ORCID
0009-0003-6003-590X (Sobol)
Document Type
Article
Publication Date
2026
DOI
10.1016/j.urology.2026.03.016
Publication Title
Urology
Volume
Advance online publication
Pages
16 pp.
Abstract
Objective
To describe the distribution of predefined Index Symptoms and Diagnostic Profiles in a cohort of men undergoing Remote multi-day urinary diagnostics (RMUD) for lower urinary tract symptoms (LUTS).
Methods
We retrospectively analyzed 1,047 RMUD performed with CarePath® in men referred for LUTS across 18 sites. RMUD combined multi-day frequency-volume and uroflowmetry data with the IPSS. Six Index Symptoms were operationalized: (1) low flow with elevated IPSS (device trial criteria), (2) overactivity, (3) primary overactivity (overactivity without obstructive RMUD findings), (4) nocturia, (5) nocturnal polyuria (NP) using the ICS NP index, and 6) no qualifying voids. Combinations of the Index Symptoms were used to define non-overlapping Diagnostic Profiles.
Results
Median age was 70 years and median IPSS was 14. Patients produced a median of 15 voids across a 2-day study and 92.8% produced at least one qualifying void ≥150 mL. Obstructive criteria were met in 37.6% of men, while 33.5% demonstrated overactivity and 13.9% had primary/idiopathic overactivity without RMUD evidence of obstruction. Nocturia >2 per night occurred in 67.3%, and NP in 46.8% of patients. Across the cohort, the 6 Index Symptoms combined into 21 discrete, non-overlapping Diagnostic Profiles, most of which reflected mixed storage-voiding-NP phenotypes rather than isolated obstruction.
Conclusion
RMUD-enabled phenotyping with Index Symptoms reveals substantial heterogeneity among men with LUTS and identifies patterns of obstruction, overactivity and NP. This LUTS phenotyping framework supports more precise counseling, treatment selection, and identification of patients who warrant further evaluation.
Rights
© 2026 The Authors
This is an open access article under the Creative Commons Attribution 4.0 International (CC BY 4.0) License.
Original Publication Citation
Watts, J., Godelfer, D., Knoedler, J., Sturdy, A., Kaplan, S., & Sobol, I. (2026). A practical phenotyping framework for male lower urinary tract symptoms using remote multi-day urinary diagnostics. Urology. Advance online publication. https://doi.org/10.1016/j.urology.2026.03.016
Repository Citation
Watts, J., Godelfer, D., Knoedler, J., Sturdy, A., Kaplan, S., & Sobol, I. (2026). A practical phenotyping framework for male lower urinary tract symptoms using remote multi-day urinary diagnostics. Urology. Advance online publication. https://doi.org/10.1016/j.urology.2026.03.016