A Prediction Model of Detrusor Underactivity Based on Symptoms and Noninvasive Test Parameters in Men with Lower Urinary Tract Symptoms: An Analysis of a Large Group of Patients undergoing Pressure-Flow Studies

Namitome, Ryo; Takei, Makoto; Takahashi, Ryuji; Kikutake, Chie; Yokomizo, Akira; Yamaguchi, Osamu; Eto, Masatoshi

doi:10.1097/ju.0000000000000616

Cited by 22 publications

(57 citation statements)

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“…Although PV correlated significantly with the degree of BOO and was a predictor of DU, 11‐15 there were differences in the cut‐off value of PV among studies. Most recently, Namitome et al have demonstrated a prediction model of DU based on symptoms and noninvasive test parameters in men with LUTS 16 . In this study, smaller PV (less than 30 mL) was shown to be a significant predictive factor for DU.…”

Section: Clinical Predictors Of Dusupporting

confidence: 55%

“…on symptoms and noninvasive test parameters in men with LUTS. 16 In this study, smaller PV (less than 30 mL) was shown to be a significant predictive factor for DU.…”

Section: Namitome Et Al Have Demonstrated a Prediction Model Of Du Basedmentioning

confidence: 48%

“…The cut-off values of predictors were determined on the basis of expert opinion as well as by considering evidence from the relevant literature. 1,[6][7][8][9][10][16][17][18] The proposed criteria include: Table 1.…”

Section: Clinical Diagnostic Criteria For Dumentioning

confidence: 99%

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Clinical diagnostic criteria for detrusor underactivity: A report from the Japanese Continence Society working group on underactive bladder

Yoshida

Sekido

Matsukawa

et al. 2020

LUTS

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Detrusor underactivity (DU) is a common bladder dysfunction that causes lower urinary tract symptoms (LUTS) in both men and women. Currently DU can only be diagnosed by an invasive urodynamic test. Underactive bladder (UAB) is the symptombased correlate of DU, as is the case with overactive bladder (OAB) and detrusor overactivity (DO). The International Continence Society (ICS) consensus group has recently proposed a working definition of UAB as a symptom syndrome suggestive of DU. However, a symptom complex of UAB is shared by LUTS attributable to bladder outlet obstruction (BOO). Thus, UAB is not specific for DU, leading to difficulties in determining a therapeutic target (DU or BOO) in the initial management of UAB. Under these circumstances, a consensus group was formed under the auspices of the Japanese Continence Society (JCS) and diagnostic criteria were produced to poten

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Section: Clinical Predictors Of Dusupporting

confidence: 55%

“…on symptoms and noninvasive test parameters in men with LUTS. 16 In this study, smaller PV (less than 30 mL) was shown to be a significant predictive factor for DU.…”

Section: Namitome Et Al Have Demonstrated a Prediction Model Of Du Basedmentioning

confidence: 48%

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Clinical diagnostic criteria for detrusor underactivity: A report from the Japanese Continence Society working group on underactive bladder

Yoshida

Sekido

Matsukawa

et al. 2020

LUTS

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“…Finally, there were 909 patients included in this study. The details of the patient selection process are described in the previous study 7 …”

Section: Methodsmentioning

confidence: 99%

“…The details of the patient selection process are described in the previous study. 7 This study was conducted in accordance with the ethical standards of the Declaration of Helsinki and was approved by the ethical committees of participating hospitals (IRB no. 28-116).…”

Section: Study Design and Patient Populationmentioning

confidence: 99%

Symptoms and noninvasive test parameters that clinically differentiate detrusor underactivity from bladder outlet obstruction without a pressure‐flow‐based diagnosis in men with lower urinary tract symptoms

