Male Voiding Behavior: Insight from 19,824 At-Home Uroflow Profiles.
Male Voiding Behavior: Insight from 19,824 At-Home Uroflow Profiles.
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DOI：
10.1097/ju.0000000000001504
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发表时间：
2021-04
期刊：
影响因子：
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通讯作者：
Hotaling JM
中科院分区：
文献类型：
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作者：
Summers SJ;Armstrong JM;Kaplan SA;Te AE;Le A;Heiner SM;Presson AP;Wei G;Hotaling JM
良性前列腺增生是普通泌尿科医生最常见的病症之一。经过验证的问卷可以深入了解患者的症状，但是基于办公室的尿流设备受到排尿行为的可变性的限制。使用家用尿流装置，我们评估了个体排尿变异性、排尿参数的时间分布以及年龄对排尿的影响。 2019 年 4 月至 2020 年 6 月期间，使用 Stream Dx 尿流量计捕获了 19,824 个独特的排尿情况并进行了回顾性分析。空洞的年龄和数量通过平均值+/-标准差来总结。我们使用混合效应模型来比较排尿参数的平均值和患者内部随时间和年龄的变化。变异系数（CV）用于评估患者内部的变异性。总共确定了 637 名患者，其中 625 名患者符合纳入标准，产生 19,824 个空白。平均年龄为 67 (+/-10.2) 岁，每位患者平均每天排尿 5 (+/-3.3) 次，持续 7 天。患者内部平均排尿参数显示出显着的变异性，其中最大流量 (Qmax) 的 CV 为 27.6%（95% CI：26.6% 至 28.6%）。清晨的排尿量与排尿量较高和排尿次数较少有关。随着年龄的增长，排尿情况呈线性恶化。相对于清晨排尿，下午和晚上排尿与患者内部变异性降低相关。使用精确的家用尿流装置对 19,824 次尿流进行评估表明，个人的排尿参数每天、全天变化很大，并且随着年龄的增长而恶化。在家进行的多次测量可以通过捕获个体排尿变异性来对真实排尿行为进行更真实的评估，并可以帮助泌尿科医生在患者护理中做出更好的决策。
Benign prostatic hyperplasia is one of the most common conditions seen by a general urologist. Validated questionnaires provide insight into patient symptoms, however office based uroflow devices are limited by the variability of voiding behavior. Using a home uroflow device, we assessed individual voiding variability, temporal distribution of voiding parameters, and the impact of age on voiding. Between April 2019 and June 2020, 19,824 unique voiding profiles were captured using the Stream Dx Uroflowmeter and retrospectively analyzed. Age and number of voids were summarized by mean +/− standard deviation. We used mixed effects models to compare average values and intra-patient variability of voiding parameters to time of day and age. The coefficient of variation (CV) was used to assess intra-patient variability. A total of 637 patients were identified with 625 meeting inclusion criteria, producing 19,824 voids. Mean age was 67 (+/−10.2) years old, each patient provided on average 5 (+/−3.3) voids a day, over 7 days. Average intra-patient voiding parameters showed notable variability, where the CV for max flow (Qmax) was 27.6% (95% CI: 26.6% to 28.6%). Early morning voids were associated with higher volume and lower number of voids. As age progressed, voiding profiles worsened in a linear fashion. Afternoon and evening voids were associated with reduced intra-patient variability relative to early morning voids. Assessment of 19,824 uroflows using an accurate and precise home uroflow device demonstrates that an individual’s voiding parameters vary greatly from day to day, throughout the day, and worsen with age. Multiple measurements performed at home provides a more realistic assessment of true voiding behavior by capturing individual voiding variability and can help urologists make better decisions in patient care.