PD39-03 POST-VOIDED RESIDUAL URINE RATIO IS A PREDICTOR OF BLADDER OUTLET OBSTRUCTION IN MEN WITH LOWER URINARY TRACT SYMPTOMS: DEVELOPMENT OF A CLINICAL NOMOGRAM

Abstract

You have accessJournal of UrologyCME1 May 2022PD39-03 POST-VOIDED RESIDUAL URINE RATIO IS A PREDICTOR OF BLADDER OUTLET OBSTRUCTION IN MEN WITH LOWER URINARY TRACT SYMPTOMS: DEVELOPMENT OF A CLINICAL NOMOGRAM Cosimo De Nunzio, Riccardo Lombardo, Antonio Nacchia, Antonio Cicione, Beatrice Turchi, Giacomo Gallo, Carmen Gravina, Alessandro Guercio, Jordi Stira, Lorenzo Maria Rivesti, Antonio Franco, Giorgio Guarnotta, Elisa Mancini, Olivia Alessandra Voglino, Valeria Baldassarri, Simone D'Annunzio, Sara Riolo, Simon Carter, Carlo Vicentini, and Andrea Tubaro Cosimo De NunzioCosimo De Nunzio More articles by this author , Riccardo LombardoRiccardo Lombardo More articles by this author , Antonio NacchiaAntonio Nacchia More articles by this author , Antonio CicioneAntonio Cicione More articles by this author , Beatrice TurchiBeatrice Turchi More articles by this author , Giacomo GalloGiacomo Gallo More articles by this author , Carmen GravinaCarmen Gravina More articles by this author , Alessandro GuercioAlessandro Guercio More articles by this author , Jordi StiraJordi Stira More articles by this author , Lorenzo Maria RivestiLorenzo Maria Rivesti More articles by this author , Antonio FrancoAntonio Franco More articles by this author , Giorgio GuarnottaGiorgio Guarnotta More articles by this author , Elisa ManciniElisa Mancini More articles by this author , Olivia Alessandra VoglinoOlivia Alessandra Voglino More articles by this author , Valeria BaldassarriValeria Baldassarri More articles by this author , Simone D'AnnunzioSimone D'Annunzio More articles by this author , Sara RioloSara Riolo More articles by this author , Simon CarterSimon Carter More articles by this author , Carlo VicentiniCarlo Vicentini More articles by this author , and Andrea TubaroAndrea Tubaro More articles by this author View All Author Informationhttps://doi.org/10.1097/JU.0000000000002597.03AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: Recently some authors have suggested a possible role of post-void residual ratio to predict bladder outlet obstruction (BOO). Aim of our study is to confirm the correlation between post-void residual urine ratio (PVR-R) and BOO diagnosed by pressure-flow studies (PFS) in males with lower urinary tract symptoms (LUTS) and to develop a clinical nomogram. METHODS: A consecutive series of patients aged 45 years or older with non-neurogenic LUTS were prospectively enrolled. Patients underwent standard diagnostic assessment for BOO including International Prostatic Symptoms Score, uroflowmetry, urodynamic studies (cystometry and pressure-flow studies), suprapubic ultrasound of the prostate and ultrasound measurements of the bladder wall thickness (BTW). PVR urine and the percentage of PVR to bladder volume (voided volume+PVR) (PVR-R) were evaluated. Logistic regression analysis was used to investigate predictors of pathological bladder emptying (BOO) defined as Schafer >II. Correlations were evaluated with Pearson test. A nomogram to predict BOO based on the multivariable logistic regression model was then developed. Discrimination and net benefit of the model was evaluated. RESULTS: Overall 335 patients with a mean age of 66±11 years were enrolled. Overall, 131/335 (40%) presented BOO on PFS. Shaefer class was correlated with PVR-ratio with a Pearson coefficient of 0,297 (Figure). In a multivariable logistic age-adjusted regression model BWT (odds ratio [OR]: 2,21 per mm; 95% confidence interval [CI], 1,57-3,11; p=0.001), PVR-R (OR: 1,01 per mL/s; 95% CI, 1,00-1,03; p=0.046) and prostate volume (OR: 1,03 per mL/s; 95% CI, 1,03-1,06; p=0.001) were significant predictors for BOO. The model presented an accuracy of 0.82 and a clinical net benefit in the range of 10-90%. Figure: A Nomogram, B: ROC curve, C: Decision Curve Analysis, D: Median PVR_ratios in different Shaffer classes. CONCLUSIONS: The present study confirms the important role of PVR-ratio in the prediction of BOO. For the first time we present a clinical nomogram including PVR-ratio for the prediction of BOO. Eternal validation is needed before clinical implementation. Source of Funding: None © 2022 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 207Issue Supplement 5May 2022Page: e652 Advertisement Copyright & Permissions© 2022 by American Urological Association Education and Research, Inc.MetricsAuthor Information Cosimo De Nunzio More articles by this author Riccardo Lombardo More articles by this author Antonio Nacchia More articles by this author Antonio Cicione More articles by this author Beatrice Turchi More articles by this author Giacomo Gallo More articles by this author Carmen Gravina More articles by this author Alessandro Guercio More articles by this author Jordi Stira More articles by this author Lorenzo Maria Rivesti More articles by this author Antonio Franco More articles by this author Giorgio Guarnotta More articles by this author Elisa Mancini More articles by this author Olivia Alessandra Voglino More articles by this author Valeria Baldassarri More articles by this author Simone D'Annunzio More articles by this author Sara Riolo More articles by this author Simon Carter More articles by this author Carlo Vicentini More articles by this author Andrea Tubaro More articles by this author Expand All Advertisement PDF DownloadLoading ...