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Abstract Background Urologic guidelines universally recommend increasing fluid intake for kidney stone prevention. Increased voided volume is thought to help reduce stone recurrence and severity, but supporting evidence is limited. Patients and Methods Nephrolithiasis outcomes and 24‐h urine data for patients from the Registry for Stones of the Kidney and Ureter (ReSKU), a registry of nephrolithiasis patients collected between 2015 and 2020, were retrospectively analysed. Outcome was stone events, either an office visit where a patient reports symptomatic passage of stones or surgery for stone removal. Results We identified 450 stone patients with 24‐h urine and kidney stone outcome data. There was no significant difference in 24‐h voided volume between patients with one stone event and patients with two or more stone events. On multivariable logistic regression, after controlling for age, gender, BMI, and 24‐h sodium and creatinine per kilogram, no significant associations were found between voided volume and stone events. There was a statistically significant negative correlation noted between voided volume and stone events in calcium oxalate dihydrate stone formers (Spearman R = −0.42, p = 0.04), but not others. Conclusions Twenty‐four‐hour voided volume was not associated with stone events in a large institutional cohort, and subset analysis reveals that some stone formers may benefit more from increased voided volume than others; identifying such patients represents a novel precision medicine opportunity.

BackgroundLower urinary tract symptoms (LUTS) are common in children and adolescents. Non-invasive tests evaluating bladder function are generally preferred over invasive tests, yet few studies have explored the range of normative values for these tests in healthy, asymptomatic children.ObjectiveTo define normative reference ranges for non-invasive tests of bladder function in healthy, asymptomatic girls and adolescents.Study designA comprehensive search strategy was performed in seven electronic databases through October 2019. English-language studies reporting data on voiding frequency, voided and postvoid residual volumes (PVR) and uroflowmetry results in healthy, asymptomatic girls (mean age ≥ 5 years) were included. Two independent reviewers performed study review, data extraction, and quality assessment. Overall mean estimates and 95% confidence intervals for each bladder function parameter were calculated using random effects models, and 95% normative reference values were estimated.ResultsTen studies met eligibility criteria for the meta-analysis (n = 2143 girls, age range: 3-18). Mean estimates of maximum voided volume and PVR were 233.4 ml (95% CI 204.3-262.6; n = 1 study) and 8.6 ml (95% CI 4.8-12.4; n = 2 studies) respectively. Pooled mean estimates for uroflowmetry parameters were: 21.5 ml/s (95% CI 20.5-2.5) for maximum flow rate (n = 6 studies), 12.5 ml/s (95% CI 11.2-13.8) for mean flow rate (n = 6 studies), 6.8 s (95% CI 4.4-9.3) for time to maximum flow (n = 3 studies), 15.7 s (95% CI 13.0-18.5) for flow time (n = 3 studies), and 198.7 ml (95% CI 154.2-234.2) for voided volume (n = 9 studies). No studies reported estimates of voiding frequency. Between-study heterogeneity was high (89.0-99.6%).ConclusionsAlthough we were able to calculate pooled mean estimates for several parameters, the small number of included studies and the wide age ranges of participants preclude generalization of reference values to all healthy girls. Further research is needed to determine normative reference values within specific age groups.

Objective: We aimed to established normal uroflowmetric values and subsequently derived nomograms of maximum flow rate (Qmax) and average flow rate (Qavg) against voided volume (VV) in children aged 5–15 years at our institute. Methods: A total of 440 children underwent uroflowmetric evaluation with no history of urological, renal, psychiatric, or neurological disorder between 5 and 15 years of age. Each subject data regarding Qmax, Qavg, VV, time to Qmax, and flow time, as well as age, sex, height, and weight were recorded. Of the 440 children, around 300 (68.18%) children could produce a normal flow rate at VV of more than 50 mL. Of the remaining 140 (31.82%) children, 50.00% voided less than 50 mL, and remaining 50.00% had abnormal voiding pattern, staccato or interrupted (21.43% each) and plateau or tower shaped (3.57% each). Cases were divided into two age groups (5–9 years and 10–15 years), and uroflowmetric analysis was done between boys and girls in both age groups to derive nomograms of Qavg and Qmax. Results: Qmax and Qavg flow nomograms were plotted for boys and girls. Mean Qmax for boys was 16.68 mL/s and for girls 20.69 mL/s. The mean Qavg values were 11.04 mL/s and 8.60 mL/s for girls and boys, respectively. The Qmax and Qavg values were higher in girls. There were significant increases in flow rates with increasing age, body surface area, and VV in both sexes. Conclusions: Nomograms for Qmax and Qavg may be a useful tool in evaluation of lower urinary tract disturbances in children.

