Miami, FL (UroToday.com) Although uroflowmetry is a frequently used diagnostic test to assess voiding dysfunction, concerns exist regarding the use of a single uroflow test for clinical decision making. It is primarily used to screen for bladder outlet obstruction, and uroflowmetry results can be affected by bladder volume and voided volume, time of day (obstructive symptoms are often worse at night), as well as the timing of medications. Key aspects of uroflowmetry involve the maximum and average flow rate, voided volume, flow time, and flow pattern.

To address the limitations that can occur with a single office-based uroflow event, Craig Comiter, MD, of Stanford University School of Medicine, and Edward Belotserkovsky, Ph.D., of BE Technologies, developed a novel mobile touchless uroflowmetry application called MenHealth® to assess lower urinary tract symptoms. They reported that the mobile application processed the sound of urine hitting the water surface in a toilet and calculated urinary flow rate and voided volume in real time.

By using a mobile application to obtain data, they believe MenHealth® can be useful for ambulatory and unlimited “home” uroflowmetry measurements, the data of which can be used to provide a more accurate assessment of urinary function. The data could be analyzed to account for varying volumes, varying times of day, and medication status, amongst other confounding factors. Furthermore, the application allowed for hand-free collection of data with voice commands to start and stop.

Dr. Comiter presented the data of his validation trial at the SUFU Winter meeting on February 28, 2019. To confirm the accuracy of the MenHealth® uroflowmetry application, the results of MenHealth® were compared to a standard medical office urinary flowmeter (Laborie UROCAP II), which served as the reference.

Two males, aged 36 and 58, provided a total of 50 voids with measurement of uroflow and voided volume (22 tests using UROCAP II and 28 tests using MenHealth® application). The average maximum flow rate and average voided volume were calculated and their ranges were determined. Comparisons between the two devices demonstrated no significant statistical difference between the MenHealth® audio uroflowmetry and the Laborie UROCAP II (p>0.05; see Figure).

Of note, a uroflowmetry report containing average flow curve information and voiding diary could be sent to the physician or an HER database.

In a separate validation trial, 101 independent testers evaluated the MenHealth® application. 94% rated the application as “easy” or “very easy” to use. 57% reported they would test their urine flow every week or several times a week, and 74% responded they would conduct self-testing once per month or more. 84% of testers stated they would purchase the application if a physician recommended it. 100% of testers responded that they would “definitely” use the app if the cost were covered by insurance.

Based on their study, flow curves and voided volumes obtained by the MenHealth® application are similar to those obtained from a standard office-based uroflowmeter. Additional advantages to the use of the application include capturing more meaningful data based on multiple events in varying conditions. The authors also stated it is a hands-free application that is easy to use, and more hygienic than the standard uroflowmetry device, and that it virtually converts any toilet into a mobile uroflowmeter.

Presented by: Craig Comiter, MD, Professor of Urology and, by courtesy, of Obstetrics and Gynecology at the Stanford University Medical Center

Written by: Judy Choi, MD, Assistant Professor, Department of Urology, University of California, Irvine @judymchoi  at the Society of Urodynamics, Female Pelvic Medicine & Urogenital Reconstruction Winter Meeting, SUFU 2019, February 26 – March 2, 2019, Miami, Florida

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