Cheng Yu, Li Taicheng, Wu Xiaoyu, Ling Qin, Rao Ke, Yuan Xiaoyi, Chen Zhong, Du Guanghui, Xu Shengfei
Department of Urology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China.
Front Surg. 2022 Sep 20;9:986679. doi: 10.3389/fsurg.2022.986679. eCollection 2022.
We conducted the first meta-analysis to determine the diagnostic value of non-invasive methods for diagnosing bladder outlet obstruction (BOO) in men with lower urinary tract symptoms (LUTS).
We searched a range of databases for relevant publications up to June 2022, including PubMed, Embase, Web of Science, and the Cochrane Library. Retrieved studies were then reviewed for eligibility and data were extracted. The risk of bias (RoB) was assessed using the QUADAS-2 tool. We then performed a formal meta-analysis to evaluate the accuracy of various non-invasive methods for diagnosing BOO in men.
We identified 51 eligible studies including 7,897 patients for meta-analysis. The majority of the studies had a low overall RoB. Detrusor wall thickness (DWT) (pooled sensitivity (SSY): 71%; specificity (SPY): 88%; diagnostic odds ratio (DOR): 17.15; area under curve (AUC) 0.87) and the penile cuff test (PCT) (pooled SSY: 87%; SPY: 78%; DOR: 23.54; AUC: 0.88) showed high accuracy for diagnosing BOO. Furthermore, data suggested that DWT had the highest pooled SPY (0.89), DOR (32.58), and AUC (0.90), when using 2 mm as the cut-off.
Of the non-invasive tests tested, DWT and PCT had the highest levels of diagnostic accuracy for diagnosing BOO in men with LUTS. DWT, with a 2 mm cut-off, had the highest level of accuracy. These two methods represent good options as non-invasive tools for evaluating BOO in males.
我们进行了首次荟萃分析，以确定非侵入性方法对诊断下尿路症状（LUTS）男性膀胱出口梗阻（BOO）的诊断价值。
我们检索了一系列数据库，以获取截至2022年6月的相关出版物，包括PubMed、Embase、科学网和考克兰图书馆。然后对检索到的研究进行资格审查并提取数据。使用QUADAS-2工具评估偏倚风险（RoB）。然后我们进行了正式的荟萃分析，以评估各种非侵入性方法对男性BOO的诊断准确性。
我们纳入了51项符合条件的研究，共7897例患者进行荟萃分析。大多数研究的总体RoB较低。逼尿肌壁厚度（DWT）（合并敏感度（SSY）：71%；特异度（SPY）：88%；诊断比值比（DOR）：17.15；曲线下面积（AUC）0.87）和阴茎袖带试验（PCT）（合并SSY：87%；SPY：78%；DOR：23.54；AUC：0.88）对BOO的诊断显示出较高的准确性。此外，数据表明，以2 mm为临界值时，DWT的合并SPY（0.89）、DOR（32.58）和AUC（0.90）最高。
在所测试的非侵入性检查中，DWT和PCT对LUTS男性BOO的诊断准确性最高。以2 mm为临界值的DWT准确性最高。这两种方法是评估男性BOO的良好非侵入性工具选择。