Abstract Background Objective assessment of voided volumes in children with lower urinary tract dysfunction is important. This study aimed to compare and evaluate voided volumes obtained from a 48-h voiding diary and uroflowmetry in children with lower urinary tract dysfunction. Methods In this retrospective cohort study, voided volumes obtained by 48-h voiding diary and contemporaneous uroflowmetry were compared in terms of age, sex, and the three most common subtypes of lower urinary tract dysfunction (monosymptomatic nocturnal enuresis, overactive bladder, and dysfunctional voiding) in children. Patients were stratified according to voided volume differences between uroflowmetry and 48-h voiding diary. Results A total of 242 children were included in the study. Maximum and average voided volumes in uroflowmetry were higher than those in 48-h voiding diaries in the entire population (P 0.05). When the two methods were compared, there was a difference in maximum and average voided volumes of more than 30% of the estimated bladder capacity in 94 (38.9%) and 86 (34.3%) children, respectively. Conclusions Uroflowmetry and a 48-h voiding diary should not be used interchangeably when evaluating children with lower urinary tract dysfunction. The results of uroflowmetry measurements should be used to support the diagnosis of underlying lower urinary tract dysfunction.

Background: Diapers are commonly used by older patients with urination disorders. A smart diaper system (SDS) may be able to estimate the weight of urine comparably to conventional measurements made by weighing diapers., Objective: The aim of the current research is to determine the degree of accuracy of an SDS technology specifically designed for the management of urination routines and the use of incontinence pads in older adults., Methods: From January to December 2022, 97 older patients with at least 1 chronic disease from 3 nursing homes were included. In this study, the SDS was used for 1 month per patient after obtaining their consent; all patients originally used traditional diapers in the nursing home. The index test measured the change in electrical resistance of the SDS and the reference test measured the change in actual urine weight. When measuring the actual urine weight, the degree of absorption was directly confirmed with the naked eye because the expression value varied according to pressure changes caused by the user's movement or position. The Pearson correlation was used to determine the correlation between the 2 test methods, the intraclass correlation coefficient (ICC) was used to check the degree of agreement between the evaluators, and the Bland-Altman test was used to confirm whether there was a significant difference between the 2 test methods., Results: The average age of the 97 participants was 86.48 (SD 6.26) years, with 10 men and 87 women. There were 73 patients (75%) with hypertension, 86 patients (88%) with dementia, and 86 patients (88%) with 2 or more comorbidities, accounting for the majority. The Pearson correlation coefficient and ICC were 0.971 and 0.985 (P<.001). In the Bland-Altman figure, the difference in the mean between the 2 tests was evenly scattered without showing a specific pattern, indicating that the SDS and actual urine weight were very consistent. The difference between the mean of the 2 tests was -0.045 of the standardized mean difference, and all measurements were located within the 95% CI, so this confirms that the 2 test methods are equivalent., Conclusions: Our study showed a fairly high correlation coefficient and ICC for all patient groups, which reveals that the 2 tests were very consistent and that the SDS can replace traditional diapers, even in a real clinical setting. This study shows the possibility that heath care professionals could be alerted by the SDS to the need for pad replacement due to incontinence, thus avoiding the development of dermatological complications., (©Jae Heon Kim, Ui Cheol Lee, Byeong Hun Jeong, Byeong Uk Kang, Sung Ryul Shim, In Gab Jeong. Originally published in JMIR Formative Research (https://formative.jmir.org), 24.10.2024.)

Purpose: To evaluate the effect of a mobile digital intervention on voiding patterns, we performed 24-h voided volume monitoring in individuals with metabolic disorders. Methods: Participants with metabolic disorders were grouped into either the intervention group (n = 17), who had access to a smartphone app (CARADA), or the non-intervention group (n = 11), who did not. Urine monitoring was conducted for 24 h using a novel digital self-health monitoring system for urine excretion (s-HMSU). Body weight, abdominal circumference, blood pressure, and biomarkers were measured. Results: Physical findings and blood test results at baseline and 6 months indicated no significant between-group differences. Night-time frequency did not change between baseline and 6 months in the intervention group but significantly worsened at 6 months in the non-intervention group, as compared to baseline (1.0 ± 0.7 vs. 1.5 ± 0.5, p < 0.05). The change in night-time frequency over 6 months did not differ between the intervention and non-intervention groups. Furthermore, the change in hours of undisturbed sleep over 6 months did not differ between the two groups. However, compared with baseline, nocturnal polyuria index tended to worsen at 6 months in the non-intervention group. Conclusion: Our study results suggest that mobile digital intervention might be useful for behavioral therapy to improve night-time frequency and urine production and that s-HMSU might be beneficial for confirming the prevention of progress in individuals with metabolic disorders, which can aid in modifying lifestyle. [ABSTRACT FROM AUTHOR]

