Video Voiding Device for Diagnosing Lower Urinary Tract Dysfunction in Men

Mehdi Shokoueinejad,Nazeeh Alothmany,John G Webster,Jacob M Levin,Rayan Alkashgari,Hisham A Mosli

doi:10.1007/s40846-017-0283-8

Abstract

We introduce a novel diagnostic Visual Voiding Device (VVD), which has the ability to visually document urinary voiding events and calculate key voiding parameters such as instantaneous flow rate. The observation of the urinary voiding process along with the instantaneous flow rate can be used to diagnose symptoms of Lower Urinary Tract Dysfunction (LUTD) and improve evaluation of LUTD treatments by providing subsequent follow-up documentations of voiding events after treatments. The VVD enables a patient to have a urinary voiding event in privacy while a urologist monitors, processes, and documents the event from a distance. The VVD consists of two orthogonal cameras which are used to visualize urine leakage from the urethral meatus, urine stream trajectory, and its break-up into droplets. A third, lower back camera monitors a funnel topped cylinder where urine accumulates that contains a floater for accurate readings regardless of the urine color. Software then processes the change in level of accumulating urine in the cylinder and the visual flow properties to calculate urological parameters. Video playback allows for reexamination of the voiding process. The proposed device was tested by integrating a mass flowmeter into the setup and simultaneously measuring the instantaneous flow rate of a predetermined voided volume in order to verify the accuracy of VVD compared to the mass flowmeter. The VVD and mass flowmeter were found to have an accuracy of ±2 and ±3% relative to full scale, respectively. A VVD clinical trial was conducted on 16 healthy male volunteers ages 23–65.

Highlights

In human physiology there are two phases of the micturition cycle: the storage phase and the voiding phase
We introduce a novel diagnostic Visual Voiding Device (VVD), which has the ability to visually document urinary voiding events and calculate key voiding parameters such as instantaneous flow rate
While storage symptoms are usually due to bladder dysfunction, voiding symptoms are thought to be due to obstruction of the urinary passage by lesions such as Benign Prostatic Hyperplasia (BPH), urethral stricture, meatal stenosis and other urethral disorders such as stones, malignancy or traumatic lesions

Summary

Introduction

In human physiology there are two phases of the micturition cycle: the storage phase and the voiding phase. A major and essential step in the medical evaluation of LUTS is physical examination of the patient This usually focuses on the examination of the urinary bladder and the prostate gland. The most important parameter is the maximum flow rate (Q-max.) or the peak flow rate defined as the highest point on the curve the flow reaches during the period of voiding [9]. This is purely physics and recorded by a device that depends only on the physical properties of the voided urine, that is weight and the speed of its accumulation [10]. Positioning (Rotation, cropping, brightness, etc.) Video based measurement s Camera Light source Flow rate Averag flow

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