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The diagnosis of benign prostatic obstruction: Development of a clinical nomogram
Author(s) -
De Nunzio Cosimo,
Autorino Riccardo,
Bachmann Alexander,
Briganti Alberto,
Carter Simon,
Chun Felix,
Novara Giacomo,
Sosnowski Roman,
Thiruchelvam Nickesh,
Tubaro Andrea,
Ahyai Sascha
Publication year - 2016
Publication title -
neurourology and urodynamics
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.918
H-Index - 90
eISSN - 1520-6777
pISSN - 0733-2467
DOI - 10.1002/nau.22705
Subject(s) - nomogram , medicine , urology , lower urinary tract symptoms , univariate , multivariate analysis , multivariate statistics , logistic regression , prostate , univariate analysis , urinary flow , international prostate symptom score , cancer , statistics , mathematics
Aims To develop a nomogram predicting benign prostatic obstruction (BPO). Methods We included in this study 600 men with lower urinary tract symptoms (LUTS) and benign prostatic enlargement (BPE) who underwent standardized pressure flow studies (PFS) between 1996 and 2000. Complete clinical and urodynamic data were available for all patients. Variables assessed in univariate and multivariate logistic regression models consisted of IPSS, PSA, prostate size, maximal urinary flow rate (Qmax) at free flow, residual urine (RU), and bladder wall thickness (BWT). These were used to predict significant BPO (defined as a Schäfer grade ≥ 3 in PFS). Results A preliminary multivariate model, including IPSS, Qmax at free flow and RU, suggested that only Qmax at free flow was a statistically significant predictor of BPO ( P = 0.00) with a predictive accuracy (PA) of 82%. Further development of the multivariate model showed how the inclusion of BWT did not increase PA. Only transitional zone volume (TZV) proved to be an additional statistically significant predictor for BPO ( P = 0.00). The combination of Qmax at free flow and TZV demonstrated a PA of 83.2% and were included in the final nomogram format. Conclusions We developed a clinical nomogram, which is both accurate and well calibrated, which can be helpful in the management of patients with LUTS and BPE. External validation is warranted to confirm our findings. Neurourol. Urodynam. 35:235–240, 2016 . © 2014 Wiley Periodicals, Inc.