Background: Lower urinary tract symptoms affect a large number of people of all ages and sexes. The clinical assessment typically involves a bladder diary and uroflowmetry test. Conventional paper-based diaries are affected by low patient compliance, whereas in-clinic uroflowmetry measurement face challenges such as patient stress and inconvenience factors. Home uroflowmetry and automated bladder diaries are believed to overcome these limitations. Objective: In this study, we present our first-year experience of managing urological patients using Minze homeflow, which combines home uroflowmetry and automated bladder diaries. Our objective was 2-fold: first, to provide a description of the reasons for using homeflow and second, to compare the data obtained from homeflow with the data obtained from in-clinic uroflowmetry (hospiflow). Methods: A descriptive retrospective analysis was conducted using Minze homeflow between July 2019 and July 2020 at a tertiary university hospital. The device comprises a Bluetooth-connected gravimetric uroflowmeter, a patient smartphone app, and a cloud-based clinician portal. Descriptive statistics, Bland-Altman plots, the McNemar test, and the Wilcoxon signed rank test were used for data analysis. Results: The device was offered to 166 patients, including 91 pediatric and 75 adult patients. In total, 3214 homeflows and 129 hospiflows were recorded. Homeflow proved valuable for diagnosis, particularly in cases where hospiflow was unreliable or unsuccessful, especially in young children. It confirmed or excluded abnormal hospiflow results and provided comprehensive data with multiple measurements taken at various bladder volumes, urge levels, and times of the day. As a result, we found that approximately one-fourth of the patients with abnormal flow curves in the clinic had normal bell-shaped flow curves at home. Furthermore, homeflow offers the advantage of providing an individual’s plot of maximum flow rate (Q-max) versus voided volume as well as an average or median result. Our findings revealed that a considerable percentage of patients (22/76, 29% for pediatric patients and 24/50, 48% for adult patients) had a Q-max measurement from hospiflow falling outside the range of homeflow measurements. This discrepancy may be attributed to the unnatural nature of the hospiflow test, resulting in nonrepresentative uroflow curves and an underestimation of Q-max, as confirmed by the Bland-Altman plot analysis. The mean difference for Q-max was −3.1 mL/s (with an upper limit of agreement of 13 mL/s and a lower limit of agreement of −19.2 mL/s), which was statistically significant (Wilcoxon signed rank test: V=2019.5; P<.001). Given its enhanced reliability, homeflow serves as a valuable tool not only for diagnosis but also for follow-up, allowing for the evaluation of treatment effectiveness and home monitoring of postoperative and recurrent interventions. Conclusions: Our first-year experience with Minze homeflow demonstrated its feasibility and usefulness in the diagnosis and follow-up of various patient categories. Homeflow provided more reliable and comprehensive voiding data compared with hospiflow.

Background: Urinary incontinence affects approximately 7% to 10% of children during the day and 9% to 12% of children during the night. Treatment mainly involves lifestyle advice and behavioral methods, but motivation and adherence are low. Traditional tools such as pen-and-paper solutions may feel outdated and no longer meet the needs of today’s “digital native” children. Meanwhile, digital interventions have already shown effectiveness in other pediatric health care areas. Objective: This scoping review aimed to identify and map innovative, technology-driven, digital tools for managing pediatric urinary incontinence. Methods: PubMed, Web of Science, and the Cochrane Library were searched in March 2022 without date restrictions, complemented by cross-referencing. Studies were eligible if they focused on pediatric patients (aged ≤18 years) with bladder and bowel dysfunctions and explored noninvasive, technology-based interventions such as digital health, remote monitoring, and gamification. Studies on adults, invasive treatments, and conventional methods without tangible tools were excluded. Gray literature was considered, but non–English-language, inaccessible, or result-lacking articles were excluded. A formal critical appraisal was not conducted as the focus was on mapping existing tools rather than evaluating effectiveness. Data analysis combined descriptive statistics and qualitative content analysis, categorizing tools through iterative coding and team discussions. Results: In total, 66 articles were included, with nearly one-third (21/66, 32%) focusing on nocturnal enuresis. Our analysis led to the identification of six main categories of tools: (1) digital self-management (7/66, 11%); (2) serious games (7/66, 11%); (3) reminder technology (6/66, 9%); (4) educational media (12/66, 18%), further divided into video (5/12, 42%) and other media (7/12, 58%); (5) telehealth and remote patient monitoring (13/66, 20%), with subcategories of communication (5/13, 38%) and technological advances (8/13, 62%); and (6) enuresis alarm innovations (21/66, 32%), further divided into novel configurations (8/21, 38%) and prevoid alarms (13/21, 62%). Conclusions: The field of pediatric urinary incontinence demonstrates a considerable level of innovation, as evidenced by the inclusion of 66 studies. Many tools identified in this review were described as promising and feasible alternatives to traditional methods. These tools were reported to enhance engagement, improve compliance, and increase patient satisfaction and preference while also having the potential to save time for health care providers. However, this review also identified gaps in research, highlighting the need for more rigorous research to better assess the tools’ effectiveness and address the complex, multifaceted challenges of pediatric urinary incontinence management. Limitations of this review include restricting the search to 3 databases, excluding non–English-language articles, the broad scope, and single-reviewer screening, although frequent team discussions ensured rigor. We propose that future tools should integrate connected, adaptive, and personalized approaches that align with stakeholder needs, guided by a multidisciplinary, human-centered framework combining both qualitative and quantitative insights.

