L Borrini1, B Lukacs, C Ciofu, B Gaibisso, F Haab, G Amarenco. 1. Service de neuro-urologie et d'explorations pelvi-périnéales, hôpital Tenon, groupe de recherche clinique en neuro-urologie, université Pierre-et-Marie-Curie (GRC-UPMC-01), 4, rue de la Chine, 75970 Paris cedex 20, France. leoborrini@yahoo.fr
Abstract
PURPOSE: To assess the diagnostic performances and the acceptability of the penile cuff test (PCT) which is a non invasive method for the evaluation of bladder outlet obstruction (BOO), in comparison with the pressure flow study (PFS), the actual gold-standard. MATERIAL: Monocentric prospective study comparing the following subsets: "obstructed", "not obstructed" or "equivocal", deduced from PFS vs PCT, in 30 consecutive patients presenting with lower urinary tract symptoms. For the PCT, a cuff placed around the penis inflated automatically during the micturition, until flow rate interruption. The interruption cuff pressure revealed the isovolumetric bladder pressure (Pcuff-int). The data collected - Pcuff-int and maximum flow rate - were automatically reported on ICS modified nomogram. RESULTS: With the PFS, 11 patients (39%) were classified "obstructed", six patients (22%) "non-obstructed" and 11 patients (39%) "equivocal". In 61% cases, the patient was classified in the same category by both techniques. The "obstructed positive predictive value" of the PCT was 82% and the "non-obstructed-equivocal negative predictive value" was 88%. The median acceptability visual analogic scale score was 1/10 (0-3) for the PCT whereas it was 5/10 (2-10) for the PFS. This difference was statistically significant (p=0.004). CONCLUSION: The PCT was a reliable non-invasive tool for the diagnosis of BOO in male, in comparison with PFS. The predictive values of the PCT were relevant and its tolerance was better than PFS.
PURPOSE: To assess the diagnostic performances and the acceptability of the penile cuff test (PCT) which is a non invasive method for the evaluation of bladder outlet obstruction (BOO), in comparison with the pressure flow study (PFS), the actual gold-standard. MATERIAL: Monocentric prospective study comparing the following subsets: "obstructed", "not obstructed" or "equivocal", deduced from PFS vs PCT, in 30 consecutive patients presenting with lower urinary tract symptoms. For the PCT, a cuff placed around the penis inflated automatically during the micturition, until flow rate interruption. The interruption cuff pressure revealed the isovolumetric bladder pressure (Pcuff-int). The data collected - Pcuff-int and maximum flow rate - were automatically reported on ICS modified nomogram. RESULTS: With the PFS, 11 patients (39%) were classified "obstructed", six patients (22%) "non-obstructed" and 11 patients (39%) "equivocal". In 61% cases, the patient was classified in the same category by both techniques. The "obstructed positive predictive value" of the PCT was 82% and the "non-obstructed-equivocal negative predictive value" was 88%. The median acceptability visual analogic scale score was 1/10 (0-3) for the PCT whereas it was 5/10 (2-10) for the PFS. This difference was statistically significant (p=0.004). CONCLUSION: The PCT was a reliable non-invasive tool for the diagnosis of BOO in male, in comparison with PFS. The predictive values of the PCT were relevant and its tolerance was better than PFS.