Objective: This retrospective cohort study with propensity score (PS) matching aimed to evaluate the efficacy and safety of a combination therapy with vaginal and urethral erbium:yttrium aluminum garnet laser (VEL+UEL) (SP Dynamis; Fotona d.o.o., Ljubljana, Slovenia) in the treatment of overactive bladder with urinary incontinence (OAB-wet)., Methods: The study included female OAB-wet patients aged 65 and above who were already taking OAB medication. Data obtained from electronic medical records were subjected to propensity score matching. All patients received instructions on pelvic floor exercises and were prescribed an appropriate dose of OAB medication. The VEL+UEL group (n=30) underwent three monthly laser sessions, while the control group (n=30) did not receive the treatment. Clinical outcomes were evaluated using the Overactive Bladder Symptom Score (OABSS), International Consultation on Incontinence Questionnaire-Short Form (ICIQ-SF), three-day urination diary, and Vaginal Health Index Score (VHIS). Medication usage and adverse events were also assessed. Statistical analysis and R code were performed using the AI chatbot GPT-4.0., Results: The VEL+UEL group showed significant improvements in OABSS score, ICIQ-SF score, voided volume, daytime frequency, nocturia, and VHIS after 12 months of treatment (p<0.001). Notably, 13.3% of patients transitioned from OAB-wet to OAB-dry. In contrast, the control group did not exhibit significant changes. Medication use was significantly reduced in the VEL+UEL group compared to the control group (p<0.001). No long-term side effects were reported., Conclusion: Combination therapy with VEL+UEL demonstrated efficacy and safety in the treatment of OAB-wet. Improvements in OAB symptoms, voided volume, frequency, nocturia, and vaginal health were observed, with a subset of patients transitioning to OAB-dry. VEL+UEL therapy offers a potential treatment option for OAB-wet, reducing medication use and improving patient outcomes. Further research is warranted to investigate the mechanism, long-term effects, safety, and cost-effectiveness of VEL+UEL therapy., Competing Interests: Human subjects: Consent was obtained or waived by all participants in this study. Ethical Review Board of Yokosuka Urogynecology and Urology Clinic issued approval 24-C001. The study was conducted in accordance with the principles of the Declaration of Helsinki. Informed consent was obtained from all patients, and written consent was signed by each patient. Animal subjects: All authors have confirmed that this study did not involve animal subjects or tissue. Conflicts of interest: In compliance with the ICMJE uniform disclosure form, all authors declare the following: Payment/services info: All authors have declared that no financial support was received from any organization for the submitted work. Financial relationships: All authors have declared that they have no financial relationships at present or within the previous three years with any organizations that might have an interest in the submitted work. Other relationships: All authors have declared that there are no other relationships or activities that could appear to have influenced the submitted work., (Copyright © 2024, Okui et al.)

Introduction: We compared voided volumes (VV) at voiding diaries (VD) and at uroflowmetry (UF) in men with lower urinary tract symptoms (LUTS). Methods: This was a prospective, multicenter study. In a cohort of males with LUTS, VV reported in 3-day VD was compared to VV recorded at UF. Demographic data were analyzed. The patients were stratified according to VV. A sub-analysis dividing males by age strata was also performed. Results: We enrolled 169 patients. Mean VV were higher at UF than at VD in the entire population and in each group, stratified by age. VV significantly decreased with aging. Males with the lowest threshold difference (50 mL) were 29%, with a moderate threshold difference (<100 mL) 55.6%, with an intermediate threshold difference 49.1% (51–150 mL), whereas 21.9% of men had a large threshold difference (>150 mL). Discussion/Conclusion: VV correlation between VD and UF was poor. A large part of men performed UF with VV which were poorly comparable to the habitual VV assessed by 3-day VD. Therefore, our results indicate the relevance to obtain more than 1 UF in these patients. [ABSTRACT FROM AUTHOR]

