Assessment of urinary flow dynamics may provide valuable insights into the mechanisms underlying lower urinary tract symptoms (LUTS) and could support monitoring of treatment-induced changes in urethral function. However, conventional ultrasound techniques have limited capacity to quantitatively capture the high-speed, dynamic, and non-periodic nature of urinary flow during voiding. To address this limitation, we developed a contrast-enhanced ultrasound vector flow imaging framework (CE-UroVPI) and evaluated its feasibility for visualizing urinary flow through the prostatic urethra in patients with benign prostatic hyperplasia (BPH). In clinical studies, CE-UroVPI enabled detailed observation of urethral flow abnormalities, including turbulence, jet formation, and flow deviation that may be caused by anatomical obstructions and related to LUTS. Additionally, during prostatic urethra lift (PUL) procedures, a recent minimally invasive treatment for BPH, CE-UroVPI was used to record changes in intraluminal flow dynamics before and after implant placement. Straightening of the flow path and increased velocity were consistently observed following implantation. Although CE-UroVPI is currently limited to research settings, our findings suggest its potential as a functional imaging tool for pre- and post-treatment assessment of the urinary tract. Integration of real-time flow visualization with anatomical information may support future advances in image-guided, minimally invasive treatment of LUTS.
Ishii et al. (Wed,) studied this question.