PD21-11 DEVELOPMENT OF BLADDER OUTLET OBSTRUCTION NOMOGRAM AND SPLIT-SAMPLE VALIDATION AMONG MEN WITH LUTS AGED 50 OR MORE

You have accessJournal of UrologyBenign Prostatic Hyperplasia: Epidemiology & Natural History1 Apr 2014PD21-11 DEVELOPMENT OF BLADDER OUTLET OBSTRUCTION NOMOGRAM AND SPLIT-SAMPLE VALIDATION AMONG MEN WITH LUTS AGED 50 OR MORE Jung Keun Lee, Jeong Hyun Kim, Choong Hee Noh, Kwang Mo Kim, Ha Rim Kook, Jin-Woo Jeong, Yong hyun Park, Sangchul Lee, Sung Kyu Hong, Seok-Soo Byun, Sang Eun Lee, and Seong Jin Jeong Jung Keun LeeJung Keun Lee More articles by this author , Jeong Hyun KimJeong Hyun Kim More articles by this author , Choong Hee NohChoong Hee Noh More articles by this author , Kwang Mo KimKwang Mo Kim More articles by this author , Ha Rim KookHa Rim Kook More articles by this author , Jin-Woo JeongJin-Woo Jeong More articles by this author , Yong hyun ParkYong hyun Park More articles by this author , Sangchul LeeSangchul Lee More articles by this author , Sung Kyu HongSung Kyu Hong More articles by this author , Seok-Soo ByunSeok-Soo Byun More articles by this author , Sang Eun LeeSang Eun Lee More articles by this author , and Seong Jin JeongSeong Jin Jeong More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2014.02.1688AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail Introduction and Objectives Urodynamic study has been considered as a gold standard for diagnosis of bladder outlet obstruction (BOO) among men. However, performing the urodynamic study is invasive, expensive and time consuming.We aimed to develop a nomogram predicting BOO among men with lower urinary tract symptoms (LUTS) aged 50 or more using only clinical parameters other than those from urodynamic study. Methods Urodynamic and clinical data were collected from men with LUTS aged 50 or more at our institution between May 2003 and June 2013. After excluding individuals who had a possible neurogenic bladder or a temporary voiding dysfunction and who had insufficient data, a total of 873 men were included in the analyses. Parameters assessed were age at urodynamic study, PSA, IPSS, transrectal ultrasound, history of acute urinary retention, maximum flow rate (Qmax) and post-void residual (PVR) volume. BOO was defined as AG number ¡Ã40 determined in a pressure-flow study. Among men assessed, 75% and 25% were randomly assigned to sub-cohorts for the development of nomograms and for the split-sample validation. The final regression model was selected through the stepwise procedure, and the regression coefficient-based nomograms were developed according to final models. Results Among all the patients, 182 (20.8%) men were detected to have BOO. In a multivariable regression analysis of the development cohort, Qmax was only the parameter that was independently associated with BOO (OR 0.861, 95%CI 0.820-0.905). To improve the predicting power, the nomogram was developed based on Qmax and additional parameters such as PVR volume and transitional zone index which met the minimum requirements for being incorporated into the nomogram (Fig. 1). The discrimination performance of the nomogram was evaluated using the calculated area under the receiver-operating characteristic curve, which demonstrated 0.720 for prediction of BOO. The developed nomogram was reasonably well fitted to the ideal line of the calibration plot. The split-sample external validation of nomograms indicated 68.3% accuracy. Conclusions We developed a nomogram for predicting BOO, and validated adequately. The proposed nomogram based on Qmax, PVR volume, and transitional zone index may be useful for surgical treatment decision in men with LUTS aged 50 or more. © 2014FiguresReferencesRelatedDetails Volume 191Issue 4SApril 2014Page: e610 Advertisement Copyright & Permissions© 2014MetricsAuthor Information Jung Keun Lee More articles by this author Jeong Hyun Kim More articles by this author Choong Hee Noh More articles by this author Kwang Mo Kim More articles by this author Ha Rim Kook More articles by this author Jin-Woo Jeong More articles by this author Yong hyun Park More articles by this author Sangchul Lee More articles by this author Sung Kyu Hong More articles by this author Seok-Soo Byun More articles by this author Sang Eun Lee More articles by this author Seong Jin Jeong More articles by this author Expand All Advertisement Advertisement PDF DownloadLoading ...