Purpose: To determine if patients can accurately estimate volumes voided in a bladder diary, and to determine the patient characteristics that are most predictive of accuracy in volume estimation in the workup of lower urinary tract symptoms (LUTs). Methods: We prospectively collected data on 180 consecutive patients undergoing a workup for LUTs at a tertiary care facility. Data collected include American Urological Association Symptom Scores (AUASS), flow time and rate, and one time measurement of voided volume into a blinded uroflow. Baseline characteristics and demographics were recorded. Descriptive statistics and linear regression analysis were performed to examine predictors of estimated voiding volume (mL) in SAS Version 9.4 (SAS Institute, Inc., Cary, NC, USA). Results: Median age and BMI were 64 years (SD = 15.4) and 26.9 kg/m2 (SD = 4.6), respectively. The median estimated voided volume and actual voided volume were 120 mL (range 1–480) and 101.5 mL (range 6.5–622.0), respectively. On linear regression analysis, 47.1% of patients estimated volume voided with a 20% margin of error, and 63.2% of patients estimated with a 30% margin of error. Each 1-year increase in age correlated with a 2% decrease in the odds of estimating voided volume within 20% of actual volume (p < 0.05). For each 1 unit increase in flow rate, there was an 8% (p < 0.005) increase in the odds of estimating voided volume within 20% of actual volume. Conclusions: Just under half of patients can accurately estimate volume voided with a margin of error of 20%. [ABSTRACT FROM AUTHOR]

Aim: To validate a novel digital health monitoring system to measure the volume of voided urine. Methods: Micturition volume was calculated using our novel digital self‐health monitoring system of urine excretion (s‐HMSU) in 18 participants (16 women and 2 men; average age, 40.8 years), without a history of voiding symptoms. Participants completed a self‐reported questionnaire regarding their medical history and water intake during the period of observation, as well as the Core Lower Urinary Tract Symptom Score (CLSS) questionnaire. To assess the reliability of the voided volumes measured using the s‐HMSU, the intraclass correlation coefficient (ICC) was calculated between the volume and the change in body weight before and after micturition. Results: The CLSS questionnaire confirmed the absence of urinary system diseases in all participants. The medical history was also negative with the exception of hypertension in one participant. The ICC (1,1) between the measured volume of urine excretion using the s‐HMSU and the change in body weight was 0.972 (95% confidence interval, 0.957‐0.982). Conclusions: The s‐HMSU system provides a reliable measure of voiding volume and is appropriate for home use. It has the potential to facilitate large‐scale clinical research to examine the relationship between medical diseases and voiding dysfunction. [ABSTRACT FROM AUTHOR]

Introduction Uroflowmetry is a widely accepted non-invasive diagnostic modality used in the evaluation of lower urinary tract dysfunction. While various nomograms have been established for different populations and races, there has been a lack of studies that focus on the South Indian populations. Consequently, the objective of the study was to investigate the urinary flow parameters in a healthy adult male South Indian population using uroflowmetry and identify the variations in flow rates. Additionally, the study sought to assess the influence of age and voided volume (VV) on flow rates and create a representative nomogram. Methods A total of 500 uroflowmetry tests were prospectively performed on healthy adult males. The gravimetric method was utilized for uroflowmetry. Flow charts and parameters were analyzed for correlation and linear regression models, and statistical calculations were employed to generate uroflow nomograms. Results The mean age of the participants was 37.77±9.91 years. The mean values for maximum flow rate (Qmax), average flow rate (Qavg), and VV were 23.42±6.64 mL/s, 11.71±3.77 mL/s, and 229.90±59 mL, respectively. A significant correlation was observed between flow rates (Qmax and Qavg) and VV, which indicated that increased VV leads to higher flow rates. Additionally, a significant negative correlation between the flow rates and age was noted. Conclusion The findings provide insight into the uroflow parameters of the South Indian adult male population and contribute to the development of nomograms, establishing normal reference ranges for flow rates across varying VVs. As a tribute to the hospital and the study participants, the nomogram was named the "Chengai Nomogram.", Competing Interests: The authors have declared that no competing interests exist., (Copyright © 2023, Javid et al.)

