MP75-18 REEVALUATION OF CUT-OFF VALUES FOR BLADDER OUTLET OBSTRUCTION BASED ON PRESSURE-FLOW STUDIES FROM ANATOMICALLY OBSTRUCTED WOMEN

Abstract

You have accessJournal of UrologyUrodynamics/Incontinence/Female Urology: Female Urology II1 Apr 2014MP75-18 REEVALUATION OF CUT-OFF VALUES FOR BLADDER OUTLET OBSTRUCTION BASED ON PRESSURE-FLOW STUDIES FROM ANATOMICALLY OBSTRUCTED WOMEN Philippe E. Zimmern, Omer Gulpinar, Alana Christie, Jack Hou, Feras Alhalabi, and Gary E. Lemack Philippe E. ZimmernPhilippe E. Zimmern More articles by this author , Omer GulpinarOmer Gulpinar More articles by this author , Alana ChristieAlana Christie More articles by this author , Jack HouJack Hou More articles by this author , Feras AlhalabiFeras Alhalabi More articles by this author , and Gary E. LemackGary E. Lemack More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2014.02.2391AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES To refine the definition of pressure-flow study cut-off values for anatomic female bladder outlet obstruction (BOO) by comparing these urodynamic parameters in women with clinical obstruction due to 3 different obstructive mechanisms. METHODS Following IRB approval, urodynamic data from 3 groups of women with BOO were reviewed, including Group 1: obstruction after sling placement, Group 2: symptomatic Stage 3-4 anterior vaginal prolapse, Group 3: meatal stricture or distal urethral fibrosis. BOO diagnosis was based on history, presenting symptoms, exam findings, and site of obstruction confirmed on lateral voiding cystogram. Urodynamic testing was done according to prior reported protocol (ref 1), with tracings excluded for abdominal straining (Pabd > 10 cm H2O). The optimal combination of maximal flow rate (Qmax) and detrusor pressure at maximal flow rate (PdetQmax) for determining BOO was calculated using nonparametric receiver operating characteristic (ROC) curves. Box and whisker plots were used for group comparison. RESULTS In the past 9 years, 146 non-neurogenic women with clinically-confirmed anatomic BOO (age 61 [41-87]) were studied in comparison to 42 age-comparable controls (age 63 [42-85]). The area under the curve for the ROC was 0.886 for Qmax and 0.778 for PdetQmax. For the Qmax cut-off of 15, the sensitivity and specificity were 0.78 and 0.82 respectively, while for Pdet Qmax cut-off of 25, they were 0.76 and 0.72 respectively (Fig .1). Age, Qmax, and PdetQmax were similar among the three BOO groups, except for lower Qmax in Group 3 versus Group 1 (Fig. 2) CONCLUSIONS This data confirms and reinforces prior data (1) on cut-off values for BOO in women. Reference: 1. Defreitas et al. Urology 64:675-681, 2004. © 2014FiguresReferencesRelatedDetails Volume 191Issue 4SApril 2014Page: e880-e881 Advertisement Copyright & Permissions© 2014MetricsAuthor Information Philippe E. Zimmern More articles by this author Omer Gulpinar More articles by this author Alana Christie More articles by this author Jack Hou More articles by this author Feras Alhalabi More articles by this author Gary E. Lemack More articles by this author Expand All Advertisement Advertisement PDF downloadLoading ...