Abstract: PD34-09
Sources of Funding: None

Introduction

Limited data supports the use of uroflowmetry parameters (Qmax:max flow; Qave: average flow; VV: voided volume) to assess for urethral patency and rule out stricture recurrence in post-urethroplasty surveillance._x000D_

Methods

From years 2012-2015, data were collected on 125 patients who underwent anterior and posterior urethroplasties and had follow-up at 3 and 12 months with cystoscopy, International Prostate Symptom Score (I-PSS) and uroflowmetry parameters. The ability to pass a 17 French flexible cystoscope was defined as a successful repair. Analyzing the receiver operating characteristics we calculated the area under the curve (AUC) to compare uroflowmetry parameters and I-PSS against cystoscopy.

Results

There were 208 encounter visits within the first 12 months, of which there were 164 cystoscopy procedures. Success was determined in 147/164 (90%). Uroflowmetry parameters were provided in 105 patients and 103 subjects were not able to void or had a VV < 100 mL. I-PSS data was available for 136 patients. Qmax of ≥10 ml/sec has a high positive predictive (92%) value and our study confirmed a significant AUC of 0.75 (p=0.002). However, the NPV is limited and cystoscopy showed that half of these subjects with a low flow (<10 ml/sec) won't have a stricture. The AUC for Qmax ≥15 mL was 0.705 (p = 0.002) with a sensitivity of 92% and specificity of 34%. When comparing (Qmax-Qave) > 8 to cystoscopy, the AUC was 0.691 (p = 0.018) with a 93% sensitivity and 29% specificity. When assessing the AUC of I-PSS Weakness score of <3, the AUC was found to not be significant. No significance was found when completing a univariate analysis of I-PSS total score and quality of life score to cystoscopy.

Conclusions

Uroflowmetry parameters of Qmax >10 mL, Qmax >15 mL, Qmax-Qave > 8 mL are not specific enough to determine recurrences of urethral stricture. The I-PSS total score, weakness score or QOL are neither sensitive nor specific enough to detect recurrences._x000D_

Funding

None