Login to Access Video or Poster Abstract: MP13-05
Sources of Funding: none

Introduction

Initial management of LUTS in elderly male may be pragmatic with lifestyle management and medication. This is frequently successful however when the patients are still symptomatic and or worried about the safety of this initial treatment it might be useful to be able to estimate the likelihood of serious bladder outflow obstruction (BOO). With the hypothesis that patients with higher grade of outflow obstruction are more likely to fail conservative (& pharmaco-therapeutic) management we tested whether clinical of symptom parameters were suitable to predict moderate and high grade BOO (hgBOO) in the elderly male patients.

Methods

452 elderly male patients referred with LUTS had IPSS, flowmetry (Q_max) and transrectal ultrasound prostate volume measurement (TRUS). Mean age (sd) was 64.8y (11.2) Q_max 11.8mL/s (6.6) and TRUS 41.7cm³(23.9). All patients underwent standard cystometry and pressure flow analysis. A cut off URA value of 40cmH₂O was taken for hgBOO (similar=: linPURR>3)

Results

ROC curve showed that TRUS and Q_max were better than IPSS to diagnose hgBOO and the combination of these to into CLIPS (TRUS-3*Q_max) further increased the diagnostic power, with ROC area .76.(Note that Q_max projects negative because a higher value is 'better')

Conclusions

CLInical Prostate Score= (prostate volume - 3*Q_max) is a far better predictor of high grade BOO than totalIPSS-score.

Funding

none