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Assessment of noninvasive predictors of bladder detrusor underactivity in BPH/LUTs patients

  • Urology - Original Paper
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Abstract

Purpose

To retrospectively assess the diagnostic predictive value of clinical characteristics to improve the diagnostic accuracy of bladder detrusor underactivity (DU) among benign prostatic hyperplasia/lower urinary tract symptoms (BPH/LUTS) patients who cannot undergo urodynamic examinations.

Methods

A total of 704 BPH/LUTS patients at Tianjin Medical Union Center from January 2013 through June 2016 were enrolled in the study. All cases were stratified by maximum detrusor pressure (Pdet.max) into two groups (DU and control). Patient and clinical variables were analyzed in both groups.

Results

One hundred twelve and 592 cases were classified into the DU and control group, respectively. PV (OR 0.976, 95% CI 0.961–0.991, P = 0.002) and PVR (OR 1.004, 95% CI 1.001–1.007, P = 0.004) were independent predictors of DU. In addition, Pdet.max was positively correlated with HTN (≥10 years) (r = 0.373, P = 0.001), smoking (r = 0.108, P = 0.039), IPSS (20–23) (r = 0.257, P = 0.013), PV (r = 0.305, P < 0.001), PSA (1–2.2 ng/mL) (r = 0.428, P = 0.002), PSAD (0–0.02) (r = 0.430, P = 0.02), and Q max (≤4 mL/s) (r = 0.372, P < 0.001), and inversely correlated with age (>76 years) (r = −0.265, P = 0.015), BMI (21–23) (r = −0.382, P = 0.001), DM (0–20 years) (r = 0.365, P = 0.009) and PVR (50–400 mL) (r = 0.423, P = 0.001). The AUCs for BMI, PV, tPSA, PSAD, Q max, and PVR were 0.762, 0.739, 0.727, 0.681, 0.749, and 0.716, respectively. Combined ROC analysis showed the AUC for PV + PVR was 0.774 with sensitivity of 77.78% and specificity of 73.68%.

Conclusion

Clinical factors were effective for predicting DU and could help improve the diagnostic accuracy for BPH/LUTS patients who cannot undergo urodynamic examinations.

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Acknowledgements

The research reported in this publication was supported by Science and Technology Fund of Tianjin Provincial Commission of Health and Family Planning, Grant Number: 2015KR02.

Authors’ contribution

FL and JL were involved in project development, data analysis, manuscript writing. HHS, YHS, ZHZ, YSW, ZZ collected and analyzed data.

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Authors and Affiliations

  1. Department of Urology, Tianjin Union Medical Center, No. 190 Jie-yuan Road, Hong-qiao District, Tianjin, China

    Fei Luo, Hong-Hong Sun, Yan-Hui Su, Zhi-Hua Zhang, Ya-Shen Wang, Zhen Zhao & Jian Li

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  1. Fei Luo
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Correspondence to Jian Li.

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All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki Declaration and its later amendments or comparable ethical standards.

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Luo, F., Sun, HH., Su, YH. et al. Assessment of noninvasive predictors of bladder detrusor underactivity in BPH/LUTs patients. Int Urol Nephrol 49, 787–792 (2017). https://doi.org/10.1007/s11255-017-1539-5

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