Kranse Ries, van Mastrigt Ron
Comprehensive Cancer Center, Rotterdam, The Netherlands.
Urology. 2003 Oct;62(4):667-71. doi: 10.1016/s0090-4295(03)00575-2.
To investigate the weak correlation between bladder outlet obstruction (BOO), as diagnosed using the provisional International Continence Society nomogram for the definition of BOO in men, and postvoid residual urine volume.
The relationship between voiding to completion and several indexes for bladder outlet resistance and bladder contractility was studied in 131 pressure flow studies in male patients using multivariate logistic regression analysis.
The International Continence Society nomogram and the related BOO index weakly predict for postvoid residual urine volume (areas under the receiver operating characteristic curve 0.63 and 0.64, respectively). The BOO index primarily measures bladder outlet resistance. If the nomogram or BOO index is augmented with bladder contractility information, the postvoid residual urine volume can be predicted significantly better (eg, area under the receiver operating characteristic curve [0.89] for the combination of the BOO index and bladder contractility information).
The weak correlation between BOO and postvoid residual urine volume is related to the fact that emptying the bladder to completion depends on bladder contractility, as well as bladder outlet resistance. It is possible to estimate the probability to void to completion quite accurately on the basis of bladder outlet resistance and bladder contractility. We named this probability "relative bladder outlet resistance." A high probability of a postvoid residual urine volume may be assumed to indicate "relative BOO." By its very nature, the correlation between "relative BOO" and postvoid residual urine volume is good.
采用国际尿失禁咨询委员会临时列线图诊断男性膀胱出口梗阻（BOO），研究其与排尿后残余尿量之间的弱相关性。
运用多因素逻辑回归分析，在131例男性患者的压力流研究中，对排尿至完成情况与膀胱出口阻力及膀胱收缩力的多个指标之间的关系进行研究。
国际尿失禁咨询委员会列线图及相关BOO指数对排尿后残余尿量的预测能力较弱（受试者工作特征曲线下面积分别为0.63和0.64）。BOO指数主要测量膀胱出口阻力。若将列线图或BOO指数与膀胱收缩力信息相结合，对排尿后残余尿量的预测效果会显著更好（例如，BOO指数与膀胱收缩力信息相结合时，受试者工作特征曲线下面积为0.89）。
BOO与排尿后残余尿量之间的弱相关性与以下事实有关，即膀胱排空至完成情况取决于膀胱收缩力以及膀胱出口阻力。基于膀胱出口阻力和膀胱收缩力，可以相当准确地估计排尿至完成的概率。我们将此概率命名为“相对膀胱出口阻力”。排尿后残余尿量可能性高可被认为提示“相对BOO”。就其本质而言，“相对BOO”与排尿后残余尿量之间的相关性良好。
