Method and system for deriving a pressure flow study score and components thereof
A method of assessing pressure flow study data is provided. The method is characterized by obtaining a select weighted average composite of select derived symptom sub-scores via use of a urodynamic system characterized by, in operative combination, a processor, memory and symptom score software executable by the processor, the urodynamic system receiving input from at least pressure and urine flow sensing devices. A flow rate efficiency sub-score is derived, along with a voided urine volume sub-score, a post void residual sub-score, a flow pattern sub-score and a pressure pattern sub-score.
1 . A method of assessing pressure flow study data for lower urinary tract symptom determination wherein voiding pressure and resulting urine flow rate determinations are obtained during a void event using a urodynamic system characterized by, in operative combination, a processor, memory and symptom score software executable by the processor, the urodynamic system receiving input from at least pressure and urine flow sensing devices in furtherance of ascertaining a maximum urine discharge flow rate, a maximum vesical pressure value, and a total volume of voided urine, comprising the steps of:
a. deriving a first primary symptom sub-score comprised of a flow rate efficiency symptom sub-score predicted upon a maximum vesical pressure value sensed via the pressure sensing device and upon a maximum urine discharge flow rate determined via the urine flow sensing device, or derivable from collected voided volume urine quantity as a function of time during a void event;
b. deriving a second primary symptom sub-score comprised of a post void residual symptom sub-score predicted upon a relationship between a measured voided volume of urine and a measured or sensed residual volume of urine remaining in a bladder post void;
c. deriving a third primary symptom sub-score comprised of a voided volume sub-score predicated upon the measured voided volume of urine;
d. deriving a first secondary symptom sub-score comprised of a flow pattern symptom sub-score predicated upon a relationship for, between and/or among a measured urine void time value, a derived hesitancy value based upon a sensing of one or more no flow conditions during a urine void event, a time to peak measured urine discharge flow, and the maximum urine discharge flow rate;
e. deriving a second secondary symptom sub-score comprised of a pressure pattern sub-score predicated flow rate efficiency and measured maximum pressure; and,
f. selectively combining select symptom sub-scores to obtain a symptom score comprising a select weighted average composite of select symptom sub-scores.
2 . The method of claim 1 wherein the selective combining of select symptom sub-scores emphasizes either of the flow rate efficiency symptom sub-score or the voided urine volume symptom sub-score.
3 . The method of claim 1 wherein the selective combining of select symptom sub-scores emphasizes both of the flow rate efficiency symptom sub-score and the voided urine volume symptom sub-score.
4 . The method of claim 1 wherein the selective combining of select symptom sub-scores comprises a hierarchical weighting of select symptom sub-scores to yield the select weighted average composite.
5 . The method of claim 1 wherein components of the pressure pattern sub-score comprise each of a shape of a curve associated with a plot of applied pressure as a function of time, a consistency of a proportional relationship between applied pressure and urine discharge flow rate, and maximum applied pressure.
6 . The method of claim 1 further comprising deriving an abdominal straining sub-score.
7 . The method of claim 1 further comprising deriving an abdominal straining sub-score, said abdominal straining sub-score reflective of plural components.
8 . The method of claim 1 further comprising deriving an abdominal straining sub-score, said abdominal straining sub-score reflective of plural components, the plural components comprising abdominal electromyography values obtained during pressure flow study performance and abdominal electromyography values obtained during performance of a simulated strain protocol.
9 . A urodynamic system for deriving a symptom score to augment findings associated with a pressure flow study for lower urinary tract symptom determination, the system comprising:
a. a processor for processing select urodynamic patient parameter inputs;
b. a database accessible by said processor;
c. a user interface device operably linked to said processor in furtherance of supporting processor control and/or display of patient parameter inputs/select processed urodynamic patient parameter inputs;
d. a pressure sensor for sensing vesical pressure during bladder filling and/or emptying, said select urodynamic patient parameter inputs characterized by pressure values obtained via said pressure sensor;
e. apparatus for deriving urine flow rate, said select urodynamic patient parameter inputs characterized by urine flow rate obtained via said apparatus for determining urine flow rate; and,
f. a symptom score derivation module operably linked/linkable with said processor, said database and said user interface device, said symptom score derivation module executing steps of deriving select symptom sub-scores characterized by two or more of a flow rate efficiency symptom sub-score, a post void residual symptom sub-score, a voided urine volume symptom sub-score, a flow pattern symptom sub-score, and a pressure pattern symptom sub-score, said flow rate efficiency sub-score predicted upon a maximum vesical pressure value sensed via the pressure sensor and upon a maximum urine discharge flow rate determined via the apparatus for deriving urine flow rate, said post void residual symptom subs-score predicted upon a relationship between a measured voided volume of urine and a measured or sensed residual volume of urine remaining in a bladder post void, said voided volume symptom sub-score predicated upon the measured voided volume of urine, said flow pattern symptom sub-score predicated upon a relationship for, between and/or among a measured urine void time value, a derived hesitancy value based upon a sensing of one or more no flow conditions during a urine void event, a time to peak measured urine discharge flow, and the maximum urine discharge flow rate, and said pressure pattern symptom sub-score predicated flow rate efficiency and measured maximum pressure, the symptom score comprising a select weighted average composite of select symptom sub-scores.