The day‐to‐day variation (test‐retest reliability) of residual urine measurement

Dunsmuir, W.D.; Feneley, Mark; Corry, D.A.; Bryan, J.; Kirby, RS

doi:10.1046/j.1464-410x.1996.08524.x

Cited by 64 publications

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“…[9][10][11]20 In addition, the present study showed that baseline PVR was a significant static variable to predict treatment failure. Although it is known that PVR is not an appropriate objective parameter, because its value fluctuates with each evaluation 23 and baseline PVR has little prognostic value for the risk of BPH-related invasive therapy in patients on a1-blockers and watchful waiting, 24 it is reported that the treatment failure rate was significantly high for patients with PVR Ն30 mL as well as those with a PV Ն35 mL, a history of AUR or complications of overactive bladder symptoms. 14 The present study had several limitations.…”

Section: Discussionmentioning

confidence: 99%

α1‐blocker tamsulosin as initial treatment for patients with benign prostatic hyperplasia: 5‐year outcome analysis of a prospective multicenter study

et al. 2012

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Abbreviations & AcronymsObjective: To comprehensively analyze the 5-year outcomes of tamsulosin treatment for patients with benign prostatic hyperplasia. Methods: Tamsulosin (0.2 mg/day) was given to 112 patients who had International Prostate Symptom Scores Ն8. They were prospectively followed for 5 years with periodic evaluation. If tamsulosin had to be discontinued, the reason was determined. Treatment failure was considered in the case of disease progression (postvoid residual urine volume Ն200 mL, acute urinary retention, febrile urinary tract infection or hydronephrosis as a result of bladder outlet obstruction), conversion to other a1-blockers or need for surgery. An intention-to-treat analysis was carried out. Results: A total of 34 patients (30.4%) continued the same medication for the overall study period, whereas 78 patients (69.6%) discontinued the medication. International Prostate Symptom Scores, Benign Prostatic Hyperplasia Problem Index and Quality of Life Index were significantly improved over the 5-year period. Treatment failure was observed in 21 patients (18.8%). Baseline prostate volume and postvoid residual urine volume were independent factors to predicting treatment failure. A total of 21 patients (18.8%) discontinued tamsulosin because of an improvement of symptoms. They were younger and had lower prostate-specific antigen levels than the remaining 91 patients. Their symptoms were stable even 1 year after termination of therapy. Conclusions: Long-term efficacy of tamsulosin was observed, although only a small portion of patients continued the treatment. a1-blocker monotherapy might be not appropriate for achieving a good long-term outcome in patients with a large prostate volume and a large amount of postvoid residual urine volume. Persistent improvement of symptoms, even after termination of tamsulosin, was observed in young patients with low prostate-specific antigen levels.

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Section: Discussionmentioning

confidence: 99%

α1‐blocker tamsulosin as initial treatment for patients with benign prostatic hyperplasia: 5‐year outcome analysis of a prospective multicenter study

et al. 2012

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“…For simplicity, correlation coeBcient of only −0.19 (-0.22 in the study by Barry et al [7]). There was no significant association between the symptom of feeling of incomplete bladder variation in Q max measured on either the same or diCerent days, and Dunsmuir et al [14] have shown poor test-retest reliability for the measurement of PVR. Thus, studies be discarded, with a diagnosis being based on symptoms alone, or can the data from low volume voids while LUTS are important in that they are what bother patients, their significance in terms of reflecting a demonbe used to make a diagnosis?…”

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confidence: 85%

The ICS‐‘BPH’ Study: uroflowmetry, lower urinary tract symptoms and bladder outlet obstruction

Reynard

Yang

Donovan

et al. 1998

British Journal of Urology

203

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Objective To explore the relationship between uroflow variables and lower urinary tract symptoms (LUTS); to define performance statistics (sensitivity, specificity, positive and negative predictive values) for maximum urinary flow rate (Qmax ) with respect to bladder outlet obstruction (BOO) at various threshold values; and to investigate the diagnostic value of low‐volume voids. Patients and methods The study comprised 1271 men aged between 45 and 88 years recruited from 12 centres in Europe, Australia, Canada, Taiwan and Japan over a 2‐year period. Symptom questionnaires, voiding diaries, uroflowmetry and pressure‐flow data were recorded. The relationship between uroflow variables and symptoms, Qmax and BOO, and the diagnostic performance of low volume voids were analysed. Results The relationship between symptoms and uroflow variables was poor. The mean difference between home‐recorded and clinic‐recorded voided volumes was −48 mL. Qmax was significantly lower in those with BOO (9.7 mL/s for void 1) than in those with no obstruction (12.6 mL/s; P<0.001) and Qmax was negatively correlated with obstruction grade (Spearman’s correlation coefficient −0.3, P<0.001), even when controlling for the negative correlation between age and Qmax (Spearman’s partial correlation coefficient −0.29, P<0.001). A threshold value of Qmax of 10 mL/s had a specificity of 70%, a positive predictive value (PPV) of 70% and a sensitivity of 47% for BOO. The specificity using a threshold Qmax of 15 mL/s was 38%, the PPV 67% and the sensitivity 82%. Those voiding <150 mL (n=225) had a 72% chance of BOO (overall prevalence of BOO 60%). In those voiding >150 mL the likelihood of BOO was 56%. The addition of a specific threshold of 10 mL/s to these higher volume voiders improved the PPV for BOO to 69%. Conclusion While uroflowmetry cannot replace pressure‐flow studies in the diagnosis of BOO, it can provide a valuable improvement over symptoms alone in the diagnosis of the cause of lower urinary tract dysfunction in men presenting with LUTS. This study provides performance statistics for Qmax with respect to BOO; such statistics may be used to define more accurately the presence or absence of BOO in men presenting with LUTS, so avoiding the need for formal pressure‐flow studies in everyday clinical practice, while improving the likelihood of a successful outcome from prostatectomy. This study also shows that low‐volume uroflowmetry can provide useful diagnostic information and that, as such, the data from such voids should not be discarded.

