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KMID : 0358320090500090848
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Korean Journal of Urology
2009 Volume.50 No. 9 p.848 ~ p.853
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Predictive Factors for Female Bladder Outlet Obstruction Defined by Pressure-Flow Study
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Ha Seung-Beom
Kim Seong-Soo
Lee Seung-Tae
Min Kyeong-Eun
Jeong Seong-Jin
Hong Sung-Kyu
Byun Seok-Soo
Lee Sang-Eun
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Abstract
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Purpose: We investigated pre-urodynamic study parameters of bladder outlet obstruction (BOO) defined by pressure-flow study (PFS) in female patients without anatomical obstruction.
Materials and Methods: The cohort of this study consisted of 320 women who did not have anatomical BOO in whom urodynamic study was conducted for lower urinary tract symptoms (LUTS). BOO was defined when the PFS maximal flow rate (Qmax) was ≤12 ml/sec and Pdet Qmax was ≥25 cmH2O. The main outcomes were the incidence of BOO and its predictive factors in our cohort.
Results: Of the total patients, 39 (12.2%) were diagnosed with BOO in the PFS. Free Qmax and maximal voided volume (MVV) were significant predictors of BOO (p＜0.001, p=0.011, respectively) in the multivariate logistic regression. When free Qmax was set to ≤15 ml/sec, its sensitivity and specificity predicting BOO were 82% and 72%, respectively; when MVV was set to ≤350 ml, its values were 71% and 46%, respectively. However, the positive predictive values (PPVs) of free Qmax and MVV were low (34.4% and 28.2%, respectively), whereas the negative predictive values (NPVs) of these parameters were relatively high (96.5% and 91.2%, respectively).
Conclusions: Factors predicting BOO defined by PFS in female patients complaining LUTS without anatomical obstruction were free Qmax and MVV. The PPV of these factors was low, and the NPV was high. Therefore, if free Qmax is ＞15 ml/sec or MVV is ＞350 ml, PFS may be not essential. On the contrary, if free Qmax and MVV are below these levels, PFS may be indicated to evaluate the presence of BOO.
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KEYWORD
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Urinary bladder neck obstruction, Urodynamics, Female
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