Uroflowmetry and a voiding diary are important diagnostic tools to assess urinary tract symptoms.  In-clinic uroflowmetry is a one off sampling and may not reflect the patient’s actual voiding patterns especially in children.  Paper voiding-diaries are a burden, for patients and frequently associated with poor compliance. Failure to collect accurate data may lead to an inaccurate assessment and diagnosis resulting in negative experiences for the patients.  iUFlow (fig. 1) is an easy to use home bladder-monitoring device, implemented on a mobile platform, allows every void at home to be a validated uroflowmetry and recorded in an electronic voiding diary. This study aims to assess the feasibility of using iUFlow in the pediatric population.

24 patients were asked to complete a 3-day home bladder monitoring using iUFlow, followed by patient Satisfaction questionnaire. Additionally, in-office uroflowmetry data were compared to multiple iUFlow readings captured at home.

22/24 (92%) subjects fully completed 3-day monitoring. Mean participant age was 7.3 years (std. dev:  3.7). Mean uroflowmetry measurements collected per participant was 12.07 (std. dev:  7.84). The shape of the curves and Qmax generated by iUFlow corresponded with the in-office uroflowmetry measurement (fig. 2) and the voiding diaries were accurate and complete for each at home void. Nighty four percent of the patients had a positive experience using iUFlow device and the related app. A minority of only six percent of the patients reported a preference to use the conventional pen and paper bladder diary over a digital bladder diary, while 62.5% favor a digital bladder diary; 31.3% reported that both are fine.

The main clinical advantage of the iUFlow is increased patient compliance when completing a voiding diary, since the device is always there (day and night), there is no need for the patient to read or write the volume of urine, and therefore there is no missing data. The data thus betters reflects the patient’s underlying symptoms. A logical explanation for the high compliance could be supported by the fact that the perceptions of the children upon completion of the fully automated voiding diary trial were positive. The iUFlow reported as a relatively easy to use for monitoring fluid intake and bladder events at home.
The home uroflowmetry data collected by iUFlow produces a picture of the children’s bladder behavior in-vivo, in its normal condition of the child daily life.
Importantly, patients found to be ripped to digital health. When were asked: “Do you think that there is a benefit in sending the diary to the doctor prior to your next visit?” 93.8% responded overwhelmingly positively, suggesting openness for new technological innovations (while 7.2% reported `possibly` and none answered `definitely no`).

iUFlow is an easy to use, automated method for monitoring fluid intake and bladder events at home improving compliance and quality of data collected. iUFlow may enable better understanding of the overall behavior of the bladder in the child’s  comfortable home environment.