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Development and validation of a clinical nomogram predicting bladder outlet obstruction via routine clinical parameters in men with refractory nonneurogenic lower urinary tract symptoms

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Asian Journal of Andrology 2019年第5期21卷 486-492页

作者： Young Ju Lee Jung Keun Lee Jung Jun Kim Hak Min Lee Jong Jin Oh Sangchul Lee Sang Wook Lee Jeong Hyun Kim Seong Jin Jeong Department of Urology Seoul National University Bundang HospitalSeongnam 13620Korea Department of Urology Kangwon National University School of MedicineChuncheon 24341Korea

We aimed to develop and validate a clinical nomogram predicting bladder outlet obstruction(BOO)solely using routine clinical parameters in men with refractory nonneurogenic lower urinary tract symptoms(LUTS).A total of 750 eligible patient ≥50 years of age who had previously not responded(International Prostate Symptom Score[IPSS]improvementmogram development(n=570)and for split-sample validation(n=180).BOO was defined as Abrams-Griffiths number^40,or 20-39.9 with a slope of linear passive urethral resistance ratio>2 cmH20 ml^-1 s^-1.A stepwise multivariable logistic regression analysis was conducted to determine the predictors of BOO,and^-coefficients of the final model were selected to create a clinical nomogram.The final multivariable logistic regression model showed that age,IPSS,maximum urinary flow rate,postvoid residual volume,total prostate volume,and transitional zone index were significant for predicting BOO;these candidates were used to develop the final nomogram.The discrimination performance of the nomogram was 88.3%(95%Cl:82.7%-93.0%,Pmogram was reasonably we 11-fitted to the ideal line of the calibration plot.Independe nt split-sample validation revealed 80.9%(95%Cl:75.5%-84.4%,Pmogram based solely on routine clinical parameters was accurate and validated properly.This nomogram may be useful in determining further treatment,primarily focused on prostatic surgery for BOO,without impeding the detection of possible BOO in men with LUTS that is refractory to empirical medications.

关键词： benign prostatic hyperplasia bladder outlet obstruction lower urinary tract symptoms no mogram urodynamics

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