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“…Estudios reportan que el VP no se correlaciona con la intensidad de los síntomas, pero sí parece existir asociación con el flujo máximo (1). Un estudio ha encontrado que el ángulo uretroprostático y el grado de protrusión intravesical prostática si estarían relacionados con la severidad de la obstrucción (15).…”

Section: Discussionunclassified

Relación del residuo post-miccional, grado de “trabeculación” vesical y el flujo urinario en pacientes con hiperplasia prostática benigna sintomática.

2012

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Relación del residuo post-miccional, grado de "trabeculación" vesical y el flujo urinario en pacientes con hiperplasia prostática benigna sintomática.Relationship between post-mictional residue, degree of bladder trabeculation and urinary flow in patients with benign prostatic hyperplasia. Humberto Condori 1 , Raúl Medina 2 , Cesar Loza RESUMENObjetivo: Determinar la relación entre el grado de "trabeculación" vesical, el residuo pos miccional y el grado de obstrucción al flujo de salida urinario en pacientes con hiperplasia benigna de próstata (HBP) sintomática. Material y métodos: Serie de casos analítico y retrospectivo que incluyó 37 pacientes con HBP sintomática atendidos ambulatoriamente en el servicio de Urología del Hospital Nacional Cayetano Heredia en el 2009. El grado de "trabeculación" vesical se determinó por cistoscopia, el residuo vesical post-miccional por ecografía y el grado de obstrucción mediante uroflujometría. Resultados: La edad de los pacientes fue: 68,2 ± 7,9 (50-83) años. Los valores del volumen prostático, porcentaje de residuo post-miccional y el flujo máximo fueron: 46,4 ± 20,6 cc (20-113); 33,4% ± 20,7 (5-80) y 6,7 ± 2,12 7 ml/seg (3-10), respectivamente. No se encontró correlación entre: el porcentaje de residuo post-miccional y el flujo urinario máximo (r s = -0,07; p=0,67) y entre el volumen prostático y el flujo máximo con (r s = 0,05; p= 0,7). Tampoco se encontró concordancia entre el grado de "trabeculación" vesical y el flujo máximo (Kappa= 0,0034; p=0,5) y entre el porcentaje de residuo post-miccional y el grado de "trabeculación" (Kappa= 0,18; p=0,06). Conclusión: No se encontró relación entre el flujo máximo urinario, el porcentaje de residuo post-miccional y el grado de "trabeculación", en pacientes con HBP sintomática.PALABRAS CLAVE: Próstata, cistoscopia, vejiga urinaria. (Fuente: DeCS BIREME) SUMMARYObjective: To determine the relationship between the degree of bladder trabeculation, post mictional residue and degree of urinary outflow obstruction in patients with benign prostatic hyperplasia (BPH). Methods: Retrospective case series of 37 ambulatory patients with symptomatic BPH attended at the Urology Service of Hospital Nacional Cayetano Heredia in 2009. The degree of bladder trabeculation was determined by cystoscopy, post-mictional residue was measured by ultrasound, and the degree of outflow obstruction was measured by uroflowmetry. Results: Mean (SD) age of patients was 68.2 ± 7.9 years. Mean (SD) values for prostatic volume, percentage of postmictional residue and maximum flow were 46.4 ± 20.6 ml; 33.4 ± 20.7% y 6.7 ± 2.1 ml/seg, respectively. No correlation between the percentage of post-mictional residue and maximum urinary flow (rs = -0.07; p = 0.67), and between prostatic volume and maximum urinary flow was found (rs = 0.05; p = 0.7). There were also no correlations INTRODUCCIÓNLa identificación del paciente con diagnóstico de hiperplasia prostática benigna (HBP) y uropatía obstructiva requiere de pruebas diagnósticas y score de síntomas con la finalidad de...

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The day‐to‐day variation (test‐retest reliability) of residual urine measurement

Cited by 64 publications

References 0 publications

α1‐blocker tamsulosin as initial treatment for patients with benign prostatic hyperplasia: 5‐year outcome analysis of a prospective multicenter study

α1‐blocker tamsulosin as initial treatment for patients with benign prostatic hyperplasia: 5‐year outcome analysis of a prospective multicenter study

The ICS‐‘BPH’ Study: uroflowmetry, lower urinary tract symptoms and bladder outlet obstruction

Relación del residuo post-miccional, grado de “trabeculación” vesical y el flujo urinario en pacientes con hiperplasia prostática benigna sintomática.

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