Efficacy and Reliability of Mobile Uroflowmetry in Patients With Benign Prostatic Hyperplasia Undergoing Transurethral Resection: Prospective Multicenter Observational Pilot Validation Study

Abstract

Background: Accurate assessment of voiding patterns before and after surgery for lower urinary tract symptoms is critical in patient care, but it places heavy burdens on both the patient and the clinic. While methods for telemedicine have been devised, no technology for acoustic assessment of urinary patterns has been prospectively evaluated for clinical use. Objective: This study aims to assess the precision of a mobile app-based uroflowmetry and compare it with in-office uroflowmetry measurements for the management of patients undergoing surgical treatment for benign prostatic hyperplasia (BPH). Methods: This study was designed as a prospective, multicenter, observational pilot validation study conducted at 3 tertiary centers. A total of 46 patients with BPH who had not received any previous treatment within 4 weeks of their initial outpatient clinic visit were prospectively enrolled. After diagnosis, participants with BPH conducted subsequent uroflowmetry measurements by using a sound-based mobile app, proudP, for at least 4 days during the pretreatment period, followed by transurethral resection of prostate (TURP). Additional measurements were taken at the preoperative visit and 4-day periods after 2, 6, and 12 weeks of treatment initiation, with concurrent in-office measurements. Uroflowmetry parameters, including maximum flow rate (Q(max)) and voided volume, were compared. Patient satisfaction was evaluated using a scale ranging from 0 to 10 at the end of the 12-week study. Results: TURP resulted in a mean Q(max) improvement of 7.2 mL/s at conventional uroflowmetry, which correlated with a mean improvement of 5.1 mL/s when measured by the app. A statistically significant correlation (P<.05) was observed between the 2 methods. The app-based uroflowmetry effectively reflected the improvement in voiding symptoms over time after the initiation of medical treatment, with statistically significant improvement in total International Prostate Symptom Scores (IPSS; -4.7), IPSS obstructive (-5.7), IPSS irritative (-2.6), and quality of life (-5.9; all P<.05). Overall, the participants reported a high level of satisfaction, with a mean score of 9.5 (SD 0.8) points at the conclusion of the study. Conclusions: The findings of this study demonstrate that app-based uroflowmetry (proudP) measurements serve as an accurate and reliable indicator of perioperative surveillance in patients undergoing TURP for BPH. By enabling personalized and portable uroflowmetry, clinicians can easily monitor treatment response as well as observe the risk of postoperative acute urinary retention.