The impact of psychological factors and anxiety on uroflowmetry results

The European Association of Urology and the International Incontinence Society recommend uroflowmetry (UF) as the first objective assessment tool for patients with signs and symptoms of lower urinary tract dysfunction. In addition, the American Urological Association stated that “clinicians should be aware that the UF may be affected by the voided volume (VV) and the conditions of the test” and that “consistent, similar and comparable serial UF measurements provide the most valuable results.” This study aimed to investigate the impact of psychological factors and anxiety on UF results. The study comprised 42 patients (20 men and 22 women) who presented to our clinic, reported lower urinary tract symptoms, and were scheduled to undergo UF between the 1st of February 2020 and the 1st of March 2022. We evaluated the generalized anxiety disorder-7 form (GAD-7) to determine the general and baseline anxiety level of the patients and the state–trait anxiety inventory scale (STAI-S) to determine the current anxiety level of the patients. A non-significant increase in post-voiding residual urine was observed in the second UF compared to the first one (p > 0.05). However, there was a significant increase in the VV, peak flow rate and average flow rate and a significant decrease in the time to peak flow rate for all patients (p < 0.05). Consistent with the GAD-7, all patients had moderate general anxiety before the first UF. However, men's anxiety levels decreased to a mild level on the second session (p < 0.05), while women's remained at a moderate level (p > 0.05). There was a non-significant decrease in STAI-S scores before the second uroflowmetry compared to the first in both genders (p > 0.05). In addition, women's STAI-S scores were higher than men's in both sessions (p < 0.01). No significant correlation was found between the percentage change in STAI-S scores and all uroflowmetry parameters (p > 0.05). We determined that patients of both genders experienced moderate general anxiety before UF, which decreased in men on the second session and remained in women. In addition, we found that the women had a higher momentary anxiety compared to men before both UF sessions. Patients' sense of privacy and embarrassment can lead to tension, anxiety and stress, which may have an impact on the results of UF. Reducing patient anxiety during the UF test can contribute to more accurate diagnoses and appropriate treatment by clinicians.