Dynamic Analysis of the Voiding Patterns in Bladder Diaries Collected in Clinical Practice.

Aims: The goal of this study is to better understand the mechanisms and phenotypes of urinary urgency through the analysis of voiding patterns of clinical patients recorded in their bladder diaries.

Methods: A recently introduced, powerful dynamic analysis approach was used to analyze bladder diaries of a heterogeneous cohort of 227 patients treated in a single clinical practice. Individual voiding patterns were examined by performing intra-subject correlation analyzes of bladder diary variables and creating multivariable linear regression models. Individuals were clustered based on the characteristics of their voiding patterns.

Results: Five clusters of patients were identified based on their voiding patterns. Strong intra-subject correlations between bladder filling rate and urinary urge growth rate were demonstrated, indicating that bladder filling rate was the main driver of urinary frequency and of the intensity of the urge to void in most of the patients in each of the five clusters and in the whole heterogeneous clinical cohort.

Conclusions: Bladder filling rate was shown to be a driver of urinary urgency and frequency. Further studies are needed to explore the causes of the peaks of bladder filling rate and of the most beneficial behavioral modifications and treatments to reduce them, and therefore to minimize urinary urgency and frequency.