Bladder Outlet Obstruction

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Paul Abrams - One of the best experts on this subject based on the ideXlab platform.

  • noninvasive methods of diagnosing Bladder Outlet Obstruction in men part 1 nonurodynamic approach
    The Journal of Urology, 2006
    Co-Authors: Mohammed Belal, Paul Abrams
    Abstract:

    Purpose: Many methods have been suggested for diagnosing Bladder Outlet Obstruction, as defined by the gold standard of pressure flow studies. Difficulty arises when comparing completely different methods of diagnosing Bladder Outlet Obstruction. A comprehensive review of the literature of the different methods used to diagnose Bladder Outlet Obstruction by noninvasive means was performed with a view to allow such a comparison.Materials and Methods: A MEDLINE search was done of the published literature covering until the end of 2004 on noninvasive methods used to diagnose Bladder Outlet Obstruction. A direct comparison of all different methods was made using the sensitivity and specificity, positive predictive value and likelihood ratio of each test. For many of the techniques these values were calculated from the data presented in the article.Results: A multitude of methods has been applied to diagnose Bladder Outlet Obstruction. Broadly the methods were divided into nonurodynamic and noninvasive urodyna...

  • noninvasive methods of diagnosing Bladder Outlet Obstruction in men part 2 noninvasive urodynamics and combination of measures
    The Journal of Urology, 2006
    Co-Authors: Mohammed Belal, Paul Abrams
    Abstract:

    Purpose: Many methods have been suggested to diagnose Bladder Outlet Obstruction, as defined by the gold standard of pressure flow studies. Difficulty arises when comparing completely different methods of diagnosing Bladder Outlet Obstruction. A comprehensive review of the literature on the different methods used to diagnose Bladder Outlet Obstruction by noninvasive means was performed with a view to allow such a comparison.Materials and Methods: A MEDLINE search was done of the published literature covering until the end of 2004 on noninvasive methods, including single measure and combinations of measures, to diagnose Bladder Outlet Obstruction. A direct comparison of all of the different methods was made using the sensitivity, specificity, likelihood ratio, and pretest and posttest probability of diagnosing Bladder Outlet Obstruction for each test. For many techniques these values were calculated from the data presented in the article.Results: A multitude of methods has been applied to diagnose Bladder ...

  • relationships between lower urinary tract symptoms and Bladder Outlet Obstruction results from the ics bph study
    Neurourology and Urodynamics, 1998
    Co-Authors: J. J. M. C. H. Rosette, Paul Abrams, W P J Witjes, W Schafer, Jenny L Donovan, T J Peters, Richard J Millard, C Frimodtmoller, P Kalomiris
    Abstract:

    Despite the lack of evidence in the literature for close relationships between lower urinary tract symptoms and Bladder Outlet Obstruction, the majority of urologists rely on symptomatology when selecting patients for prostatic surgery. We investigated the relationships between a wide range of lower urinary tract symptoms from the ICSmale questionnaire and the results of urodynamic pressure and flow studies. We evaluated 933 patients with lower urinary tract symptoms suggestive for Bladder Outlet Obstruction from 12 countries who participated in the ICS-“BPH” study with the ICSmale questionnaire and urodynamic pressure and flow studies. Spearman rank correlation coefficients were obtained between symptoms and measures of Bladder Outlet Obstruction. There was little or no correlation between a wide range of symptoms and the results of free uroflowmetry and pressure and flow studies. From symptoms alone, it is not possible to diagnose Bladder Outlet Obstruction. Pressure and flow studies and symptom profiles measure different aspects of the clinical condition that should be viewed separately in the evaluation and treatment decision of the patient presenting with lower urinary tract symptoms. Neurourol. Urodynam. 17:99–108, 1998. © 1998 Wiley-Liss, Inc.

Michael E. Disanto - One of the best experts on this subject based on the ideXlab platform.