Introduction: Uroflowmetry is the objective method of measuring rate of urine flow. Nomograms are required to observe the change in flow rates at different voided volumes (VVs) and the use of which overcomes the limitation of referencing flow rates to any single VV. The purpose of the present study was to construct the Indian uroflow nomogram for adult healthy males between 15-40 years of age. Methods: A total of 1000 healthy males between 15 and 40 years of age were included in the study. Exclusion criteria were any urinary symptoms or urological intervention. Parameters analyzed statistically were age, peak flow rate (Q max ), average flow rate (Q avg ), and VV. A nomogram was drawn for the fitted regression model. Results: The mean age was 27.26 ΁ 6.71 years. The mean Q max , Q avg , and VV were 24.32 ΁ 3.50 ml/s, 9.45 ΁ 2.55 ml/s, and 420.93 ΁ 97.89 ml, respectively. The correlation between flow rates and VV was statistically significant, indicating that the higher the VV, the higher the flow rates. A negative significant correlation of Q max with age was seen in our study. We observed a decline of Q max by 1 ml/s/decade. The relationship of Q max with VV is in linear progression up to 600 ml, and then it becomes a plateau and with higher VV it declined. Conclusion: Q max exhibits significant correlation with VV and age. A nomogram was constructed to attain normal reference values of flow rate over different VVs.

Objective To examine whether voided volume ( VV) could change the uroflow patterns and result in children with lower urinary tract dysfunction ( LUTD). Methods Between January 2009 and May 2010, the children with LUTD were enrolled in this study. Uroflowmetry ( UF) combined with electromyography ( EMG) was performed two times and was reviewed independently by two urologists. UF-EMG curves were classified as bell, staccato, intermittent, plateau, and tower. Patients' expected bladder capacity ( EBC) and VV were recorded. Patients were divided into four groups according to their VV and EBC. Group 1, VV <50% of EBC; group 2, VV between 50 and 100% of EBC; group 3, VV between 100 and 125% of EBC; group 4, VV >125% of EBC. Results A total of 143 patients underwent UF-EMG at least two times and 382 results were obtained. Groups 1, 2, 3 and 4 consisted of 27, 60, 27 and 29 children, respectively. The percentages of normal, intermittent, plateau voiding patterns were 58.5, 12.8, 7.1% in group 1; 79.8, 5.4, 1.8% in group 2; 59.2, 8.5, 2.8% in group 3; and 37.2, 5.1, 2.6% in group 4, respectively. The percentages of staccato and tower pattern were 1.4, 20% in group 1; 9.1, 3.6% in group 2; 30, 0% in group 3; and 55.1, 0% in group 4, respectively. The rate of tower shape curve decreased as voided volume increased, but the rate of staccato curve increased as voided volume increased. Conclusions In case of exceeding the EBC, the test should be repeated with normal VV when UF results are being evaluated. [ABSTRACT FROM AUTHOR]

Background: Urologic guidelines universally recommend increasing fluid intake for kidney stone prevention. Increased voided volume is thought to help reduce stone recurrence and severity, but supporting evidence is limited., Patients and Methods: Nephrolithiasis outcomes and 24-h urine data for patients from the Registry for Stones of the Kidney and Ureter (ReSKU), a registry of nephrolithiasis patients collected between 2015 and 2020, were retrospectively analysed. Outcome was stone events, either an office visit where a patient reports symptomatic passage of stones or surgery for stone removal., Results: We identified 450 stone patients with 24-h urine and kidney stone outcome data. There was no significant difference in 24-h voided volume between patients with one stone event and patients with two or more stone events. On multivariable logistic regression, after controlling for age, gender, BMI, and 24-h sodium and creatinine per kilogram, no significant associations were found between voided volume and stone events. There was a statistically significant negative correlation noted between voided volume and stone events in calcium oxalate dihydrate stone formers (Spearman R  = -0.42, p  = 0.04), but not others., Conclusions: Twenty-four-hour voided volume was not associated with stone events in a large institutional cohort, and subset analysis reveals that some stone formers may benefit more from increased voided volume than others; identifying such patients represents a novel precision medicine opportunity., Competing Interests: All authors declare that they have no conflict of interest regarding the material presented in this manuscript. All authors declare that they approve submission of the final article., (© 2023 The Authors. BJUI Compass published by John Wiley & Sons Ltd on behalf of BJU International Company.)

The article provides information on the etiology and treatment of nocturia. Nocturia refers to the number of voids experienced while sleeping in which every void is preceded and followed by sleep. In the U.S., nocturia has been observed between 58 and 66 percent in women, as well as men ages 50 to 59 years old. Among the kinds of nocturia include polyuria, nocturnal polyuria and mixed nocturia.

