Near-infrared spectroscopy of the urinary bladder during voiding in men with lower urinary tract symptoms: a preliminary study.
OBJECTIVE
To determine the difference in response of NIRS of the bladder during voiding between men with and without BOO.LUTS.


METHODS
A prospective, case series, study included 36 men with LUTS. Patients completed the IPSS questionnaire; prostate volumes were measured sonographically. Patients underwent pressure flow study (PFS) with simultaneous NIRS of the bladder. Amplitudes of HHb, O2Hb, and Hbsum were calculated at Qmax, relative to baseline. Patients were urodynamically classified as obstructed and unobstructed. Recursive partition analysis (RPA) was performed to reclassify patients using NIRS amplitudes, followed by combined data of NIRS amplitudes, prostate volume, IPSS, and Qmax to determine the best predictor(s) of BOO.


RESULTS
PFS classified 28 patients as obstructed and 8 as unobstructed. The median HHb amplitude was significantly higher in obstructed group. RPA of NIRS amplitudes correctly reclassified 89% of patients [AUC: 0.91]. RPA of the combined IPSS, prostate volume, PVR, and Qmax correctly reclassified 72% of patients [AUC: 0.84]. When NIRS amplitudes were added to this combination, RPA revealed a significantly (P < 0.01) higher rate of correct reclassification in 89% of patients with 89.3% sensitivity and 88% specificity for obstruction [AUC: 0.96].


CONCLUSIONS
NIRS data can be of diagnostic value for BOO in men with LUTS.
Department of Urology, Radboud University Nijmegen Medical Centre, Nijmegen, The Netherlands. f.farag@uro.umcn.nl
Fawzy F
FF
Farag
Joseph
J
Meletiadis
Mohamad D
MD
Saleem
Wout F
WF
Feitz
John P
JP
Heesakkers
D000368:Aged; D000369:Aged, 80 and over; D006801:Humans; D059411:Lower Urinary Tract Symptoms / Q000175:diagnosis* / Q000473:pathology; D008297:Male; D008875:Middle Aged; D011467:Prostate / Q000000981:diagnostic imaging; D019265:Spectroscopy, Near-Infrared; D014463:Ultrasonography; D001743:Urinary Bladder / Q000473:pathology; D001748:Urinary Bladder Neck Obstruction / Q000175:diagnosis* / Q000473:pathology; D014563:Urodynamics / Q000502:physiology