Long Depaquit T, Michel F, Gaillet S, Savoie P-H, Karsenty G
Service d'urologie, HIA Sainte-Anne, 2 boulevard Sainte-Anne BP600, 83000 Toulon, France; Service d'urologie et de transplantation rénale, hôpital de La Conception, AP-HM, Marseille, France; Aix-Marseille université, Marseille, France.
Service d'urologie et de transplantation rénale, hôpital de La Conception, AP-HM, Marseille, France; Aix-Marseille université, Marseille, France.
Prog Urol. 2022 Dec;32(17):1531-1542. doi: 10.1016/j.purol.2022.07.142. Epub 2022 Aug 9.
Urine flowmetry (UF) is a key non-invasive urodynamic test for the evaluation of the voiding phase in patients with lower urinary tract symptoms (LUTS). Traditional free urodynamic testing (FUT) performed on a one-time basis in the office is limited by difficulty in capturing normal voiding and high intrapatient variability in urine flow parameters. Home measurement of urine flow by the patient could be a way to obtain multiple data in real-life conditions, addressing its limitations. The objective of this article was to review the literature on the different techniques of home uroflowmetry (HUF) and their clinical interest in comparison with FUT.
A search on the PubMed database using the key words "Urodynamics, Uroflowmetry, non-invasive urodynamics, Ambulatory urodynamics, bladder outlet obstruction, male LUTS" was performed to find articles in English or French that had been published with no time limit and March 2022. The sorting by reading the abstract allowed the selection of all articles describing and/or evaluating a HUF technique that were read entirely according to the same collection grid to propose a narrative synthesis.
Thirty-one articles were identified, selected, and analyzed. Simple and inexpensive techniques by timing or use of funnels reliably and reproducibly estimate the average and maximum urine flow in relation to the FUT, without providing a complete flow curve. More sophisticated electronic or sonometric methods, some using connected mobile applications, present results that are more consistent with ICS recommendations for flow measurement. With the possibility of studying the average of several values of the maximum urinary flow (Qmax) captured during micturition in physiological conditions, some studies suggest a gain in diagnostic value in the evaluation of the emptying phase and lower urinary tract symptoms in men. However, the literature is sparse, old and the clinical benefits are not yet proven.
There is a wide range of techniques for measuring urine flow in the patient's home, all of which aim to fill the gaps in conventional urine flow measurement. Further studies are needed to demonstrate the acceptability of this type of measurement by patients, the existence of a real clinical benefit, to assess the cost/benefit balance and finally to define a possible place for home uroflowmetry in daily practice, compared with traditional free flowmetry and invasive urodynamics (pressure-flow test).
尿流率测定（UF）是评估下尿路症状（LUTS）患者排尿期的一项关键非侵入性尿动力学检查。传统的一次性在诊室进行的自由尿动力学检查（FUT）存在局限性，难以捕捉正常排尿情况，且尿流参数在患者个体间差异较大。患者在家中自行测量尿流率可能是一种在实际生活条件下获取多个数据的方法，可弥补其局限性。本文的目的是回顾关于家庭尿流率测定（HUF）不同技术的文献及其与FUT相比的临床意义。
在PubMed数据库中使用关键词“尿动力学、尿流率测定、非侵入性尿动力学、动态尿动力学、膀胱出口梗阻、男性LUTS”进行检索，以查找不限时间且截至2022年3月发表的英文或法文文章。通过阅读摘要进行筛选，选择所有描述和/或评估HUF技术的文章，并按照相同的收集框架完整阅读，以进行叙述性综述。
共识别、选择并分析了31篇文章。通过计时或使用漏斗的简单且廉价的技术能够可靠且可重复地估计与FUT相关的平均尿流率和最大尿流率，但无法提供完整的尿流曲线。更复杂的电子或声测方法，有些使用连接的移动应用程序，其呈现的结果与国际尿控学会（ICS）的尿流测量建议更为一致。由于有可能研究在生理条件下排尿过程中捕获的多个最大尿流率（Qmax）值的平均值，一些研究表明在评估男性排尿期和下尿路症状时诊断价值有所提高。然而，相关文献稀少且陈旧，临床益处尚未得到证实。
患者在家中测量尿流率的技术种类繁多，所有这些技术都旨在填补传统尿流率测量的空白。需要进一步研究以证明患者对这种测量方式的接受程度、是否存在真正的临床益处、评估成本效益平衡，最终确定与传统自由尿流率测定和侵入性尿动力学（压力 - 流率试验）相比，家庭尿流率测定在日常实践中的可能地位。
