It is believed that maximum flow rate (Qmax) is influenced by several factors including a patient’s voided volume (VV), disease progression, treatment results, or random artifact. We attempt to utilize a smartphone-based application that generates audio-based uroflowmetry (UFM) to evaluate within-patient Qmax variability and to associate the variability with International Prostate Symptom Score (IPSS).

METHODS:

A total of 1,739 male patients were instructed to download the “proudP” application on their smartphones and to collect UFM results at home between December 2020 and October 2023. proudP captures urinating sound and generates a UFM result using a proprietary algorithm (Young Ju Lee, 2020). 89 patients who have more than 20 proudP measurements obtained within 15 days of an in-clinic IPSS response date, termed an IPSS-proudP pair, were included in the analysis. IPSS-proudP pairs were categorized based on the Qmax variability and the correlation with VV, and Mann-Whitney U tests were conducted to test whether the mean of IPSS scores among categories are equal or not.

RESULTS:

A total of 126 IPSS-proudP pairs were analyzed and classified into five categories. Archetypal cases for these five categories are presented in Figure 1. Intergroup differences in IPSS scores and subscores are displayed in Figure 2. Significant differences are observed between Category A/E, as well as between Category D/E, in all IPSS total and subscores. However, no significant differences were found between Category A/B, Category A/C, Category A/D, and Category B/C in any of the scores.

CONCLUSIONS:

Smartphone-based repeated UFM measurements may reveal archetypal voiding categories indicative of symptomatology which correlates to IPSS. Progression through categories may reflect the natural evolution of lower urinary tract symptoms related to benign prostatic hyperplasia. Clinically, this easily collected information could guide management or intervention. Further studies with larger cohorts are required.