Department of Urology, Radboud University Nijmegen Medical Centre, Nijmegen, The Netherlands.
Biomed Res Int. 2013;2013:452857. doi: 10.1155/2013/452857. Epub 2013 Jul 14.
To determine the difference in response of NIRS of the bladder during voiding between men with and without BOO.LUTS.
A prospective, case series, study included 36 men with LUTS. Patients completed the IPSS questionnaire; prostate volumes were measured sonographically. Patients underwent pressure flow study (PFS) with simultaneous NIRS of the bladder. Amplitudes of HHb, O2Hb, and Hbsum were calculated at Qmax, relative to baseline. Patients were urodynamically classified as obstructed and unobstructed. Recursive partition analysis (RPA) was performed to reclassify patients using NIRS amplitudes, followed by combined data of NIRS amplitudes, prostate volume, IPSS, and Qmax to determine the best predictor(s) of BOO.
PFS classified 28 patients as obstructed and 8 as unobstructed. The median HHb amplitude was significantly higher in obstructed group. RPA of NIRS amplitudes correctly reclassified 89% of patients [AUC: 0.91]. RPA of the combined IPSS, prostate volume, PVR, and Qmax correctly reclassified 72% of patients [AUC: 0.84]. When NIRS amplitudes were added to this combination, RPA revealed a significantly (P < 0.01) higher rate of correct reclassification in 89% of patients with 89.3% sensitivity and 88% specificity for obstruction [AUC: 0.96].
NIRS data can be of diagnostic value for BOO in men with LUTS.
确定逼尿肌排空时 NIRS 对有和无 BOO.LUTS 的男性膀胱反应的差异。
前瞻性病例系列研究纳入 36 例有 LUTS 的男性患者。患者完成了 IPSS 问卷；经超声测量前列腺体积。患者进行压力-流率研究（PFS），同时对膀胱进行 NIRS。在 Qmax 时计算 HHb、O2Hb 和 Hbsum 的振幅，相对于基线。根据 PFS 将患者分为梗阻和非梗阻组。采用递归分区分析（RPA）根据 NIRS 振幅重新分类患者，然后结合 NIRS 振幅、前列腺体积、IPSS 和 Qmax 的数据来确定 BOO 的最佳预测因素。
PFS 将 28 例患者分类为梗阻组，8 例患者分类为非梗阻组。梗阻组的 HHb 振幅中位数明显较高。NIRS 振幅的 RPA 正确地重新分类了 89%的患者[AUC：0.91]。结合 IPSS、前列腺体积、PVR 和 Qmax 的 RPA 正确地重新分类了 72%的患者[AUC：0.84]。当将 NIRS 振幅添加到该组合中时，RPA 显示出明显更高的正确再分类率（89%的患者，89.3%的敏感性和 88%的特异性），用于梗阻的 AUC 为 0.96。
NIRS 数据对有 LUTS 的男性 BOO 具有诊断价值。
