Noninvasive Methods of Diagnosing Bladder Outlet Obstruction in Men. Part 1: Nonurodynamic Approach

Belal, Mohammed; Abrams, Paul

doi:10.1016/s0022-5347(06)00569-6

Cited by 70 publications

(38 citation statements)

References 47 publications

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“…A number of studies reviewing the evidence for various noninvasive urodynamic tests have been published in recent years [49][50][51][52][53][54][55][56]. All reviews have reported similar findings to the present review: some noninvasive tests appear promising, especially in combination, but further investigation is required before they can replace invasive urodynamics.…”

Section: How the Review Compares To Previous Reviews/guidelinessupporting

confidence: 73%

Systematic Review of the Performance of Noninvasive Tests in Diagnosing Bladder Outlet Obstruction in Men with Lower Urinary Tract Symptoms

et al. 2017

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Keywords:Bladder outlet obstruction (BOO) Men Lower urinary tract symptoms Diagnosis Urodynamics Noninvasive Systematic review Please visit www.eu-acme.org/ europeanurology to read and answer questions on-line. The EU-ACME credits will then be attributed automatically. AbstractContext: Several noninvasive tests have been developed for diagnosing bladder outlet obstruction (BOO) in men to avoid the burden and morbidity associated with invasive urodynamics. The diagnostic accuracy of these tests, however, remains uncertain. Objective: To systematically review available evidence regarding the diagnostic accuracy of noninvasive tests in diagnosing BOO in men with lower urinary tract symptoms (LUTS) using a pressure-flow study as the reference standard. Evidence acquisition: The EMBASE, MEDLINE, Cochrane Database of Systematic Reviews, Cochrane Central, Google Scholar, and WHO International Clinical Trials Registry Platform Search Portal databases were searched up to May 18, 2016. All studies reporting diagnostic accuracy for noninvasive tests for BOO or detrusor underactivity in men with LUTS compared to pressure-flow studies were included. Two reviewers independently screened all articles, searched the reference lists of retrieved articles, and performed the data extraction. The quality of evidence and risk of bias were assessed using the QUADAS-2 tool. Evidence synthesis: The search yielded 2774 potentially relevant reports. After screening titles and abstracts, 53 reports were retrieved for full-text screening, of which 42 (recruiting a total of 4444 patients) were eligible. Overall, the results were predominantly based on findings from nonrandomised experimental studies and, within the limits of such study designs, the quality of evidence was typically moderate across the literature. Differences in noninvasive test threshold values and variations in the urodynamic definition of BOO between studies limited the comparability of the data.

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Section: How the Review Compares To Previous Reviews/guidelinessupporting

confidence: 73%

Systematic Review of the Performance of Noninvasive Tests in Diagnosing Bladder Outlet Obstruction in Men with Lower Urinary Tract Symptoms

et al. 2017

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“…Though it may be a condition related to bladder outlet obstruction, hypocontractile bladder may also be responsible. [6] Therefore, increased PVR is insufficient to define the type or degree of disease. However, interpretation of significant PVR in favor of isolated benign prostatic obstruction (BPO) has been proposed in numerous studies.…”

Section: Discussionmentioning

confidence: 99%

“…[14,15] Similarly, recurrent urinary tract infection has been reported to be caused by residual urine in the elderly population and in girls. [6,16,17] Klarskov et al demonstrated that PVR increased the risk of acute urinary retention 3.6 times. [18] Increased PVR or low Qmax value may suggest bladder outlet obstruction and/or underactive bladder.…”

Section: Discussionmentioning

confidence: 99%

Predictive Factors of Post-Void Residual Urine in Patients with Lower Urinary Tract Symptoms

Türk

Ün

2017

EJMO

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Objectives: Benign prostatic hyperplasia is considered one of the most important health issues seen in older males, and is characterized by clinical lower urinary tract symptoms (LUTS). A high volume of residual urine can be seen in both organic obstructions as well as bladder dysfunctions. In this study, the primary objective was to evaluate clinical and lab results that can be used as predictive factors in significantly high residual urine volume/urinary retention. Methods: A total of 491 patients over the age of 40 years who presented at the urology clinic with LUTS complaints from September 2015 to December 2016 were included in the study. Our routine evaluation protocol, which consists of patient history, physical examination, prostate-specific antigen test, urinalysis, uroflowmetry, and post-void residual volume assessment, was used to evaluate all the patients included in the study. Results: In univariate analysis, body mass index, peak flow rate (Qmax), and prostate volume were found to be significant predictive factors of post void residual (PVR) urine (p=0.001, <0.0001, and <0.001, respectively). Multivariate analysis also confirmed these as significant predictive factors of PVR (p=0.013, <0.0001, and 0.001, respectively). Conclusion: Uroflowmetry is a very important tool in the assessment and follow-up of patients with LUTS. As a complementary action, PVR urine volume should also be measured. Residual urine can be significant in patients Qmax of less than 10.1 mL/second and with large prostate volume (>40 cc).

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“…Hence, augmentation procedures should be optimized to be specifically targeted to regions with the most morphological alterations. Current in vivo imaging methods such as x-ray, ultrasound and MRI can only identify anatomical changes in the bladder that are spatially nearly uniform throughout the bladder wall [5,14]. Therefore, new in vivo imaging techniques are needed that can identify the regions with the most pronounced morphological changes, to localize and optimize augmentation procedures.…”

Section: Introductionmentioning

confidence: 99%

Assessment of local structural disorders of the bladder wall in partial bladder outlet obstruction using polarized light imaging

Alali

Aitken

Schröder

et al. 2014

Biomed. Opt. Express

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Partial bladder outlet obstruction causes prominent morphological changes in the bladder wall, which leads to bladder dysfunction. In this paper, we demonstrate that polarized light imaging can be used to identify the location of obstruction induced structural changes that other imaging modalities fail to detect. We induced 2-week and 6-week partial outlet obstruction in rats, harvested obstructed bladders, then measured their retardances while distended to high pressures and compared them to controls. Our results show that the retardance of the central part of the ventral side (above the ureters) closer to the urethra can be used as a potential metric of the distending bladder obstruction.

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Noninvasive Methods of Diagnosing Bladder Outlet Obstruction in Men. Part 1: Nonurodynamic Approach

Cited by 70 publications

References 47 publications

Systematic Review of the Performance of Noninvasive Tests in Diagnosing Bladder Outlet Obstruction in Men with Lower Urinary Tract Symptoms

Systematic Review of the Performance of Noninvasive Tests in Diagnosing Bladder Outlet Obstruction in Men with Lower Urinary Tract Symptoms

Predictive Factors of Post-Void Residual Urine in Patients with Lower Urinary Tract Symptoms

Assessment of local structural disorders of the bladder wall in partial bladder outlet obstruction using polarized light imaging

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