Once Upon a Stream

Once Upon a Stream

The shape of your urine stream may help diagnose prostate problems.

A new report from Great Britain suggests that the shape of a man's urine stream can help diagnose prostate and other urinary issues. The researchers are hoping that their data will help lead to a solution that could help men monitor their rate of their urine flow, which is an important tool in diagnosing urinary issues, easily at home.

The results were published in the journal PLoS ONE, by Martin Knight and his colleagues from Queen Mary, University of London. Their paper describes the first study to analyze the physics of a man's urine flow as a potential tool to diagnose problems.

Your prostate gland tends to enlarge as you age. This condition known as benign prostatic hyperplasia , or BPH. As your prostate enlarges, a layer of tissue surrounding it prevents it from expanding, causing the gland to force against the urethra. The bladder becomes irritable and begins to contract even when it is not full, causing more frequent urination. Eventually, the bladder may weaken and lose the ability to completely empty, and some urine will remain in the bladder. This constricting of the urethra and limited voiding of the bladder produce many of the problems associated with BPH.

The researchers found that healthy men had characteristic spiral shaped urine streams, and this formation correlated with their maximum flow rate.

By applying some principles of fluid dynamics, they were able to demonstrate for the first time that the shape of the urine stream can be used as a diagnostic tool for physicians, according to aerodynamics researcher Andrew Wheeler from University of Southampton, and lead author of the study.

Uroflowmetry, which is the study of urine flow rate, has been used to help diagnose a wide range of urinary conditions for the past 50 years. Because of this, a range of procedures have been developed to allow measurement of urine flow involving weighing of the urine.

However, despite the long history of studying uroflowmetry, there had not been studies to see whether the characteristic shape or wave pattern of the urine stream could have diagnostic possibilities.

In order to test the theory that the shape of one’s urine stream may be diagnostic, Wheeler and colleagues first modeled the shape of a possible urine stream issuing from a number of different shaped orifices using computer software before confirming their findings using a video taken of a volunteer’s urine stream.

They discovered that for a healthy shaped urethral opening, the wavelength, or distance to the first ‘pinch point’ in a urine stream should be shaped like a repeating figure eight or hourglass. This was directly and positively related to the flow rate of urine, as measured using a clinical urine flow meter.

Monitoring the shape of the ‘wavelength’ and flow rate can be used to determine poor flow rate and dilation of the urethra. Low flow rate is an important indicator for underlying urological problems, according to Wheeler.

To test their theory, the researchers recruited healthy volunteers with an average age of 26, and a group of men averaging 67 years with urinary flow problems

They found that a simple measure of the characteristic shape of the flow pattern could accurately predict the maximum urine flow rate, an important measure in the diagnosis of urinary problems like those linked to prostate enlargement.

For the healthy volunteers, there was a significant positive correlation between peak flow rate and their estimated maximum wavelength. However, no such correlation was seen for the men with urine flow problems who showed substantial variation in these measurements.

This technique on its own can’t diagnose whether a low flow rate is caused by an obstruction in the urethra or problems with the bladder muscle, Wheeler explained. It also can’t establish whether any obstruction is due to an enlarged prostate or other problem. Only your physician can determine that.

The technique could be useful in monitoring a patient over an extended period of time. For example, it could be used measure the effectiveness of medication given to patients to reduce the size of an enlarged prostate.

There may even be a way that this could be monitored easily at home, where patients' flow rates are likely to be more typical than when measured in the hospital.

BPH symptoms can limit your daily (and nightly) functions. Symptoms associated with irritation are often a combination of the actual obstruction and the effects of the obstruction. Among the symptoms you may experience:

  • A weak or hesitant urine stream
  • Incontinence (leaking or dribbling)
  • Increased frequency of urination, particularly at night
  • Trouble beginning a urine stream or only making a dribble
  • Sensation that the bladder has not completely emptied
  • A strong or sudden urge to urinate
  • Stopping and starting again several times
  • Pushing or straining to begin

Early symptoms of BPH may take many years to become bigger problems. In most cases, these symptoms may point to an enlarged prostate, but they may also be a sign that other, more serious conditions that require prompt attention. If you are experiencing these early symptoms, it is a good time to see your doctor.

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