Beyond Pressure-flow: Integrating Lower Urinary Tract Ex Vivo, In Vitro and In Silico Modelling with Urodynamics

Abstract Purpose of Review The lower urinary tract (LUT) plays a critical role in urine storage and voiding, and its dysfunction is associated with a range of clinically significant conditions. A wide variety of modelling approaches have been developed to investigate LUT function; however, these efforts remain fragmented across experimental and computational domains. The purpose of this review is to provide a comprehensive overview of macroscale LUT modelling approaches (focusing on ex vivo, in vitro, and in silico models) and to evaluate their clinical relevance, applications, and limitations. This work aims to identify opportunities for integration and guide future research in clinically relevant LUT modelling. Recent Findings Recent studies have advanced LUT modelling through improved experimental characterisation of tissue mechanics and contractility, the development of anatomically and mechanically representative in vitro platforms, and increasingly sophisticated computational models, including computational fluid dynamics, finite element analysis, and fluid-structure interaction. These approaches have enabled detailed investigation of pressure-flow relationships, tissue deformation, and device-tissue interactions. Emerging trends include the use of patient-specific geometries, reduced-order computational models, and hybrid experimental-computational frameworks. Despite these advances, challenges remain in model validation, multi-scale integration, and the translation of findings into clinical practice. Summary This review highlights the complementary strengths of ex vivo, in vitro, and in silico models in advancing the understanding of LUT function. Greater integration of these approaches, particularly through the incorporation of clinical data such as urodynamics, offers significant potential to improve mechanistic insight, enhance model validation, and support the development of personalised diagnostic and therapeutic strategies.