A basic urine flowmeter and a non-invasive bladder pressure measurement device used in conjunction for the diagnosis of bladder outlet obstruction

Benign enlargement of the prostate gland (and associated bladder outlet obstruction) is common in ageing men and can cause symptoms such as poor urine flow, urinating frequently and having to pass urine up at night. Many ageing men would benefit from treatment which is increasingly available in developing countries. Benefit from treatment, in particular surgery, is known to be more likely to improve if there is an objective diagnosis of outlet obstruction. Currently, the diagnosis of obstruction is a two-stage process. First of all, symptom assessment and a measurement of urine flow rate using specialised equipment are performed during a visit to a hospital clinic. Then, if a more definitive diagnosis is required, an invasive pressure-flow study, usually performed on a separate visit using specialised equipment and expert staff may be conducted. The test is expensive, uncomfortable and carries a risk of infection. We have been involved in the recent development of simpler alternatives to both of these measurement techniques. The first is a very simple disposable flowmeter which can be supplied to individuals and which allows serial, and by virtue of combining the measurements, more representative results. The second is an alternative to the pressure-flow study, a new device for obtaining bladder pressure measurements using a similar technique to noninvasive blood pressure measurements. We describe the principles underlying these techniques and propose how they may be introduced into a "low-tech" health care programme.