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Controlled Clinical Trial
. 2022 Nov:169:162-166.
doi: 10.1016/j.urology.2022.05.058. Epub 2022 Aug 12.

Voiding Time for the Evaluation of Lower Urinary Tract Symptoms in Men - A Potential Option for Addressing Disparity Related Access to Urodynamic Testing

Affiliations
Controlled Clinical Trial

Voiding Time for the Evaluation of Lower Urinary Tract Symptoms in Men - A Potential Option for Addressing Disparity Related Access to Urodynamic Testing

Gaurav Pahouja et al. Urology. 2022 Nov.

Abstract

Objective: To investigate voiding time (VT) in asymptomatic and symptomatic men, and compare VT to other parameters such as maximum flow rates (Qmax) as a possible solution to disparity related lack of access to standard urodynamic testing.

Methods: We conducted a controlled prospective study on a total of 30 patients. Exclusion criteria included ongoing medical therapy for lower urinary tract symptoms (LUTS) or a history of invasive therapy for LUTS. Patients completed International Prostate Symptom Score (IPSS) questionnaire, uroflowmetry, and post-void residual (PVR) testing. Symptomatic LUTS was defined as an IPSS ≥8.

Results: On univariate analysis, men with a symptomatic LUTS had a significantly longer VT than asymptomatic men (30.6 seconds (Interquartile rage [IQR] 24.2-42.4) vs 20.5 seconds (IQR 16.6-40.5), P = .04). VT was not otherwise associated with age, race, or primary complaint. There was trend towards lower Qmax in symptomatic patients (13.4 vs 20.5 seconds, P = .07), although this was not statistically significant. Our study demonstrated that the sensitivity of a VT ≥23.5 seconds, or probability of observing a VT exceeding 23.5 seconds when the patient has a symptomatic IPSS, is 85%. On sensitivity and specificity analysis, there was no difference between the abilities of VT and Qmax to predict that a patient would have symptomatic LUTS (P = .80).

Conclusion: In this controlled prospective study, we found that VT was as accurate as Qmax in predicting symptomatic IPSS scores. This novel finding might improve the ability to diagnose and treat LUTS, especially in primary care offices and underserved areas.

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Comment in

  • EDITORIAL COMMENT.
    Daneshgari F. Daneshgari F. Urology. 2022 Nov;169:166. doi: 10.1016/j.urology.2022.05.059. Urology. 2022. PMID: 36371096 No abstract available.
  • Benign Prostatic Hyperplasia.
    Kaplan SA. Kaplan SA. J Urol. 2023 Mar;209(3):611-614. doi: 10.1097/JU.0000000000003095. Epub 2022 Dec 8. J Urol. 2023. PMID: 36475931 No abstract available.

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