A Practical Phenotyping Framework for Male Lower Urinary Tract Symptoms Using Remote Multi-day Urinary Diagnostics.

Area of Science:

• Urology
• Medical Diagnostics
• Patient Phenotyping

Background:

• Lower urinary tract symptoms (LUTS) affect many men.
• Accurate phenotyping is crucial for effective LUTS management.
• Current diagnostic methods may not fully capture symptom complexity.

Purpose of the Study:

• To describe the distribution of Index Symptoms and Diagnostic Profiles in men with LUTS using Remote multi-day urinary diagnostics (RMUD).
• To establish a phenotyping framework for LUTS based on RMUD data.

Main Methods:

• Retrospective analysis of 1,047 RMUD studies in men with LUTS.
• RMUD combined frequency-volume, uroflowmetry, and International Prostate Symptom Score (IPSS) data.
• Six Index Symptoms and non-overlapping Diagnostic Profiles were defined.

Main Results:

• 37.6% of men met obstructive criteria; 33.5% had overactivity, with 13.9% primary overactivity.
• Nocturia (>2/night) affected 67.3%, and nocturnal polyuria (NP) affected 46.8%.
• 21 distinct Diagnostic Profiles emerged, often showing mixed storage-voiding-NP phenotypes.

Conclusions:

• RMUD-based phenotyping reveals significant heterogeneity in LUTS presentation among men.
• Identified patterns include obstruction, overactivity, and nocturnal polyuria.
• This framework supports precise patient counseling, treatment selection, and further evaluation.