J. J. M. C. H. Rosette - One of the best experts on this subject based on the ideXlab platform.

  • relationships between lower urinary tract symptoms and Bladder Outlet Obstruction results from the ics bph study
    Neurourology and Urodynamics, 1998
    Co-Authors: J. J. M. C. H. Rosette, Paul Abrams, W P J Witjes, W Schafer, Jenny L Donovan, T J Peters, Richard J Millard, C Frimodtmoller, P Kalomiris
    Abstract:

    Despite the lack of evidence in the literature for close relationships between lower urinary tract symptoms and Bladder Outlet Obstruction, the majority of urologists rely on symptomatology when selecting patients for prostatic surgery. We investigated the relationships between a wide range of lower urinary tract symptoms from the ICSmale questionnaire and the results of urodynamic pressure and flow studies. We evaluated 933 patients with lower urinary tract symptoms suggestive for Bladder Outlet Obstruction from 12 countries who participated in the ICS-“BPH” study with the ICSmale questionnaire and urodynamic pressure and flow studies. Spearman rank correlation coefficients were obtained between symptoms and measures of Bladder Outlet Obstruction. There was little or no correlation between a wide range of symptoms and the results of free uroflowmetry and pressure and flow studies. From symptoms alone, it is not possible to diagnose Bladder Outlet Obstruction. Pressure and flow studies and symptom profiles measure different aspects of the clinical condition that should be viewed separately in the evaluation and treatment decision of the patient presenting with lower urinary tract symptoms. Neurourol. Urodynam. 17:99–108, 1998. © 1998 Wiley-Liss, Inc.

  • Is there a correlation between prostate size and Bladder-Outlet Obstruction?
    World Journal of Urology, 1995
    Co-Authors: P. F. W. M. Rosier, J. J. M. C. H. Rosette
    Abstract:

    This retrospective study was conducted in 521 men with micturition complaints to determine the relationship between prostate size and Bladder-Outlet Obstruction. Analysis showed a statistically significant correlation between Bladder-Outlet Obstruction and prostate size. Urodynamic Bladder-Outlet Obstruction was confirmed in 90% of the patients with a prostate size of more than 80 cm^3. In 32% of the patients with a prostate smaller than 40 cm^3, no urodynamic evidence of Bladder-Outlet Obstruction was found. There was no correlation between symptom scores (Madsen and I-PSS) and the grade of Bladder-Outlet Obstruction or prostate size. We conclude that precise determination of the prostate size and urodynamics investigations are important (complementary) parameters in the assessment of elderly men with micturition complaints.

Samuel Chacko - One of the best experts on this subject based on the ideXlab platform.

Jerry G Blaivas - One of the best experts on this subject based on the ideXlab platform.

  • Bladder Outlet Obstruction in women definition and characteristics
    Neurourology and Urodynamics, 2000
    Co-Authors: Asnat Groutz, Jerry G Blaivas, David C Chaikin
    Abstract:

    The prevalence of Bladder Outlet Obstruction in women is unknown and most probably has been underestimated. Moreover, there are no standard definitions for the diagnosis of Bladder Outlet Obstruction in women. Our study was conducted to define as well as to examine the clinical and urodynamic characteristics of Bladder Outlet Obstruction among women referred for evaluation of voiding symptoms. Bladder Outlet Obstruction was defined as a persistent, low, maximum “free” flow rate of 20 cm H2O) during detrusor pressure–uroflow studies. A urodynamic database of 587 consecutive women identified 38 (6.5%) women with Bladder Outlet Obstruction. The mean age of the patients was 63.9 ± 17.5 years. The mean maximum “free” flow, voided volume, and residual urinary volume were 9.4 ±3.9 mL/s, 144.9 ± 72.7 mL, and 86.1 ± 98.8 mL, respectively. The mean pdet.Qmax was 37.2 ± 19.2 cm H2O. Previous anti-incontinence surgery and severe genital prolapse were the most common etiologies, accounting for half of the cases. Other, less common, etiologies included urethral stricture (13%), primary Bladder neck Obstruction (8%), learned voiding dysfunction (5%), and detrusor external sphincter dyssynergia (5%). Symptomatology was defined as mixed obstructive and irritative in 63% of the patients, isolated irritative in 29%, and isolated obstructive in other 8%. In conclusion, Bladder Outlet Obstruction in women appears to be more common than was previously recognized, occurring in 6.5% of our patients. Micturition symptoms relevant to Bladder Outlet Obstruction are non-specific, and a full urodynamic evaluation is essential in making the correct diagnosis and formulating a treatment plan. Neurourol. Urodynam. 19:213–220, 2000. © 2000 Wiley-Liss, Inc.

