Simple modification of the bladder outlet obstruction index for better prediction of endoscopically-proven prostatic obstruction: A preliminary study

Jang Hee Han, Ho Song Yu, Joo Yong Lee, Joohan Kim, Dong Hyuk Kang, Jong Kyu Kwon, Young Deuk Choi, Kang Su Cho

Research output: Contribution to journalArticle

3 Citations (Scopus)

Abstract

Purpose: The bladder outlet obstruction index (BOOI), also known as the Abrams-Griffiths (AG) number, is the most widely used index for predicting BOO. However, the obstructed prostatic urethra determined by the BOOI is often inconsistent with endoscopically-proven obstruction. We assessed abdominal straining pattern as a novel parameter for improving the prediction of BOO. Materials and Methods: We retrospectively reviewed the pressure-flow studies (PFS) and cystourethroscopy in 176 BPH/LUTS patients who were unresponsive to medical therapy. During PFS, some groups of patients tried to urinate with abdominal straining, which can increases intravesical pressure and underestimate BOOI theoretically. Accordingly, the modified BOOI was defined as (PdetQmax+ΔPabd)-2Qmax. Results: Ultimately, 130 patients were eligible for the analysis. In PFS, ΔPabd (PabdQmax-initial Pabd) was 11.81±13.04 cmH2O, and it was 0-9 cmH2O in 75 (57.7%), 10-19 cmH2O in 23 (17.7%) and ≥20 cmH2O in 32 (24.6%) patients. An endoscopically obstructed prostatic urethra in 92 patients was correctly determined in 47 patients (51.1%) by the original BOOI versus 72 patients (78.3%) based on the modified BOOI. Meanwhile, an "unobstructed" urethra according to the original BOOI was present in 11 patients (12.0%), whereas according to the modified BOOI, only 2 (2.1%) would be labeled as "unobstructed". In receiver operating characteristic curves, the area under the curve was 0.906 using the modified BOOI number versus 0.849 in the original BOOI (p<0.05). Conclusions: The change in abdominal pressure was correlated with endoscopically-proven obstruction. Our simple modification of the BOOI on the basis of this finding better predicted bladder outlet obstruction and, therefore, should be considered when evaluating BOO in patients with LUTS/BPH.

Original languageEnglish
Article numbere0141745
JournalPloS one
Volume10
Issue number10
DOIs
Publication statusPublished - 2015 Oct 27

Fingerprint

Urinary Bladder Neck Obstruction
bladder
prediction
urethra
Pressure
Urethra
ROC Curve
Area Under Curve

All Science Journal Classification (ASJC) codes

  • Biochemistry, Genetics and Molecular Biology(all)
  • Agricultural and Biological Sciences(all)
  • General

Cite this

Han, Jang Hee ; Yu, Ho Song ; Lee, Joo Yong ; Kim, Joohan ; Kang, Dong Hyuk ; Kwon, Jong Kyu ; Choi, Young Deuk ; Cho, Kang Su. / Simple modification of the bladder outlet obstruction index for better prediction of endoscopically-proven prostatic obstruction : A preliminary study. In: PloS one. 2015 ; Vol. 10, No. 10.
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title = "Simple modification of the bladder outlet obstruction index for better prediction of endoscopically-proven prostatic obstruction: A preliminary study",
abstract = "Purpose: The bladder outlet obstruction index (BOOI), also known as the Abrams-Griffiths (AG) number, is the most widely used index for predicting BOO. However, the obstructed prostatic urethra determined by the BOOI is often inconsistent with endoscopically-proven obstruction. We assessed abdominal straining pattern as a novel parameter for improving the prediction of BOO. Materials and Methods: We retrospectively reviewed the pressure-flow studies (PFS) and cystourethroscopy in 176 BPH/LUTS patients who were unresponsive to medical therapy. During PFS, some groups of patients tried to urinate with abdominal straining, which can increases intravesical pressure and underestimate BOOI theoretically. Accordingly, the modified BOOI was defined as (PdetQmax+ΔPabd)-2Qmax. Results: Ultimately, 130 patients were eligible for the analysis. In PFS, ΔPabd (PabdQmax-initial Pabd) was 11.81±13.04 cmH2O, and it was 0-9 cmH2O in 75 (57.7{\%}), 10-19 cmH2O in 23 (17.7{\%}) and ≥20 cmH2O in 32 (24.6{\%}) patients. An endoscopically obstructed prostatic urethra in 92 patients was correctly determined in 47 patients (51.1{\%}) by the original BOOI versus 72 patients (78.3{\%}) based on the modified BOOI. Meanwhile, an {"}unobstructed{"} urethra according to the original BOOI was present in 11 patients (12.0{\%}), whereas according to the modified BOOI, only 2 (2.1{\%}) would be labeled as {"}unobstructed{"}. In receiver operating characteristic curves, the area under the curve was 0.906 using the modified BOOI number versus 0.849 in the original BOOI (p<0.05). Conclusions: The change in abdominal pressure was correlated with endoscopically-proven obstruction. Our simple modification of the BOOI on the basis of this finding better predicted bladder outlet obstruction and, therefore, should be considered when evaluating BOO in patients with LUTS/BPH.",
author = "Han, {Jang Hee} and Yu, {Ho Song} and Lee, {Joo Yong} and Joohan Kim and Kang, {Dong Hyuk} and Kwon, {Jong Kyu} and Choi, {Young Deuk} and Cho, {Kang Su}",
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Simple modification of the bladder outlet obstruction index for better prediction of endoscopically-proven prostatic obstruction : A preliminary study. / Han, Jang Hee; Yu, Ho Song; Lee, Joo Yong; Kim, Joohan; Kang, Dong Hyuk; Kwon, Jong Kyu; Choi, Young Deuk; Cho, Kang Su.

