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논문 기본 정보

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대한배뇨장애요실금학회 International Neurourology Journal International Neurourology Journal 제21권
발행연도
2017.1
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55 - 65 (11page)

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Purpose: As the elderly population increases, a growing number of patients have lower urinary tract symptom (LUTS)/benign prostatic hyperplasia (BPH). The aim of this study was to develop decision support formulas and nomograms for the prediction of bladder outlet obstruction (BOO) and for BOO-related surgical decision-making, and to validate them in patients with LUTS/BPH. Methods: Patient with LUTS/BPH between October 2004 and May 2014 were enrolled as a development cohort. The available variables included age, International Prostate Symptom Score, free uroflowmetry, postvoid residual volume, total prostate volume, and the results of a pressure-flow study. A causal Bayesian network analysis was used to identify relevant parameters. Using multivariate logistic regression analysis, formulas were developed to calculate the probabilities of having BOO and requiring prostatic surgery. Patients between June 2014 and December 2015 were prospectively enrolled for internal validation. Receiver operating characteristic curve analysis, calibration plots, and decision curve analysis were performed. Results: A total of 1,179 male patients with LUTS/BPH, with a mean age of 66.1 years, were included as a development cohort. Another 253 patients were enrolled as an internal validation cohort. Using multivariate logistic regression analysis, 2 and 4 formulas were established to estimate the probabilities of having BOO and requiring prostatic surgery, respectively. Our analysis of the predictive accuracy of the model revealed area under the curve values of 0.82 for BOO and 0.87 for prostatic surgery. The sensitivity and specificity were 53.6% and 87.0% for BOO, and 91.6% and 50.0% for prostatic surgery, respectively. The calibration plot indicated that these prediction models showed a good correspondence. In addition, the decision curve analysis showed a high net benefit across the entire spectrum of probability thresholds. Conclusions: We established nomograms for the prediction of BOO and BOO-related prostatic surgery in patients with LUTS/BPH. Internal validation of the nomograms demonstrated that they predicted both having BOO and requiring prostatic surgery very well.
#Prostatic Hyperplasia #Decision Support Systems #Clinical #Nomograms #Urinary Bladder Neck Obstruction #Prostatectomy

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참고문헌 (23)

참고문헌 신청
Abrams P / 2002 / The standardisation of terminology of lower urinary tract function : report from the Standardisation Sub-committee of the International Continence Society / google schola Carlos Arturo Levi D’Ancona / 2012 / Noninvasive Urodynamic Evaluation / International Neurourology Journa google schola Gratzke C / 2015 / EAU guidelines on the assessment of nonneurogenic male lower urinary tract symptoms including benign prostatic obstruction / Eur Urol 67 : 1099 ~ 1109 google schola Gravas S / / Treatment of non-neurogenic male LUTS google schola Greenland JE / 2001 / The effect of bladder outflow obstruction on detrusor blood flow changes during the voiding cycle in conscious pigs / J Urol 165 : 245 ~ 248 google schola

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