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).
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.
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.
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.
Urology. 2026 Mar 12 [Epub ahead of print]
Jeremy Watts, Daniel Godelfer, John Knoedler, Ashley Sturdy, Steven Kaplan, Ilya Sobol
iO Urology Corporation, Knoxville, TN, USA., Department of Urology, Icahn School of Medicine at Mount Sinai., Urology of Virginia, Virginia Beach, VA, USA; Department of Urology, Eastern Virginia Medical School, Norfolk, VA, USA. Electronic address: .