We compared the utility of the penile cuff test (PCT) and the conventional urodynamic study (UDS) for the preoperative assessment of patients undergoing scheduled photoselective vaporization of the prostate (PVP) for benign prostate hyperplasia (BPH).
Fifty-nine patients with voiding lower urinary tract symptoms (LUTS) underwent a simultaneous PCT and conventional UDS before PVP. The modified International Continence Society (ICS) nomogram was used to confirm bladder outlet obstruction after measuring maximum urinary flow rate and highest pressure at flow interruption. The PCT and UDS results, in terms of modified ICS nomogram predictions, were compared. Their sensitivities, specificities, and positive and negative predictive values were calculated.
Thirty-six patients were diagnosed as obstructed and 23 as non-obstructed/equivocal using the modified ICS nomogram during the PCT. All 36 of the first group were confirmed as obstructed by UDS. Of the 23 diagnosed as non-obstructed/equivocal by the PCT, 14 were confirmed to be non-obstructed by UDS, with nine diagnosed as obstructed. The PCT showed a sensitivity of 80% and a specificity of 100%. The positive and negative predictive values were 100% and 60.9%, respectively.
In conclusion, despite our small number of patients, the PCT's high sensitivity and specificity suggest that it may provide diagnostic information about bladder outlet obstruction before PVP for patients with voiding LUTS. Evidently, the PCT has the potential to be used for some patients as a screening alternative to invasive UDS.
Journal of clinical medicine. 2020 Apr 21*** epublish ***
Kang Sup Kim, Yong Sun Choi, Woong Jin Bae, Hyuk Jin Cho, Ji Youl Lee, Sung-Hoo Hong, Sae Woong Kim
Department of Urology, Incheon St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Incheon 2143, Korea., Department of Urology, Eunpyeong St. Mary's Hospital, College of Medicine, The Catholic University of Korea 1021, Tongil-ro, Eunpyeong-gu, 03312, Seoul, Korea., Department of Urology, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul 137-701, Korea.