Abstract
ObjectivesTo develop a per‐patient volume correction for maximum flow rate using multiple home uroflowmetry, and to carry out a pilot study to determine the most prognostically useful volume at which to evaluate this measurement and estimate its relationship with outcome from disobstructive bladder outlet surgery.MethodsA total of 30 men carried out home uroflowmetry using a portable device and completed symptom scores before surgery. This was repeated at least 4 months after surgery. For each man's presurgery flow data, voided volume was plotted against maximum flow rate, and a line of best fit with logarithmic form calculated. This allowed maximum flow rate to be corrected for any volume. Percentage reduction in symptom score and increase in mean maximum flow rate were correlated with volume‐corrected maximum flow rates.ResultsCorrected maximum flow rate at all volumes showed the expected negative correlation with both outcome measures. A statistically significant correlation occurred for volumes >190 mL, with the best performance at volumes >300 mL.ConclusionsWe have devised a novel method allowing estimation of maximum flow rate at any volume, which is a step forward for non‐invasive diagnostics. We found this volume‐corrected maximum flow rate to correlate significantly with treatment outcome at sufficiently high volumes.
Highlights
The decision to carry out surgery for BOO in men with LUTS is guided by uroflowmetry.Typically a one-off measurement of Qmax is obtained using office-based uroflowmetry
Clinical guidelines recommend that the Vvoid should be at least mL, but this is not always feasible for men with habitual low Vvoid
Nomograms have been developed enabling Qmax to be evaluated in the context of Vblad or
Summary
The decision to carry out surgery for BOO in men with LUTS is guided by uroflowmetry. A one-off measurement of Qmax is obtained using office-based uroflowmetry. There is evidence that when multiple measurements of Qmax are made for an individual, either the highest or average Qmax improves diagnostic accuracy for BOO. In order to control for dependency on Vblad, Qmax should be measured at a specific volume, but this is impractical. Clinical guidelines recommend that the Vvoid should be at least mL, but this is not always feasible for men with habitual low Vvoid.. Nomograms have been developed enabling Qmax to be evaluated in the context of Vblad or
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