Introduction: Uroflowmetry is the objective method of measuring rate of urine flow. Nomograms are required to observe the change in flow rates at different voided volumes (VVs) and the use of which overcomes the limitation of referencing flow rates to any single VV. The purpose of the present study was to construct the Indian uroflow nomogram for adult healthy males between 15‑40 years of age. Methods: A total of 1000 healthy males between 15 and 40 years of age were included in the study. Exclusion criteria were any urinary symptoms or urological intervention. Parameters analyzed statistically were age, peak flow rate (Qmax), average flow rate (Qavg), and VV. A nomogram was drawn for the fitted regression model. Results: The mean age was 27.26 ± 6.71 years. The mean Qmax, Qavg, and VV were 24.32 ± 3.50 ml/s, 9.45 ± 2.55 ml/s, and 420.93 ± 97.89 ml, respectively. The correlation between flow rates and VV was statistically significant, indicating that the higher the VV, the higher the flow rates. A negative significant correlation of Qmax with age was seen in our study. We observed a decline of Qmax by 1 ml/s/decade. The relationship of Qmax with VV is in linear progression up to 600 ml, and then it becomes a plateau and with higher VV it declined. Conclusion: Qmax exhibits significant correlation with VV and age. A nomogram was constructed to attain normal reference values of flow rate over different VVs. [ABSTRACT FROM AUTHOR]

To determine, in a prospective study, whether detrusor pressure (pdet.Qmax) and maximum urinary flow rate (Qmax) measurements obtained after filling to maximum cystometric capacity (MCC) differ from those obtained with filling restricted to average voided volume (Vvoid), as standard protocols for pressure flow studies (PFS) mandate bladder filling until the subject has a strong desire to void, which aids standardization but further divorces the test from real-life experience. After calculating the appropriate sample size, 84 patients attending for PFS with an adequately completed 3-day frequency-volume chart were recruited. Each underwent two consecutive PFS with filling to MCC and average Vvoid in a random order, and measurements of pdet.Qmax and Qmax were compared. For men, the agreement for a diagnosis of obstruction between the tests was also assessed. Complete data were obtained from 76 (90%) of the patients, with a mean (range) age of 64 (20–94) years. The mean ( sd) difference between MCC and average Vvoid was 134 (113) mL ( P < 0.01). There were no significant differences between estimates of Qmax, at − 0.1 (3) mL/s ( P = 0.75), and of pdet.Qmax, at − 1 (13) cmH2O ( P = 0.91), obtained within each patient. For men there was 91% agreement (32 of 35) in the classification of obstruction. Restriction of filling to the average Vvoid during PFS allows a closer approximation to normal voiding and results in no clinically relevant change to the value of standard pressure-flow measurements or alters individual classification of obstruction. [ABSTRACT FROM AUTHOR]

Objective: We aimed to established normal uroflowmetric values and subsequently derived nomograms of maximum flow rate (Q max ) and average flow rate (Q avg ) against voided volume (VV) in children aged 5-15 years at our institute., Methods: A total of 440 children underwent uroflowmetric evaluation with no history of urological, renal, psychiatric, or neurological disorder between 5 and 15 years of age. Each subject data regarding Q max , Q avg , VV, time to Q max , and flow time, as well as age, sex, height, and weight were recorded. Of the 440 children, around 300 (68.18%) children could produce a normal flow rate at VV of more than 50 mL. Of the remaining 140 (31.82%) children, 50.00% voided less than 50 mL, and remaining 50.00% had abnormal voiding pattern, staccato or interrupted (21.43% each) and plateau or tower shaped (3.57% each). Cases were divided into two age groups (5-9 years and 10-15 years), and uroflowmetric analysis was done between boys and girls in both age groups to derive nomograms of Q avg and Q max ., Results: Q max and Q avg flow nomograms were plotted for boys and girls. Mean Q max for boys was 16.68 mL/s and for girls 20.69 mL/s. The mean Q avg values were 11.04 mL/s and 8.60 mL/s for girls and boys, respectively. The Q max and Q avg values were higher in girls. There were significant increases in flow rates with increasing age, body surface area, and VV in both sexes., Conclusions: Nomograms for Q max and Q avg may be a useful tool in evaluation of lower urinary tract disturbances in children., Competing Interests: The authors declare no conflict of interest., (© 2022 Editorial Office of Asian Journal of Urology. Production and hosting by Elsevier B.V.)

