THE ROLE OF BLADDER WALL THICKNESS IN THE EVALUATION OF DETRUSOR UNDERACTIVITY: DEVELOPMENT OF A CLINICAL NOMOGRAM

De Nunzio C1, Cancrini F1, Lombardo R1, Tema G1, Nacchia A1, Sica A1, Tubaro A1

Research Type

Clinical

Abstract Category

Male Lower Urinary Tract Symptoms (LUTS) / Voiding Dysfunction

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Abstract 510
Bladder Wall, Microbiome and Nocturia
Scientific Podium Short Oral Session 27
Friday 6th September 2019
09:45 - 09:52
Hall G1
Underactive Bladder Voiding Dysfunction Questionnaire
1.Sant'Andrea Hospital, Sapienza University of Rome, Rome, Italy.
Presenter
F

Fabiana Cancrini

Links

Abstract

Hypothesis / aims of study
The aim of our study was to investigate non-invasive predictors for Detrusor Underactivity (DU) in male patients with LUTS and benign prostatic enlargement (BPE).
Study design, materials and methods
Each new patient, aged 45 years or older with LUTS, due to benign prostatic enlargement, presenting at the Charing Cross Hospital, Dept. of Urology, London, United Kingdom and at the Department of Urology, Teramo Hospital, University of Aquila, Italy, was prospectively enrolled. Patients underwent standard diagnostic assessment including International Prostatic Symptoms Score (IPSS), uroflowmetry, urodynamic studies (cystometry and pressure flow studies), transrectal ultrasound and ultrasound measurements of the bladder wall thickness (BWT). A nomogram was generated based on the logistic regression model used to predict DU defined as a BCI<100 cmH2O. Accuracy of the nomogram was evaluated using the L-ROC
Results
Overall 448 patients were enrolled. Mean age of the study cohort was 66± 11 years. DU was observed in 194/448 patients (43%). Patients with DU presented an lower Qmax (7.3 ± 3.1 ml/sec vs 12.5 ± 5.9 ml/sec; p= 0.01) and a lower BWT (3.4 ± 1.4 mm vs 4 ± 1.1; p= 0.001) when compared to patients without DU. IPSS, prostate volume and PVR demonstrated no statistically significant difference between patients with or without DU.
Interpretation of results
In a multivariable logistic, age-adjusted regression model BWT (OR: 0.51 per mm; CI: 0.40-0-66; p= 0.001) and Qmax (OR: 0.75 per ml/sec; CI: 0.70-0.81; p= 0.001) remained statistically significant predictors for DU. Calibration plot and decision curve analysis showed good calibration of the nomogram in the 10-85% probabilities. The nomogram predicting DU risk presented a predictive accuracy of 0.82 (Figure 1-2).
Concluding message
According to our results BWT and Qmax can non-invasively predict the presence of DU in patients with LUTS and BPE. Our study, although should be confirmed in a larger prospective cohort showed for the first time that BWT in male patients with LUTS and BPE could reflect the presence of DU.
Figure 1
Figure 2
Disclosures
Funding none Clinical Trial No Subjects Human Ethics Committee Sant'Andrea Hospital Helsinki Yes Informed Consent Yes