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Conclusions: The toiletattached uroflow device reported in this paper represents an innovative and useful tool for both patients and clinicians. Patients receive a uroflowmetry measurement that is comparable in data acquisition and interpretation to a standard uroflow procedure while the device does not require cleaning between patients, and patients can urinate in privacy on the toilet. For surgeons and patients, the time saved can be a significant improvement in clinic workflow.
Introduction: Uroflowmetry is an important tool for the assessment and management of patients with lower urinary tract symptoms (LUTS). Traditionally, the system requires a patient to urinate into a weightsensing or gravimetric collection vessel and then outputs urine flowrate or volume over time. Although noninvasive, this approach has major limitations. Patients undergo testing in uncomfortable and unrepresentative voiding environments that may compromise diagnostic accuracy. Furthermore, it requires manual cleaning and setup between each use, which leads to interruptions in clinic workflow and longer wait times. This study aims to design and implement a toiletattached uroflow device that performs the same standard of care measurements as gravimetric uroflow, but inside any standard toilet and without an external urine collection vessel.
Materials & Methods: A total of 66 patients met inclusion criteria. Average age at the time of RALP was 63.8 years old, while average preoperative PSA was 23.7. Average grade group (GG) on prostate biopsy was 3.3 with a mean of 13.9 cores taken and 6.9 cores being positive for disease. 55 patients (84.6%) underwent preoperative multiparametric magnetic resonance imaging of the prostate (mpMRI). Imaging displayed signs of extracapsular extension (ECE) in 11 patients (16.9%), seminal vesicle invasion in 5 patients (7.7%), and lymph node involvement in 5 patients (7.7%). Preoperative androgen deprivation therapy (ADT) was given to 7 patients (10.8%). Surgical pathology demonstrated an average GG of 3.6 with one specimen showing intraductal pathology and an additional three with cribriform changes. Positive margins were seen in 24 patients (36.9%), SVI in 25 patients (38.5%), and ECE in 41 patients (63.1%). An average of 8.8 lymph nodes were extracted per case with 9 cases positive for involvement (13.8%). Seven patients underwent postoperative PET/CT with two showing positive local disease. Average postoperative PSA nadir was 0.9ng/mL. Evidence of biochemical recurrence was found in 24 patients (36.9%).
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