In: PloS one, Vol. 10, No. 10, e0141745, 27.10.2015.

Research output: Contribution to journalArticle

TY - JOUR

T1 - Simple modification of the bladder outlet obstruction index for better prediction of endoscopically-proven prostatic obstruction

T2 - A preliminary study

AU - Han, Jang Hee

AU - Yu, Ho Song

AU - Lee, Joo Yong

AU - Kim, Joohan

AU - Kang, Dong Hyuk

AU - Kwon, Jong Kyu

AU - Choi, Young Deuk

AU - Cho, Kang Su

PY - 2015/10/27

Y1 - 2015/10/27

N2 - Purpose: The bladder outlet obstruction index (BOOI), also known as the Abrams-Griffiths (AG) number, is the most widely used index for predicting BOO. However, the obstructed prostatic urethra determined by the BOOI is often inconsistent with endoscopically-proven obstruction. We assessed abdominal straining pattern as a novel parameter for improving the prediction of BOO. Materials and Methods: We retrospectively reviewed the pressure-flow studies (PFS) and cystourethroscopy in 176 BPH/LUTS patients who were unresponsive to medical therapy. During PFS, some groups of patients tried to urinate with abdominal straining, which can increases intravesical pressure and underestimate BOOI theoretically. Accordingly, the modified BOOI was defined as (PdetQmax+ΔPabd)-2Qmax. Results: Ultimately, 130 patients were eligible for the analysis. In PFS, ΔPabd (PabdQmax-initial Pabd) was 11.81±13.04 cmH2O, and it was 0-9 cmH2O in 75 (57.7%), 10-19 cmH2O in 23 (17.7%) and ≥20 cmH2O in 32 (24.6%) patients. An endoscopically obstructed prostatic urethra in 92 patients was correctly determined in 47 patients (51.1%) by the original BOOI versus 72 patients (78.3%) based on the modified BOOI. Meanwhile, an "unobstructed" urethra according to the original BOOI was present in 11 patients (12.0%), whereas according to the modified BOOI, only 2 (2.1%) would be labeled as "unobstructed". In receiver operating characteristic curves, the area under the curve was 0.906 using the modified BOOI number versus 0.849 in the original BOOI (p<0.05). Conclusions: The change in abdominal pressure was correlated with endoscopically-proven obstruction. Our simple modification of the BOOI on the basis of this finding better predicted bladder outlet obstruction and, therefore, should be considered when evaluating BOO in patients with LUTS/BPH.

AB - Purpose: The bladder outlet obstruction index (BOOI), also known as the Abrams-Griffiths (AG) number, is the most widely used index for predicting BOO. However, the obstructed prostatic urethra determined by the BOOI is often inconsistent with endoscopically-proven obstruction. We assessed abdominal straining pattern as a novel parameter for improving the prediction of BOO. Materials and Methods: We retrospectively reviewed the pressure-flow studies (PFS) and cystourethroscopy in 176 BPH/LUTS patients who were unresponsive to medical therapy. During PFS, some groups of patients tried to urinate with abdominal straining, which can increases intravesical pressure and underestimate BOOI theoretically. Accordingly, the modified BOOI was defined as (PdetQmax+ΔPabd)-2Qmax. Results: Ultimately, 130 patients were eligible for the analysis. In PFS, ΔPabd (PabdQmax-initial Pabd) was 11.81±13.04 cmH2O, and it was 0-9 cmH2O in 75 (57.7%), 10-19 cmH2O in 23 (17.7%) and ≥20 cmH2O in 32 (24.6%) patients. An endoscopically obstructed prostatic urethra in 92 patients was correctly determined in 47 patients (51.1%) by the original BOOI versus 72 patients (78.3%) based on the modified BOOI. Meanwhile, an "unobstructed" urethra according to the original BOOI was present in 11 patients (12.0%), whereas according to the modified BOOI, only 2 (2.1%) would be labeled as "unobstructed". In receiver operating characteristic curves, the area under the curve was 0.906 using the modified BOOI number versus 0.849 in the original BOOI (p<0.05). Conclusions: The change in abdominal pressure was correlated with endoscopically-proven obstruction. Our simple modification of the BOOI on the basis of this finding better predicted bladder outlet obstruction and, therefore, should be considered when evaluating BOO in patients with LUTS/BPH.

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