Categorization of Obstruction Using Noninvasive Pressure Flow Measurements: Sensitivity to Change Following Prostatectomy (2007)

No AccessJournal of UrologyAdult urology1 Sep 2007Categorization of Obstruction Using Noninvasive Pressure Flow Measurements: Sensitivity to Change Following Prostatectomy Mustafa Sajeel, Christopher Harding, Wendy Robson, Michael Drinnan, Clive Griffiths, and Robert Pickard Mustafa SajeelMustafa Sajeel Department of Urology, Newcastle upon Tyne, United Kingdom More articles by this author , Christopher HardingChristopher Harding Department of Urology, Newcastle upon Tyne, United Kingdom More articles by this author , Wendy RobsonWendy Robson Department of Urology, Newcastle upon Tyne, United Kingdom More articles by this author , Michael DrinnanMichael Drinnan Department of Medical Physics, Newcastle upon Tyne, United Kingdom Financial interest and/or other relationship with Mediplus. More articles by this author , Clive GriffithsClive Griffiths Department of Medical Physics, Newcastle upon Tyne, United Kingdom Financial interest and/or other relationship with Mediplus. More articles by this author , and Robert PickardRobert Pickard Freeman Hospital and School of Surgical and Reproductive Sciences, Newcastle University, Newcastle upon Tyne, United Kingdom Financial interest and/or other relationship with Mediplus. More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2007.05.050AboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract Purpose: We determined whether categorizing men with lower urinary tract symptoms using a noninvasive pressure flow nomogram is sensitive to change following the removal of obstruction. Materials and Methods: A prospective cohort of men undergoing transurethral prostate resection was recruited, of whom 143 (69%) underwent noninvasive pressure flow study using the penile cuff technique before and 4 months following surgery. Cuff pressure required to interrupt voiding, estimated isovolumetric bladder pressure and maximum flow rate were recorded during a single void. Values were plotted on a nomogram categorizing cases as obstructed (upper left quadrant), not obstructed (lower right quadrant) or diagnosis uncertain (upper right and lower left quadrants). Changes in maximum flow rate, cuff pressure required to interrupt voiding and nomogram position following transurethral prostate resection were then analyzed. Results: Transurethral prostate resection resulted in an improved flow rate for all diagnostic groups, which was highest for obstructed cases with a mean ± SD increase of 11 ± 6 ml second-1 (p <0.01). Men categorized with obstruction and those placed in the upper right quadrant showed significant decreases in cuff pressure required to interrupt voiding following transurethral prostate resection with a mean decrease of −45 ± 35 and −48 ± 32 cm H2O, respectively (p <0.01). The number of cases classified as not obstructed increased from 28 (19%) preoperatively to 114 (80%) after transurethral prostate resection. Conclusions: Sensitivity to change following the removal of obstruction further validates the usefulness of noninvasive measurement of bladder pressure by the penile cuff test and the categorization of obstruction by the noninvasive nomogram. Decreased isovolumetric bladder pressure following transurethral prostate resection may reflect a return to normal detrusor contraction strength. References 1 : Noninvasive assessment of bladder contractility in men. J Urol2004; 172: 1394. Link, Google Scholar 2 : A nomogram to classify men with lower urinary tract symptoms using urine flow and noninvasive measurement of bladder pressure. J Urol2005; 174: 1323. Link, Google Scholar 3 : Predicting the outcome of prostatectomy using non-invasive bladder pressure and urine flow measurements. Eur Urol2007; 52: 186. 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Link, Google Scholar © 2007 by American Urological AssociationFiguresReferencesRelatedDetailsCited byKaplan S, Kohler T and Kausik S (2020) Noninvasive Pressure Flow Studies in the Evaluation of Men with Lower Urinary Tract Symptoms Secondary to Benign Prostatic Hyperplasia: A Review of 50,000 PatientsJournal of Urology, VOL. 204, NO. 6, (1296-1304), Online publication date: 1-Dec-2020. Volume 178Issue 3September 2007Page: 996-1001 Advertisement Copyright & Permissions© 2007 by American Urological AssociationKeywordsbladder neck obstructionurodynamicsprostatic hyperplasiabladdertransurethral resection of prostateAcknowledgmentsThe Departments of Urology and Medical Physics, Newcastle upon Tyne Hospitals National Health Service Trust are beneficiaries of royalty payments arising from commercial sale of the penile cuff device by Mediplus Ltd., High Wycombe, United Kingdom. Mediplus Ltd. provided the penile cuffs.MetricsAuthor Information Mustafa Sajeel Department of Urology, Newcastle upon Tyne, United Kingdom More articles by this author Christopher Harding Department of Urology, Newcastle upon Tyne, United Kingdom More articles by this author Wendy Robson Department of Urology, Newcastle upon Tyne, United Kingdom More articles by this author Michael Drinnan Department of Medical Physics, Newcastle upon Tyne, United Kingdom Financial interest and/or other relationship with Mediplus. More articles by this author Clive Griffiths Department of Medical Physics, Newcastle upon Tyne, United Kingdom Financial interest and/or other relationship with Mediplus. More articles by this author Robert Pickard Freeman Hospital and School of Surgical and Reproductive Sciences, Newcastle University, Newcastle upon Tyne, United Kingdom Financial interest and/or other relationship with Mediplus. More articles by this author Expand All Advertisement PDF downloadLoading ...