Background: Caregivers of patients who wear conventional diapers are required to check for voiding every hour because prolonged wearing of wet diapers causes health problems including diaper dermatitis and urinary tract infections. However, frequent checking is labor intensive and disturbs patients' and caregivers' sleep. Furthermore, assessing patients' urine output with diapers in an acute care setting is difficult. Recently, a smart diaper system with wetness detection technology was developed to solve these issues.Objective: We aimed to evaluate the applicability of the smart diaper system for urinary detection, its accuracy in measuring voiding volume, and its effect on incontinence-associated dermatitis (IAD) occurrence in an acute care hospital.Methods: This prospective, observational, single-arm pilot study was conducted at a single tertiary hospital. We recruited 35 participants aged ≥50 years who were wearing diapers due to incontinence between August and November 2020. When the smart diaper becomes wet, the smart diaper system notifies the caregiver to change the diaper and measures voiding volume automatically. Caregivers were instructed to record the weight of wet diapers on frequency volume charts (FVCs). We determined the voiding detection rate of the smart diaper system and compared the urine volume as automatically calculated by the smart diaper system with the volume recorded on FVCs. Agreement between the two measurements was estimated using a Bland-Altman plot. We also checked for the occurrence or aggravation of IAD and bed sores.Results: A total of 30 participants completed the protocol and 390 episodes of urination were recorded. There were 108 records (27.7%) on both the FVCs and the smart diaper system, 258 (66.2%) on the FVCs alone, 18 (4.6%) on the smart diaper system alone, and 6 (1.5%) on the FVCs with sensing device lost. The detection rate of the smart diaper system was 32.8% (126/384). When analyzing records concurrently listed in both the FVCs and the smart diaper system, linear regression showed a strong correlation between the two measurements (R2=0.88, P<.001). The Bland-Altman assessment showed good agreement between the two measurements, with a mean difference of -4.2 mL and 95% limits of agreement of -96.7 mL and 88.3 mL. New occurrence and aggravation of IAD and bed sores were not observed. Bed sores improved in one participant.Conclusions: The smart diaper system showed acceptable accuracy for measuring urine volume and it could replace conventional FVCs in acute setting hospitals. Furthermore, the smart diaper system has the potential advantage of preventing IAD development and bed sore worsening. However, the detection rate of the smart diaper system was lower than expected. Detection rate polarization among participants was observed, and improvements in the user interface and convenience are needed for older individuals who are unfamiliar with the smart diaper system. [ABSTRACT FROM AUTHOR]

ABSTRACT Bladder capacity is an important factor in the diagnosis and treatment of individuals with voiding dysfunction. In contrast, self-reported quantity of normal maximal voided volume in healthy young is few. The purpose of this study was to define the quantity of normal maximal voided volume in healthy young. This prospective study was carried out in 72 students aged 17-24 years who did not have clinical voiding dysfunction undergoing nursing education in a University in Sakarya, Turkey. The study was conducted in December 2011. Healthy young were recruited to determine the quantity of the normal maximal voided volume. The maximal voided volume was determined in all subjects using a frequency volume chart with a voiding observation. In our study, the normal maximal voided volume (mL) for females was 413·3 ± 167.9 and the normal maximal voided volume (mL) for male was 589·2 ± 108·5. These formulas may be useful for the diagnosis of abnormal bladder capacity and the evaluation of voiding dysfunction in young. This research may be the source for studies that could include climate, cultures and different age groups. [ABSTRACT FROM AUTHOR]

Attention deficit hyperactivity disorder (ADHD) is characterised by a range of symptoms, such as excessive mobility, difficulty in maintaining attention and inadequate impulse control. Methylphenidate (MPH) is widely prescribed as a treatment for ADHD. In the literature, studies investigating the effects of MPH on the lower urinary tract (LUT) are limited. The aim of the study was to evaluate MPH-induced LUT symptoms (LUTSs) in patients with ADHD without a diagnosis of voiding dysfunction (VD). After ethical committee approval, volunteers aged 7–17 y were divided into two groups, with group 1 composed of individuals diagnosed with ADHD but not VD and group 2 (control) composed of healthy individuals. Lower urinary tract symptoms and quality of life, in addition to uroflowmetry test results and postvoiding residual volume (PVRV), were evaluated in both groups at baseline and again 4 wk later. The individuals in group 1 were treated with MPH after baseline screening. The dysfunctional voiding scoring system questionnaire was used for scoring LUTSs. Postvoiding residual volume was measured by ultrasound. Bladder capacity (BC) was calculated as the sum of voided volume (VV) and PVRV. The means of the maximum flow rate (Q max), mean flow rate (Q mean), VV, PVRV and BC were recorded. After exclusions, there were 43 participants in group 1 and 39 participants in group 2. There was no significant difference between the mean age of groups (p = 0.727). Compared with the baseline, VV and BC increased significantly in group 1 (p = 0.001 and p = 0.002, respectively) at the 4-wk follow-up. There was no significant difference in these parameters in group 2. This study demonstrated that VV and BC increased after MPH treatment in patients with ADHD without a diagnosis of VD. The mechanism underlying this effect is unclear, but it may be associated with dopaminergic and noradrenergic effects. The findings of the present study can inform further studies on the mechanism underlying the effect of MPH on the LUT. In a future study, the authors suggest evaluating the effects of MPH in a urodynamic study in patients with ADHD diagnosed with VD. Summary Table The significant results of the study group (group 1). Summary Table Evaluated parameters Initial (mean ± SD); (n = 43) 4th week (mean ± SD); (n = 43) p value VV (ml) 216.86 ± 36.63 232.09 ± 37.48 0.001 ∗ BC (ml) 222.79 ± 38.85 237.09 ± 39.45 0.002 ∗ VV = voided volume; BC = bladder capacity; SD = standard deviation. ∗ Bolded results are statistically significant p values. [ABSTRACT FROM AUTHOR]