  • Bladder Outlet Obstruction nomogram for women with lower urinary tract symptomatology
    Neurourology and Urodynamics, 2000
    Co-Authors: Jerry G Blaivas, Asnat Groutz
    Abstract:

    The aim of our study was to construct a Bladder Outlet Obstruction nomogram for women with lower urinary tract symptoms. A urodynamic database of 600 consecutive women was reviewed. Bladder Outlet Obstruction, utilizing strict diagnostic criteria, was diagnosed in 50 (8.3%) patients. A comparison of patient characteristics, uroflowmetry, and detrusor pressure-uroflow studies was carried out between the obstructed patients (mean age, 64.4 ± 17.6 years) and 50 age-matched unobstructed controls (mean age, 64.8 ± 10.7 years). Maximum flow rates were significantly higher in free uroflow studies (free Qmax) than in pressureflow studies (Qmax), in both obstructed (9.3 ± 3.7 versus 5.7 ± 3.6 mL/s, respectively. P 4 2.6 10 ˛6 ) and unobstructed (25.6 ± 11.2 versus 11.8 ± 5.9 mL/s, respectively. P 4 8.7 10 ˛12 ) patients. Comparison of detrusor pressure at maximum flow (pdet.Qmax) and maximum detrusor pressure during voiding (pdet.max) values did not reveal significant differences, in both obstructed (39.3 ± 18.4 versus 49.7 ± 25.5 cm H 2O, respectively) and unobstructed (16.5 ± 8.4 versus 20.6 ± 9.2 cm H 2O, respectively) patients. Further statistical analysis was carried out to construct Bladder Outlet Obstruction nomogram. The nomogram classifies any pair of values of free Qmax and pdet.max into one of the following four zones: no Obstruction, mild Obstruction, moderate Obstruction, and severe Obstruction. Of the 50 obstructed women, 34 (68%) were classified by the nomogram as mildly, 12 (24%) as moderately, and 4 (8%) as severely obstructed. A positive correlation was found between subjective severity of the symptoms (assessed by the AUA Symptom Index score) and the four nomogram zones. In conclusion, the nomogram makes it possible to differentiate between obstructed and unobstructed women and between various degrees of Obstruction. We believe the nomogram may also serve as an instrument to assess treatment outcomes. Neurourol. Urodynam. 19:553‐564, 2000. © 2000 Wiley-Liss, Inc.

  • Bladder Outlet Obstruction versus impaired detrusor contractility the role of uroflow
    The Journal of Urology, 1991
    Co-Authors: Michael B Chancellor, Steven A. Kaplan, Jerry G Blaivas, Sheldon L Axelrod
    Abstract:

    AbstractThe uroflow curves of 45 men with either Bladder Outlet Obstruction or impaired detrusor contractility were retrospectively reviewed. The definitive diagnoses were attained by clinical and video-urodynamic studies with simultaneous detrusor pressure and uroflow measurements. Eight parameters were analyzed to determine if uroflow can differentiate Obstruction from impaired contractility. There were no differences between the 2 groups in any of the parameters. This finding suggests that uroflowmetry as a single examination cannot distinguish between Bladder Outlet Obstruction and impaired detrusor contractility.