This paper addresses challenges in pediatric urotherapy, focusing on low patient compliance and motivation. Informed by creative sessions with children aged 9-13y, a novel urotherapy ecosystem concept is designed. It includes a smart drinking bottle, context-aware reminder watch, home uroflowmeter, smartphone app, and clinician portal. Interconnected products, embodied interaction, stigma-free design, and a digital training buddy aim to enhance engagement, motivation, and patient experience. This concept showcases the potential of integrating diverse design methodologies in healthcare design.

Lower urinary tract (LUT) dysfunctions, such as urinary incontinence, are a common condition among school-aged children (8 to 12 years old) and can negatively affect their quality of life. Urotherapy is the recommended first-line treatment, but patient compliance and motivation are low, resulting in a lower success rate. The traditional products used in urotherapy are often paper-based and outdated. In order to improve the products and services supporting urotherapy, it is important to involve users in the design process. This study describes the preparatory process for conducting focus groups and co-creation sessions with children following a 10-day urotherapy group training in the Wilhelmina Children's Hospital of UMC Utrecht, Netherlands. A literature search was conducted to design a focus group/co-creation toolkit and script tailored to the context of research on urotherapy supporting products with children. The toolkit consists of four key exercises: icebreaker and warm up exercise, collaging exercise, anonymous pen and paper exercise and a storyline character exercise. The goal is to optimize the products supporting urotherapy by defining patient needs and desires based on the current context and patient experiences.

Background: Standard urotherapy for childhood incontinence involves traditional tools like paper bladder diaries, timer watches, wetting alarms, and uroflowmeters. However, little is known about how these tools are experienced by today’s digitally native children. Objective: This study aimed to explore how children undergoing urotherapy perceive and experience these commonly used tools, with the goal of informing more engaging and child-centered design approaches. Methods: A qualitative focus group design was used with purposive sampling of children undergoing in-clinic urotherapy group training. In total, 19 participants (13 boys and 6 girls) aged 9-13 years took part in focus groups of 3 to 4 children, held at the hospital. A child-friendly focus group toolkit was used to facilitate discussion through creative and playful exercises. A total of 7 focus groups were conducted, including 2 repeated sessions, until thematic saturation was reached. All sessions were held in Dutch, video- and audio-recorded, and transcribed verbatim. An inductive conventional content analysis was conducted using a dual-coder approach to identify and iteratively refine emerging themes. Results: Four themes emerged: (1) attitudes and motivation: ranging from willingness to engage in urotherapy and use tools to reluctance or resistance; (2) social acceptance: highlighting the impact of peer perception, fear of being bullied, and opportunities to break the taboo and reframe tools as socially desirable; (3) contextual influences: including dissatisfaction with school toilets and limited child involvement at doctor visits, contrasted with the positive peer support experienced during group therapy; and (4) digital integration: children saw many traditional tools as outdated and suggested gamified, smart alternatives. The drawings created by children during the exercises served as a creative reflection of these thematic findings. Conclusions: Involving children in research and design is essential for creating interventions that are truly child-centered. Through creative, qualitative methods, this study uncovered rich insights into children’s experiences with urotherapy tools, pointing to 4 key design priorities: personalization, stigma-free design, adaptability, and digital innovation.