Predicting the Outcome of Prostatectomy Using Noninvasive Bladder Pressure and Urine Flow Measurements

Harding, Chris; Robson, Wendy; Drinnan, Michael; Sajeel, M; Ramsden, P. D.; Griffiths, Clive; Pickard, Robert

doi:10.1016/j.eururo.2006.11.009

Cited by 39 publications

(43 citation statements)

References 16 publications

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“…They therefore represent a particular subgroup of the population of men complaining of lower urinary tract symptoms, and it remains uncertain whether the encouraging results of the present study are repeatable in different centres and across different patient groups. Our findings are however consistent with those from the original Newcastle-upon-Tyne reports [13].…”

Section: Discussionsupporting

confidence: 76%

“…This figure is similar to that obtained by the current gold standard, formal invasive urodynamic studies [8,13]. This information is still useful and aids an informed pre-operative discussion with patients.…”

Section: Discussionsupporting

confidence: 71%

“…This study prospectively analyses a device known as the penile cuff test. First designed in Newcastle-upon-Tyne, United Kingdom, in 2007, this is the first study of this device, to our knowledge, to be published outside the original unit [13].…”

Section: Introductionmentioning

confidence: 99%

“…Indeed, good access to invasive urodynamic studies in many hospitals is limited. Furthermore, many urologists believe its sensitivity for excluding obstruction is poor enough (between 60 and 80%) [13] not to justify its routine use in patients presenting with voiding-type lower urinary tract symptoms.…”

Section: Introductionmentioning

confidence: 99%

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Non‐invasive urodynamics predicts outcome prior to surgery for prostatic obstruction

2013

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Objective To assess whether the penile cuff non‐invasive urodynamic test serves as an effective diagnostic tool for predicting outcomes prior to disobstructive surgery for men presenting with voiding lower urinary tract symptoms. Patients with proven urodynamic obstruction do better after surgery. The current gold standard, invasive pressure‐flow studies, imposes cost, resource demand, discomfort and inconvenience to patients. Patients and Methods Patients undergoing surgery for prostatic obstruction at Palmerston North Hospital had pre‐operative non‐invasive urodynamics and completed an International Prostate Symptom Score (IPSS). Catheterised patients were excluded. Two months post‐operatively they completed a further IPSS score. An improvement of seven or greater was defined as a clinically successful outcome. Results were compared with the outcome predicted by the nomogram supplied with the urodynamic device. Results Data was obtained for 62 patients with mean age 70 years (range 49 to 86 years; SD 9 years). Follow‐up was complete for all patients. Thirty‐eight patients underwent transurethral resection and 24 holmium laser enucleation of the prostate. Mean IPSS score was 21 (range 5 to 35; SD 6) pre‐operatively and 11 (range 1 to 31; SD 9) post‐operatively. Thirty‐five patients were predicted obstructed and 27 not obstructed. 94% of those predicted obstructed had a successful outcome (p < 0.01). 70% predicted as not obstructed did not have a successful outcome after surgery (p < 0.01). Conclusion The penile cuff test is an exciting adjunct in the decision to proceed to surgery for prostatic obstruction. Patients predicted to be obstructed have an excellent likelihood of a good surgical outcome, yet 30% of those shown not to be obstructed will still do well. Whilst numbers in our study are small, outcomes compare favourably with published results on invasive urodynamic methods.

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Section: Discussionsupporting

confidence: 76%

Section: Discussionsupporting

confidence: 71%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Non‐invasive urodynamics predicts outcome prior to surgery for prostatic obstruction

2013

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“…Furthermore, a number of factors need to be considered when discussing the generalisability and delivery costs of these tests. PCT may cause discomfort or urethral bleeding, although this has been reported in only 2% of patients, and it has been reported that technical difficulties result in exclusion rates of 23-46% [18,48]. Similarly, the external condom method may also cause discomfort and results may be affected by low flow rates, low voided volumes, and abdominal straining [37].…”

Section: Implications For Clinical Practicementioning

confidence: 91%

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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Non‐invasive Urodynamics

Bray¹,

Blake²,

Harding³

2021

Abrams’ Urodynamics

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Predicting the Outcome of Prostatectomy Using Noninvasive Bladder Pressure and Urine Flow Measurements

Cited by 39 publications

References 16 publications

Non‐invasive urodynamics predicts outcome prior to surgery for prostatic obstruction

Non‐invasive urodynamics predicts outcome prior to surgery for prostatic obstruction

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

Non‐invasive Urodynamics

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