Takahashi

Takei

Namitome

et al. 2020

Neurourology and Urodynamics

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Aim: To examine the symptoms and noninvasive test parameters that clinically differentiate detrusor underactivity (DU) from bladder outlet obstruction (BOO) without using a pressure-flow study (PFS) in male patients with lower urinary tract symptoms. Methods: We examined 909 men who underwent PFS and also had the following data: International Prostate Symptom Score (IPSS), free uroflowmetry, postvoid residual (PVR), and prostate volume (PV). Using these data, significant symptoms and noninvasive test parameters that clinically differentiate DU from BOO were examined. Results: Significant parameters between DU patients and BOO patients were older age, smaller PV, and lower urgency symptom score (IPSS Q4). Optimal cutoff values were determined using receiver operating characteristic curves (≥74 years old, PV ≤ 34.8, and IPSS Q4 ≤ 1) and patients were categorized on the basis of the number of significant factors. The probability of DU or BOO in patients with three significant factors were 77% and 34%, respectively. Conclusion: Three factors (older age, smaller PV, and fewer urgency symptom) were the predictive factors to differentiate DU from BOO, which might be useful for estimating the probability of DU in clinical practice without a PFS.

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Muscarinic‐3‐receptor positive allosteric modulator ASP8302 in patients with underactive bladder. A randomized controlled trial

Till

Arita

Kuroishi

et al. 2022

Neurourology and Urodynamics

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The aim of this study is to evaluate safety and efficacy of ASP8302, a novel positive allosteric modulator for the muscarinic M3 receptor (M3-PAM), in patients with underactive bladder (UAB). Methods: A randomized, double-blind, placebo-controlled multicenter study was performed in adult male/female subjects with UAB, defined as incomplete bladder emptying (postvoid residual volume [PVR] > 100 ml) without significant bladder outlet obstruction and/or overactive bladder. Subjects were randomized (1:1) to receive 4-week oral once-daily administration of 100 mg ASP8302 or matching placebo. Primary endpoint was a change from baseline in PVR measured by catheterization after standardized bladder filling (PVR C2 ). Other endpoints included PVR and bladder voiding efficiency (BVE) measured in various ways, uroflowmetry, bladder diary, and questionnaires. Pressureflow studies were performed in a subgroup.Results: One hundred and thirty-five patients were randomized (ASP8302 group: 65 patients, placebo group: 70 patients). The median change in PVR C2 was −40.0 ml (ASP8302) versus −35.0 ml (placebo) and the difference between groups was −5.0 ml (p = 0.960). In males, functional and symptomatic outcomes improved, for example, maximum urine flow rate (Q max ) and detrusor pressure at Q max (P det.Qmax ) increased (mean difference in change ASP8302 vs. placebo: 3.8 ml/s, p = 0.031 and 12.7 cm H 2 O, p = 0.034, respectively). Urinary incontinence episodes/24 h decreased in males with preexisting incontinence (mean difference: −0.35; p = 0.028). The incidence of adverse events was similar between study groups (ASP8302: 33.3%, placebo: 31.4%). In the included subjects, both baseline urine flow and bladder voiding pressure was low. Compared with PVR, simultaneous BVE measurements were more consistent between various methods (spontaneous vs. standardized bladder filling, catheterization vs. ultrasound [US]).

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A Prediction Model of Detrusor Underactivity Based on Symptoms and Noninvasive Test Parameters in Men with Lower Urinary Tract Symptoms: An Analysis of a Large Group of Patients undergoing Pressure-Flow Studies

Cited by 22 publications

References 0 publications

Clinical diagnostic criteria for detrusor underactivity: A report from the Japanese Continence Society working group on underactive bladder

Clinical diagnostic criteria for detrusor underactivity: A report from the Japanese Continence Society working group on underactive bladder

Symptoms and noninvasive test parameters that clinically differentiate detrusor underactivity from bladder outlet obstruction without a pressure‐flow‐based diagnosis in men with lower urinary tract symptoms

Muscarinic‐3‐receptor positive allosteric modulator ASP8302 in patients with underactive bladder. A randomized controlled trial

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