Our study is predicated on the hypothesis that there exists a significant correlation between uroflowmetry (UFM) and ultrasound (US) measurements in males suffering from lower urinary tract symptoms (LUTS). The primary objective is to explore how these correlations can inform the clinical assessment and management strategies for LUTS, potentially leading to improved patient outcomes.

We conducted a comprehensive analysis involving males diagnosed with LUTS. Participants underwent simultaneous UFM and US examinations to collect a wide array of data points. The UFM data encompassed maximum flow rate, mean flow rate, voiding time, voiding volume, post-void residual urine (PVR), bladder voiding efficiency (BVE), and flow pattern. Correspondingly, the US data included measurements of bladder wall thickness (BWT), prostate length, prostate volume, and intravesical prostatic protrusion (IPP). Through this methodological approach, we aimed to capture a holistic view of the urinary tract's functional and anatomical aspects in the context of LUTS.

The study cohort consisted of 473 men, with an average age of 62 years. Cases with incomplete data or low voiding volumes were systematically excluded to ensure the integrity of the analysis. Our investigation revealed three pivotal findings, each contributing to our understanding of LUTS pathophysiology:

Correlation Between Prostate Measurements and Uroflowmetry Parameters: Prostate length and volume demonstrated a notable correlation with UFM parameters such as maximum flow rate, mean flow rate, PVR, and BVE. This suggests that prostate size may directly impact the urinary flow and bladder emptying efficiency.

IPP, BWT and Voiding Time: IPP was found to correlate specifically with voiding time, independent of other prostate measurements. This indicates that IPP may have a unique role in influencing the mechanics of voiding. Similar to IPP, BWT was also associated with voiding time, suggesting that the structural characteristics of the bladder wall could affect voiding dynamics.

Symptoms and Flow Patterns: The study found a significant relationship between voiding symptoms and specific UFM parameters, such as maximum flow rate and mean flow rate, with these factors being indicative of intermittent and obstructive flow patterns. This highlights the clinical relevance of UFM in diagnosing and characterizing LUTS.

The findings from our study underscore the multifaceted nature of LUTS, where both anatomical features and functional parameters play critical roles. IPP, BWT, and symptoms correlate with voiding time. In contrast, prostate length and volume exhibit a stronger correlation with parameters such as maximum flow rate, mean flow rate, PVR, and BVE, without significant links to IPP. Symptoms, maximum flow rate, and mean flow rate indicate associations with the flow pattern. By unraveling these associations, our study contributes to a more nuanced understanding of LUTS pathophysiology, offering potential pathways for more effective diagnosis and management strategies that consider the multifactorial nature of these conditions.

Specific prostate and bladder parameters, notably IPP and BWT, are crucial for assessing voiding dynamics in LUTS, while prostate size impacts flow rates and bladder efficiency. Flow pattern is not only related to symptoms but also UFR. These insights not only enhance our understanding of LUTS pathophysiology but also pave the way for more targeted and effective management strategies, ultimately improving patient care in the realm of urology.

Continence 12S (2024) 101407
DOI: 10.1016/j.cont.2024.101407