MP15-10 VALSALVA VOIDING DISTINGUISHES SLOW URINARY FLOW CAUSED BY ANTERIOR URETHRAL STRICTURES FROM PROSTATIC OBSTRUCTION

Abstract

You have accessJournal of UrologyTrauma/Reconstruction: Urethral Reconstruction (including Stricture) I1 Apr 2015MP15-10 VALSALVA VOIDING DISTINGUISHES SLOW URINARY FLOW CAUSED BY ANTERIOR URETHRAL STRICTURES FROM PROSTATIC OBSTRUCTION Rajveer Purohit, Matthew Benedon, Gabriel Mekel, James Weinberger, Johnson Tsui, and Jerry Blaivas Rajveer PurohitRajveer Purohit More articles by this author , Matthew BenedonMatthew Benedon More articles by this author , Gabriel MekelGabriel Mekel More articles by this author , James WeinbergerJames Weinberger More articles by this author , Johnson TsuiJohnson Tsui More articles by this author , and Jerry BlaivasJerry Blaivas More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2015.02.893AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES It is difficult to distinguish decreased uroflow in patients who may have anterior urethral strictures (US) from prostatic obstruction (PO) such as older patients who may have undergone a urethroplasty. We hypothesize that in patients with US, Valsalva Voiding (VV) will significantly increase maximum urinary flow rate (Qmax) and will not do so in patients with PO. METHODS A prospective IRB-approved study of men seen at a tertiary care urology clinic was conducted. Subjects were divided into three groups based on clinical and cystoscopic information: group 1 (US), group 2 (PO), and a control group (group 3) with no obstruction. Each subject voided twice without intervention; once with NVV and once with VV. Qmax, voided volume, and PVR were recorded. Patients with voided volumes less than 150ml on either VV or NVV were excluded. In each patient, the difference in Qmax between VV and NVV was compared. In addition, the Siroky nomogram was used to compare normalized bladder volumes with a difference of greater than 1 standard deviation considered a significant increase in flow. A student T-test was used to assess statistical difference. RESULTS 113 individuals were evaluated. 26 were excluded due to voided volume < 150 ml. Mean age was 54 years (range 23–83). Table 1 depicts changes in Qmax between VV & NVV for each group. P values compare differences between VV and NVV. CONCLUSIONS These data suggest that change in Qmax with VV is a useful non-invasive test to distinguish PO from US. Patients with prostatic obstruction do not have any increase in Qmax with VV whereas those with US have slight increases and normal unobstructed individuals have large increases. Change in Qmax between Valsalva Voids and Non-Valsalva Voids Among Each Group Number of Patients Mean Change in Qmax Median Change in Qmax Standard Deviation P-value Urethral Stricture (Group 1) 23 5.04 5 6.75 0.03 Prostatic Obstruction (Group 2) 29 1.66 1 4.79 0.47 Unobstructed (Group 3) 35 7.69 9 8.51 0.01 © 2015 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 193Issue 4SApril 2015Page: e162-e163 Advertisement Copyright & Permissions© 2015 by American Urological Association Education and Research, Inc.MetricsAuthor Information Rajveer Purohit More articles by this author Matthew Benedon More articles by this author Gabriel Mekel More articles by this author James Weinberger More articles by this author Johnson Tsui More articles by this author Jerry Blaivas More articles by this author Expand All Advertisement Advertisement PDF DownloadLoading ...