A novel algorithm for the non-invasive detection of bladder outlet obstruction in men with lower urinary tract symptoms
Objective: To determine the ability of bladder wall thickness (BWT) in combination with non-invasive variables to distinguish patients with bladder outlet obstruction (BOO). Patients and methods: Patients completed the International Prostate Symptom Score (IPSS) questionnaire and prostate size was m...
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Taylor & Francis Group
2017
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oai:doaj.org-article:7b5c2dabe5e147bfad180f35d2fb7fd52021-12-02T11:11:25ZA novel algorithm for the non-invasive detection of bladder outlet obstruction in men with lower urinary tract symptoms2090-598X10.1016/j.aju.2017.01.002https://doaj.org/article/7b5c2dabe5e147bfad180f35d2fb7fd52017-06-01T00:00:00Zhttp://www.sciencedirect.com/science/article/pii/S2090598X17300062https://doaj.org/toc/2090-598XObjective: To determine the ability of bladder wall thickness (BWT) in combination with non-invasive variables to distinguish patients with bladder outlet obstruction (BOO). Patients and methods: Patients completed the International Prostate Symptom Score (IPSS) questionnaire and prostate size was measured by transrectal ultrasonography (US). Pressure-flow studies were performed to determine the urodynamic diagnosis. BWT was measured at 250-mL bladder filling using transabdominal US. Recursive partition analysis (RPA) recursively partitions data for relating independent variable(s) to a dependent variable creating a tree of partitions. It finds a set of cuts of the dependent variable(s) that best predict the independent variable, by searching all possible cuts until the desired fit is reached. RPA was used to test the ability of the combined data of BWT, maximum urinary flow rate (Qmax), post-void residual urine volume (PVR), IPSS, and prostate size to predict BOO. Results: In all, 72 patients were included in the final analysis. The median BWT, voided volumes, PVR, mean Qmax, and IPSS were significantly higher in patients who had an Abrams/Griffiths (A/G) number of >40 (55 patients) compared to those with an A/G number of ≤40 (17 patients). RPA revealed that the combination of BWT and Qmax gave a correct classification in 61 of the 72 patients (85%), with 92% sensitivity and 65% specificity, 87% positive predictive value, and 76% negative predictive value (NPV) for BOO (area under the curve 0.85). The positive diagnostic likelihood ratio of this reclassification fit was 2.6. Conclusions: It was possible to combine BWT with Qmax to create a new algorithm that could be used as a screening tool for BOO in men with lower urinary tract symptoms.Fawzy FaragMohamed ElbadryMohammed SaberAbdelbasset A. BadawyJohn HeesakkersTaylor & Francis GrouparticleBladder wall thicknessDiagnosisUrinary bladder neck obstructionUrodynamicsUrinary flowmetryDiseases of the genitourinary system. UrologyRC870-923ENArab Journal of Urology, Vol 15, Iss 2, Pp 153-158 (2017) |
| institution |
DOAJ |
| collection |
DOAJ |
| language |
EN |
| topic |
Bladder wall thickness Diagnosis Urinary bladder neck obstruction Urodynamics Urinary flowmetry Diseases of the genitourinary system. Urology RC870-923 |
| spellingShingle |
Bladder wall thickness Diagnosis Urinary bladder neck obstruction Urodynamics Urinary flowmetry Diseases of the genitourinary system. Urology RC870-923 Fawzy Farag Mohamed Elbadry Mohammed Saber Abdelbasset A. Badawy John Heesakkers A novel algorithm for the non-invasive detection of bladder outlet obstruction in men with lower urinary tract symptoms |
| description |
Objective: To determine the ability of bladder wall thickness (BWT) in combination with non-invasive variables to distinguish patients with bladder outlet obstruction (BOO).
Patients and methods: Patients completed the International Prostate Symptom Score (IPSS) questionnaire and prostate size was measured by transrectal ultrasonography (US). Pressure-flow studies were performed to determine the urodynamic diagnosis. BWT was measured at 250-mL bladder filling using transabdominal US. Recursive partition analysis (RPA) recursively partitions data for relating independent variable(s) to a dependent variable creating a tree of partitions. It finds a set of cuts of the dependent variable(s) that best predict the independent variable, by searching all possible cuts until the desired fit is reached. RPA was used to test the ability of the combined data of BWT, maximum urinary flow rate (Qmax), post-void residual urine volume (PVR), IPSS, and prostate size to predict BOO.
Results: In all, 72 patients were included in the final analysis. The median BWT, voided volumes, PVR, mean Qmax, and IPSS were significantly higher in patients who had an Abrams/Griffiths (A/G) number of >40 (55 patients) compared to those with an A/G number of ≤40 (17 patients). RPA revealed that the combination of BWT and Qmax gave a correct classification in 61 of the 72 patients (85%), with 92% sensitivity and 65% specificity, 87% positive predictive value, and 76% negative predictive value (NPV) for BOO (area under the curve 0.85). The positive diagnostic likelihood ratio of this reclassification fit was 2.6.
Conclusions: It was possible to combine BWT with Qmax to create a new algorithm that could be used as a screening tool for BOO in men with lower urinary tract symptoms. |
| format |
article |
| author |
Fawzy Farag Mohamed Elbadry Mohammed Saber Abdelbasset A. Badawy John Heesakkers |
| author_facet |
Fawzy Farag Mohamed Elbadry Mohammed Saber Abdelbasset A. Badawy John Heesakkers |
| author_sort |
Fawzy Farag |
| title |
A novel algorithm for the non-invasive detection of bladder outlet obstruction in men with lower urinary tract symptoms |
| title_short |
A novel algorithm for the non-invasive detection of bladder outlet obstruction in men with lower urinary tract symptoms |
| title_full |
A novel algorithm for the non-invasive detection of bladder outlet obstruction in men with lower urinary tract symptoms |
| title_fullStr |
A novel algorithm for the non-invasive detection of bladder outlet obstruction in men with lower urinary tract symptoms |
| title_full_unstemmed |
A novel algorithm for the non-invasive detection of bladder outlet obstruction in men with lower urinary tract symptoms |
| title_sort |
novel algorithm for the non-invasive detection of bladder outlet obstruction in men with lower urinary tract symptoms |
| publisher |
Taylor & Francis Group |
| publishDate |
2017 |
| url |
https://doaj.org/article/7b5c2dabe5e147bfad180f35d2fb7fd5 |
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