Christopher A Tam1, Bryan B Voelzke2, Sean P Elliott3, Jeremy B Myers4, Christopher D McClung5, Alex J Vanni6, Benjamin N Breyer7, Bradley A Erickson8. 1. Department of Urology, University of Iowa, Iowa City, IA. 2. Deparment of Urology, University of Washington, Seattle, WA. 3. Department of Urology, University of Minnesota, Minneapolis, MN. 4. Division of Urology, University of Utah, Salt Lake City, UT. 5. Department of Urology, Ohio State University, Columbus, OH. 6. Institute of Urology, Lahey Hospital and Medical Center, Burlington, MA. 7. Department of Urology, University of California, San Francisco, San Francisco, CA. 8. Department of Urology, University of Iowa, Iowa City, IA. Electronic address: brad-erickson@uiowa.edu.
Abstract
OBJECTIVE: To critically evaluate the use of uroflowmetry (UF) in a large urethral stricture disease cohort as a means to monitor for stricture recurrence. MATERIALS AND METHODS: This study included men that underwent anterior urethroplasty and completed a study-specific follow-up protocol. Pre- and postoperative UF studies of men found to have cystoscopic recurrence were compared to UF studies from successful repairs. UF components of interest included maximum flow rate (Qm), average flow rate (Qa), and voided volume, in addition to the novel post-UF calculated value of Qm minus Qa (Qm-Qa). Area under the receiver operating characteristic curves (AUC) of individual UF parameters was compared. RESULTS: Qm-Qa had the highest AUC (0.8295) followed by Qm (0.8241). UF performed significantly better in men ≤40 with an AUC of 0.9324 and 0.9224 for Qm-Qa and Qm respectively, as compared to 0.7484 and 0.7661 in men >40. Importantly, of men found to have anatomic recurrences, only 41% had a Qm of ≤15 mL/s at time of diagnostic cystoscopy, whereas over 83% were found to have a Qm-Qa of ≤10 mL/s. CONCLUSION: Qm rate alone may not be sensitive enough to replace cystoscopy when screening for stricture recurrence in all patients, especially in younger men where baseline flow rates are higher. Qm-Qa is a novel calculated UF measure that appears to be more sensitive than Qm when using UF to screen for recurrence, as it may be a better numerical representation of the shape of the voiding curve. Published by Elsevier Inc.
OBJECTIVE: To critically evaluate the use of uroflowmetry (UF) in a large urethral stricture disease cohort as a means to monitor for stricture recurrence. MATERIALS AND METHODS: This study included men that underwent anterior urethroplasty and completed a study-specific follow-up protocol. Pre- and postoperative UF studies of men found to have cystoscopic recurrence were compared to UF studies from successful repairs. UF components of interest included maximum flow rate (Qm), average flow rate (Qa), and voided volume, in addition to the novel post-UF calculated value of Qm minus Qa (Qm-Qa). Area under the receiver operating characteristic curves (AUC) of individual UF parameters was compared. RESULTS:Qm-Qa had the highest AUC (0.8295) followed by Qm (0.8241). UF performed significantly better in men ≤40 with an AUC of 0.9324 and 0.9224 for Qm-Qa and Qm respectively, as compared to 0.7484 and 0.7661 in men >40. Importantly, of men found to have anatomic recurrences, only 41% had a Qm of ≤15 mL/s at time of diagnostic cystoscopy, whereas over 83% were found to have a Qm-Qa of ≤10 mL/s. CONCLUSION: Qm rate alone may not be sensitive enough to replace cystoscopy when screening for stricture recurrence in all patients, especially in younger men where baseline flow rates are higher. Qm-Qa is a novel calculated UF measure that appears to be more sensitive than Qm when using UF to screen for recurrence, as it may be a better numerical representation of the shape of the voiding curve. Published by Elsevier Inc.
Authors: M J Barry; C J Girman; M P O'Leary; E S Walker-Corkery; B S Binkowitz; A T Cockett; H A Guess Journal: J Urol Date: 1995-01 Impact factor: 7.450
Authors: Christopher A Tam; Sean P Elliott; Bryan B Voelzke; Jeremy B Myers; Alex J Vanni; Benjamin N Breyer; Thomas G Smith; Christopher D McClung; Bradley A Erickson Journal: Urology Date: 2016-04-21 Impact factor: 2.649
Authors: Nima Baradaran; Kirkpatrick B Fergus; Rachel A Moses; Darshan P Patel; Thomas W Gaither; Bryan B Voelzke; Thomas G Smith; Bradley A Erickson; Sean P Elliott; Nejd F Alsikafi; Alex J Vanni; Jill Buckley; Lee C Zhao; Jeremy B Myers; Benjamin N Breyer Journal: World J Urol Date: 2019-02-02 Impact factor: 4.226
Authors: Nima Baradaran; Lindsay A Hampson; Todd C Edwards; Bryan B Voelzke; Benjamin N Breyer Journal: Curr Urol Rep Date: 2018-05-17 Impact factor: 3.092
Authors: Freek P W de Rooij; Femke R M Peters; Brechje L Ronkes; Wouter B van der Sluis; Muhammed Al-Tamimi; R Jeroen A van Moorselaar; Mark-Bram Bouman; Garry L S Pigot Journal: BJU Int Date: 2021-06-17 Impact factor: 5.969