1747 PREDICTION OF BLADDER PROSTATIC OBSTRUCTION: DEVELOPMENT OF A SIMPLIFIED CLINICAL NOMOGRAM

Abstract

You have accessJournal of UrologyBenign Prostatic Hyperplasia: Epidemiology & Natural History/Evaluation & Markers1 Apr 20131747 PREDICTION OF BLADDER PROSTATIC OBSTRUCTION: DEVELOPMENT OF A SIMPLIFIED CLINICAL NOMOGRAM Cosimo De Nunzio, Riccardo Autorino, A. Bachmann, A. Briganti, Simon Carter, G. Novara, R. Sosnowski, N. Thiruchelvam, Andrea Tubaro, and S. Ahyai Cosimo De NunzioCosimo De Nunzio Roma, Italy More articles by this author , Riccardo AutorinoRiccardo Autorino Naples, Italy More articles by this author , A. BachmannA. Bachmann Basel, Switzerland More articles by this author , A. BrigantiA. Briganti Milan, Italy More articles by this author , Simon CarterSimon Carter London, United Kingdom More articles by this author , G. NovaraG. Novara Padua, Italy More articles by this author , R. SosnowskiR. Sosnowski Warsaw, Poland More articles by this author , N. ThiruchelvamN. Thiruchelvam Cambridge, United Kingdom More articles by this author , Andrea TubaroAndrea Tubaro Roma, Italy More articles by this author , and S. AhyaiS. Ahyai Hamburg, Germany More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2013.02.2917AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES Indication for surgical therapy in patients with lower urinary tract symptoms (LUTS) and benign prostatic enlargement (BPE) is ideally confirmed by pressure flow studies demonstrating significant prostatic obstruction. Unfortunately, urodynamic studies are invasive and time consuming. To address this void we developed a nomogram predicting benign prostatic obstruction (BPO). METHODS Between 1996-2000, all patients with LUTS and BPE underwent standardized pressure flow studies (PFS) before considering transurethral surgery. Complete clinical and urodynamic data was available for 300 men enrolled in two centres (London and Roma). Variables assessed were IPSS, PSA, prostate size, transitional volume, maximal urinary flow rate (Qmax), post void residual urine (PVR) and bladder wall thickness (BWT). These were used to predict significant BPO (defined as a Schaefer grade ≥3 in PFS) in multivariate models. RESULTS In the base model, consisting of IPSS, Qmax and PVR, only Qmax was a statistically significant predictor of BPO. The predictive accuracy (PA) of the base model was 82%. Interestingly, clinical parameters such as PSA and BWT were not statistically significant and did not increase PA. Only transitional volume (TV) was an additional statistically significant predictor for BPO. Qmax and TV, together in a multivariable model, demonstrated a PA of 83.2%. The two-variable model was found to be highly accurate and well calibrated (Fig. 1). CONCLUSIONS A simplified nomogram based on two variables can represent a easy non-invasive tool to determine surgical treatment decision in patients with BOO related to LUTS/BPE. External validation is warranted to confirm our findings. © 2013 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 189Issue 4SApril 2013Page: e718 Peer Review Report Advertisement Copyright & Permissions© 2013 by American Urological Association Education and Research, Inc.MetricsAuthor Information Cosimo De Nunzio Roma, Italy More articles by this author Riccardo Autorino Naples, Italy More articles by this author A. Bachmann Basel, Switzerland More articles by this author A. Briganti Milan, Italy More articles by this author Simon Carter London, United Kingdom More articles by this author G. Novara Padua, Italy More articles by this author R. Sosnowski Warsaw, Poland More articles by this author N. Thiruchelvam Cambridge, United Kingdom More articles by this author Andrea Tubaro Roma, Italy More articles by this author S. Ahyai Hamburg, Germany More articles by this author Expand All Advertisement Advertisement PDF downloadLoading ...