title: Application of the Blaivas-Groutz bladder outlet obstruction nomogram in women with urinary incontinence.
abstract: OBJECTIVE
  To test the applicability of the Blaivas-Groutz nomogram for female bladder outlet obstruction in urinary incontinent women presenting in a general gynecologic practice and to determine how the nomogram results related to the presence of obstructive symptoms according to a standardized questionnaire.
  
  
  METHODS
  All women with complaints of urinary incontinence underwent multichannel urodynamic testing, free uroflowmetry and were asked to complete a standardized quality of life questionnaire consisting of the urogenital distress inventory (UDI). The patients were classified according to the Blaivas-Groutz nomogram.
  
  
  RESULTS
  One hundred and nine patients were classified according to the nomogram. Thirty-three patients (30.3%) were classified as unobstructed, 63 patients (57.8%) as mildly, 12 patients (11%) as moderately, and 1 patient (0.9%) was classified as severely obstructed. Fifty patients correctly completed the UDI. There was no significant difference (P = 0.61) in the score on the domain UDI obstruction between, according to the nomogram, obstructed and unobstructed patients. Only 18% of the obstructed patients had isolated voiding symptoms suggestive of obstruction. Forty-nine percent of the obstructed patients had urgency-frequency symptoms as well as voiding symptoms suggestive of obstruction. There was no correlation (Pearson, r = -0.06, P = 0.61) between the severity of the symptoms (assessed by the UDI scale) and the degree of obstruction (the four nomogram zones).
  
  
  CONCLUSIONS
  Application of the Blaivas-Groutz nomogram gave an unlikely high prevalence of obstruction in our patient group, which showed no correlation with symptoms when measured with the UDI.
authors.affiliation: Department of Obstetrics and Gynecology, Erasmus Medical Center, Rotterdam, The Netherlands. Elskemassolt@hotmail.com
authors.forename: Elske T
authors.initials: ET
authors.lastname: Massolt
authors.forename: Jan
authors.initials: J
authors.lastname: Groen
authors.forename: Mark E
authors.initials: ME
authors.lastname: Vierhout
mesh_terms: D005260:Female; D006801:Humans; D049451:Nomograms; D011237:Predictive Value of Tests; D015995:Prevalence; D012680:Sensitivity and Specificity; D012720:Severity of Illness Index; D011795:Surveys and Questionnaires; D001748:Urinary Bladder Neck Obstruction / Q000175:diagnosis* / Q000453:epidemiology / Q000503:physiopathology; D014549:Urinary Incontinence / Q000175:diagnosis* / Q000453:epidemiology / Q000503:physiopathology; D014563:Urodynamics