Methods and value of home uroflowmetry in the assessment of men with lower urinary tract symptoms: a literature review.
OBJECTIVE
Uroflowmetry is a key clinical assessment for men with LUTS. Home uroflowmetry is a convenient way to obtain multiple flow readings and has the potential to combat problems inherent to clinic-based measurements. We reviewed current evidence regarding the technology and value of multiple and home uroflowmetry.


METHODS
We searched PubMed and Embase from January 1988 to February 2011 using a predetermined strategy. Reference lists from retrieved articles were scanned and additional papers screened for relevance. Proceedings of the annual meetings of the International Continence Society since 2008 were also searched. Relevant guidelines were obtained from the UK NHS Evidence repository.


RESULTS
Eight studies described five simple, low-cost instruments giving multiple representative estimates of Q(max) but not a complete flow curve. A further eight studies described home use of four sophisticated, electronic flowmeters similar to clinic-based equipment. The above methods were assessed against ICS recommendations for uroflowmetry and the results of several studies investigating variability of flow parameters such as Q(max) were presented.


CONCLUSIONS
Our findings illustrate the gulf between low-cost methods of obtaining average or peak flow measurements and precise, expensive devices with the capabilities of clinic flowmeters. Further studies are required to confirm the statistical benefit of averaging multiple values of Q(max) and to investigate the diagnostic and predictive value of flow variables other than Q(max) that can be derived from multiple recordings.
Institute of Cellular Medicine, Newcastle University, Newcastle upon Tyne, UK. alison.bray@nuth.nhs.uk
Alison
A
Bray
Clive
C
Griffiths
Michael
M
Drinnan
Robert
R
Pickard
D003362:Cost-Benefit Analysis; D006801:Humans; D059411:Lower Urinary Tract Symptoms / Q000503:physiopathology*; D008297:Male; D018670:Monitoring, Ambulatory / Q000191:economics / Q000295:instrumentation / Q000379:methods*; D015203:Reproducibility of Results; D012212:Rheology / Q000191:economics / Q000295:instrumentation* / Q000379:methods; D006113:United Kingdom; D014554:Urination / Q000502:physiology*; D014563:Urodynamics / Q000502:physiology