Assessment of the Daily Variation in Urinary Symptoms in Patients with Benign Prostatic Hyperplasia Using 24-Hr Home Uroflowmetry

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We used home uroflowmetry to assess urinary excretion over a 24-hr period and used the results of this study to evaluate the reliability of the International Prostate Symptom Score (IPSS) and to determine the daily variation in urinary excretion. Fifteen patients (mean age 68.3 years) with benign prostatic hyperplasia (BPH) were examined using home uroflowmetry. These patients also completed the IPSS questionnaire. The IPSS score was checked for agreement with the data recorded by home uroflowmetry. Urinations were classified into the following 4 periods. The 24-hr period was divided into the active period and the sleeping period. The home uroflowmetry parameters were compared to these periods. The IPSS scores for frequency and intermittency of urination correlated well with the respective home uroflowmetry scores. Regarding daily variation, maximum flow rate (Qmax) was often highest in the evening and lowest at night, and the voided volume and voiding time tended to be highest at night, and lowest in the afternoon. The mean Qmax and mean average flow rate (Qave) were significantly higher during the active period than during the sleeping period. In contrast, the mean voided volume and mean voiding time were significantly higher values during the sleeping period than during the active period. Two items on the IPSS questionnaire, frequency and interruption of the urinary stream, were found to be highly reliable. Qmax and Qave values varied during the 24-hr period and were an estimated 10% and 20% higher, respectively, during the active period than during sleeping period.

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