
- Graduate School of Peking Union Medical College, Beijing 100730, China
| | - Lingfeng Meng
- Department of Urology, Beijing Hospital, National Center of Gerontology, Institute of Geriatric Medicine, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing 100730, China
| | - Jiawen Wang
- Department of Urology, Beijing Hospital, National Center of Gerontology, Institute of Geriatric Medicine, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing 100730, China
| | - Tianming Ma
- Department of Urology, Beijing Hospital, National Center of Gerontology, Institute of Geriatric Medicine, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing 100730, China
| | - Benkang Shi
- Department of Urology, Qilu Hospital, Shandong University, Jinan, Shandong 250013, China
| | - Hai Huang
- Department of Urology, SUN YAT-SEN Memorial Hospital, Guangzhou, Guangdong 510235, China
| | - Qingwei Wang
- Department of Urology, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, Henan 450003, China
| | - Min Chen
- Department of Urology, Tongji Hospital, Tongji Medical College of Huazhong University of Science and Technology, Wuhan, Hubei 430030, China
| | - Limin Liao
- Department of Urology, China Rehabilitation Research Center, Beijing 100068, China
| | - Hong Shen
- Department of Urology, West China Hospital, Chengdu, Sichuan 610041, China
| | - Zhongqing Wei
- Department of Urology, The Second Affiliated Hospital of Nanjing Medical University, Nanjing, Jiangsu 210011, China
| | - Yuansong Xiao
- Department of Urology, General Hospital of Southern Theatre Command, Guangzhou, Guangdong 510010, China
| | - Tiejun Pan
- Department of Urology, General Hospital of Central Theatre Command, Wuhan, Hubei 430071, China
| | - Jian Ren
- Department of Urology, China-Japan Friendship Hospital, Beijing 100029, China
| | - Peng Zhang
- Department of Urology, Beijing Chao-Yang Hospital, Beijing 100027, China
| | - Xiaojun Tian
- Department of Urology, Peking University Third Hospital, Beijing 100191, China
| | - Yaoguang Zhang
- Department of Urology, Beijing Hospital, National Center of Gerontology, Institute of Geriatric Medicine, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing 100730, China
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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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Sinha S. The Use of Uroflowmetry as a Diagnostic Test. Curr Urol Rep 2024; 25:99-107. [PMID: 38416321 DOI: 10.1007/s11934-024-01200-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/22/2024] [Indexed: 02/29/2024]
Abstract
PURPOSE OF REVIEW Uroflowmetry is widely used for initial non-invasive evaluation of lower urinary tract disorders. Current clinical use is mostly restricted to a scrutiny of the maximum flow rate and uroflow pattern recorded by a conventional flowmeter in a health care facility. There are several advancements in our understanding and in available technologies that promise to transform clinical utilization of this simple test. RECENT FINDINGS Several aspects of the uroflow test in addition to maximum flow rate and uroflow pattern show potential diagnostic utility. This includes flow acceleration, uroflow indices, uroflow-electromyography including lag time, stop uroflow test, and uroflow-based nomograms. There are initial attempts to use artificial intelligence in analysis. There is also new data with regard to factors influencing variability of uroflow testing that might influence the diagnostic value in as yet uncertain ways including diurnal variability, postural variability, locational variability, and operator variability. There are new technologies for uroflow testing in a home environment allowing for easy repetition. However, there are several challenges owing to a paucity of clinical data and standardization. There are also critical lacunae in terminology that need to be addressed. There are exciting new advancements in the field of uroflowmetry. However, there is need to standardize and validate the newer uroflow tracing analyses and technologies.
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Affiliation(s)
- Sanjay Sinha
- Department of Urology, Apollo Hospital, Hyderabad, India.
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Zeng X, Liu MZ, Shen SH, Yang SQ, Zhang J, Shen H, Luo DY, Jin T. The design and evaluation of a quick checklist for urodynamic quality control: A prospective single-center small sample study. Neurourol Urodyn 2024; 43:382-389. [PMID: 38078752 DOI: 10.1002/nau.25357] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2023] [Revised: 10/23/2023] [Accepted: 11/29/2023] [Indexed: 02/06/2024]
Abstract
PURPOSE To design a quick checklist for urodynamic study (UDS), aiming to reduce the occurrence of errors in the process, which may help to increase the quality of UDS. And further to analyze the effectiveness of this quick checklist for UDS quality control. METHODS First, a quick checklist for uroflow study and pressure-flow study was developed, based on the International Continence Society-Good Urodynamic Practice standards, our previous studies, and recent literature, as well as expert suggestions. Then, patients who underwent UDS between January 2023 to February 2023 were randomly assigned to a study group or a control group. For the study group, the quick checklist was used throughout the UDS process, while the control group did not. The main artefacts were chosen to verify the effectiveness of the quick checklist for improving the UDS quality. RESULTS The quick checklist comprised three subtypes: checklist for patients, checklist for environment and device, and checklist for UDS test process. 38 UDS traces per group were included. The incidence of missing the standard cough test decreased significantly from 18.4% to 0 (p = 0.012), with the checklist implementation. The baseline drift frequency rate also declined significantly from 39.5% to 5.3% (p < 0.05). Volume < 150 mL on uroflow study occurred in 68.4% of cases and its frequency rate decreased significantly with checklist implementation (p < 0.05). CONCLUSION A quick checklist for quality control of UDS was developed. The quick checklist as a convenient, quick, and easy used urodynamic quality control method, may help to reduce the technical artefacts and improve fundamental urodynamic quality control. Future research with a larger sample size is needed to confirm the effectiveness of the checklist.
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Affiliation(s)
- Xiao Zeng
- Laboratory of Reconstructive Urology, Department of Urology, Institute of Urology, West China Hospital, Sichuan University, Chengdu, China
- Pelvic Floor Diseases Center, West China Tianfu Hospital, Sichuan University, Chengdu, China
| | - Meng-Zhu Liu
- Laboratory of Reconstructive Urology, Department of Urology, Institute of Urology, West China Hospital, Sichuan University, Chengdu, China
| | - Si-Hong Shen
- Laboratory of Reconstructive Urology, Department of Urology, Institute of Urology, West China Hospital, Sichuan University, Chengdu, China
| | - Shi-Qin Yang
- Laboratory of Reconstructive Urology, Department of Urology, Institute of Urology, West China Hospital, Sichuan University, Chengdu, China
| | - Jie Zhang
- Laboratory of Reconstructive Urology, Department of Urology, Institute of Urology, West China Hospital, Sichuan University, Chengdu, China
- Pelvic Floor Diseases Center, West China Tianfu Hospital, Sichuan University, Chengdu, China
| | - Hong Shen
- Laboratory of Reconstructive Urology, Department of Urology, Institute of Urology, West China Hospital, Sichuan University, Chengdu, China
- Pelvic Floor Diseases Center, West China Tianfu Hospital, Sichuan University, Chengdu, China
| | - De-Yi Luo
- Laboratory of Reconstructive Urology, Department of Urology, Institute of Urology, West China Hospital, Sichuan University, Chengdu, China
- Pelvic Floor Diseases Center, West China Tianfu Hospital, Sichuan University, Chengdu, China
| | - Tao Jin
- Laboratory of Reconstructive Urology, Department of Urology, Institute of Urology, West China Hospital, Sichuan University, Chengdu, China
- Pelvic Floor Diseases Center, West China Tianfu Hospital, Sichuan University, Chengdu, China
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