Objectives To evaluate the accuracy of sonouroflowmetry in recording urinary flow parameters and voided volume. Methods A total of 25 healthy male volunteers (age 18-63 years) were included in the study. All participants were asked to carry out uroflowmetry synchronous with recording of the sound generated by the urine stream hitting the water level in the urine collection receptacle, using a dedicated cell phone. From 188 recordings, 34 were excluded, because of voided volume <150 mL or technical problems during recording. Sonouroflowmetry recording was visualized in a form of a trace, representing sound intensity over time. Subsequently, the matching datasets of uroflowmetry and sonouroflowmetry were compared with respect to flow time, voided volume, maximum flow rate and average flow rate. Pearson's correlation coefficient was used to compare parameters recorded by uroflowmetry with those calculated based on sonouroflowmetry recordings. Results The flow pattern recorded by sonouroflowmetry showed a good correlation with the uroflowmetry trace. A strong correlation (Pearson's correlation coefficient 0.87) was documented between uroflowmetry-recorded flow time and duration of the sound signal recorded with sonouroflowmetry. A moderate correlation was observed in voided volume (Pearson's correlation coefficient 0.68) and average flow rate (Pearson's correlation coefficient 0.57). A weak correlation (Pearson's correlation coefficient 0.38) between maximum flow rate recorded using uroflowmetry and sonouroflowmetry-recorded peak sound intensity was documented. Conclusions The present study shows that the basic concept utilizing sound analysis for estimation of urinary flow parameters and voided volume is valid. However, further development of this technology and standardization of recording algorithm are required. [ABSTRACT FROM AUTHOR]

Purpose: We determined flow rates and generated flow rate-voided volume nomograms based on healthy children 5 to 15 years old voiding spontaneously in their natural environment., Materials and Methods: A total of 824 healthy school children of both genders were enrolled. A single uroflow record from each child was evaluated. A total of 103 children with a voided volume of less than 50 ml and/or a staccato/interrupted uroflow pattern were excluded, and 721 records were analyzed. Data were evaluated using several mathematical formulas and goodness of fit was determined. Linear regression analysis was used to generate nomograms., Results: Flow rates and voided volumes increased with increasing age, with the effect being more pronounced in girls. No significant difference was noted in uroflow rates from 5 to 10 years, but significant differences (p <0.001) started appearing at 11 to 15 years. Also no significant difference was noted in uroflow rates among children 11 to 15 years. Therefore, 2 age groups were designated, with group 1 consisting of patients 5 to 10 years old and group 2 consisting of patients 11 to 15 years old. There were 222 boys and 122 girls in group 1 and 240 boys and 137 girls in group 2. In group 1 the maximum and average ± SD flow rates were 15.26 ± 4.54 ml per second and 7.68 ± 3.26 ml per second, respectively, for boys and 17.98 ± 6.06 ml per second and 9.19 ± 4.23 ml per second, respectively, for girls. In group 2 these rates were 22.50 ± 7.24 ml per second and 10.78 ± 4.03 ml per second, respectively, for boys and 27.16 ± 9.37 ml per second and 13.48 ± 5.21 ml per second, respectively, for girls., Conclusions: This large study, which expands the scant existing literature on uroflow parameters in healthy children, will hopefully promote wider application of uroflowmetry testing in the pediatric population., (Copyright © 2013 American Urological Association Education and Research, Inc. Published by Elsevier Inc. All rights reserved.)