van Venrooij Ger E P M, Eckhardt Mardy D, Boon Tom A
Department of Urology, University Medical Center Utrecht, Utrecht, The Netherlands.
Urology. 2004 Mar;63(3):476-80. doi: 10.1016/j.urology.2003.10.021.
To investigate what combination of easily available parameters allows the noninvasive prediction of infravesical obstruction in optimal agreement with urodynamic classification. Urodynamically, men with lower urinary tract symptoms suggestive of benign prostatic hyperplasia are classified as nonobstructed or obstructed.
Mandatory and recommended tests were performed in 160 consecutive men with lower urinary tract symptoms suggestive of benign prostatic hyperplasia. The classification of the International Continence Society, the group-specific urethral resistance factor, and Schäfer's obstruction grade were estimated from urodynamic studies. The frequency-volume charts were analyzed. A separate group of 173 consecutive men was used for validation.
The formula, prostate volume (in cubic centimeters) - 3 x maximal urinary free flow rate (in milliliters per second) - 0.2 x mean voided volume (in milliliters; as estimated from frequency-volume charts), was optimal in the classification compared with the urodynamic classification. Extension of this formula to more than three parameters did not result in better selection. As estimated from receiver operating characteristic curves, the accuracy of the formula appeared to be good. The method of quantifying urethral resistance minimally affected the classification that resulted from the combination. From the results, a diagram was created presenting the probability of an individual to have infravesical obstruction. The validation results were satisfactory.
The prediction of the probability of a man with lower urinary tract symptoms suggestive of benign prostatic hyperplasia to have infravesical obstruction can be deduced from a diagram based on a formula composed of three readily available parameters: prostate volume, maximal urinary free flow rate, and mean voided volume.
研究哪些易于获取的参数组合能够实现与尿动力学分类最佳吻合的膀胱下梗阻无创预测。在尿动力学方面，有提示良性前列腺增生的下尿路症状的男性被分类为无梗阻或梗阻。
对160例有提示良性前列腺增生的下尿路症状的连续男性患者进行了强制性和推荐性检查。根据尿动力学研究评估国际尿控协会的分类、组特异性尿道阻力因子和舍费尔梗阻分级。分析了频率-容量图。另一组173例连续男性患者用于验证。
与尿动力学分类相比，公式前列腺体积（立方厘米）-3×最大尿流率（毫升/秒）-0.2×平均排尿量（毫升；根据频率-容量图估算）在分类中是最佳的。将该公式扩展到三个以上参数并没有带来更好的选择。根据受试者工作特征曲线估计，该公式的准确性似乎良好。量化尿道阻力的方法对组合产生的分类影响最小。根据结果，绘制了一张图，显示个体发生膀胱下梗阻的概率。验证结果令人满意。
对于有提示良性前列腺增生的下尿路症状的男性，其发生膀胱下梗阻概率的预测可根据一张基于由前列腺体积、最大尿流率和平均排尿量这三个易于获取的参数组成的公式的图来推导。
