Vírseda Chamorro Miguel, Salinas Casado Jesús, Adot Zurbano José María, Martín García Carlos
Servicio de Urología, Hospital Central de la Defensa, Madrid.
Arch Esp Urol. 2006 Jul-Aug;59(6):601-6. doi: 10.4321/s0004-06142006000600006.
To compare the results of the Blaivas and Groutz nomogram in the diagnosis of female urinary obstruction with videourodynamic tests.
We performed a transverse study in a series of 52 female patients with ages between 20 and 81 years (mean age: 48.7 years; standard deviation: 14.4 years) and functional lower urinary tract symptoms referred for videourodynamic studies. All patients underwent free flowmetry and voiding videourodynamic study. From the scores of free flowmetry and maximum detrusor pressure in the detrusor pressure/voiding flow test of the urodynamic study they were classified in one of four categories following the Blaivas and Groutz nomogram. Following urodynamic data they were classified into three categories: absence of obstruction, bladder neck obstruction and urethral obstruction. The nomogram results were compared with the videourodynamic data using the Pearson chi-square statistical test. The diagnostic sensitivity and specificity of the nomogram were also determined.
The Blaivas and Groutz nomogram showed a significant association with the videourodynamic data (p = 0.000). Its diagnostic sensitivity for obstruction was 100%, but its specificity was only 67.5%. The percentage of diagnostic discrepancies was maximal in the mild obstruction, where one third of the patients were obstructed following the videourodynamic data.
The Blaivas and Groutz nomogram is a sensitive method for the diagnosis of obstruction, but its specificity is low so that it has the tendency to overdiagnose the presence of obstruction in the female patient.
比较布莱瓦斯（Blaivas）和格鲁茨（Groutz）列线图在女性尿路梗阻诊断中与影像尿动力学检查结果的差异。
我们对一系列52例年龄在20至81岁之间（平均年龄：48.7岁；标准差：14.4岁）且有功能性下尿路症状并接受影像尿动力学检查的女性患者进行了横向研究。所有患者均接受了自由尿流率测定和排尿影像尿动力学检查。根据尿动力学检查中自由尿流率和逼尿肌压力/排尿流率试验中的最大逼尿肌压力得分，按照布莱瓦斯和格鲁茨列线图将她们分为四类之一。根据尿动力学数据，她们被分为三类：无梗阻、膀胱颈梗阻和尿道梗阻。使用Pearson卡方统计检验将列线图结果与影像尿动力学数据进行比较。还确定了列线图的诊断敏感性和特异性。
布莱瓦斯和格鲁茨列线图与影像尿动力学数据显示出显著相关性（p = 0.000）。其对梗阻的诊断敏感性为100%，但特异性仅为67.5%。诊断差异百分比在轻度梗阻中最大，在该组中，根据影像尿动力学数据，三分之一的患者存在梗阻。
布莱瓦斯和格鲁茨列线图是一种诊断梗阻的敏感方法，但其特异性较低，因此有对女性患者梗阻存在过度诊断的倾向。
