The role of noninvasive penile cuff test in patients with bladder outlet obstruction.
OBJECTIVE
The aim of this study was to compare the penile cuff test (PCT) and standard pressure-flow study (PFS) in patients with bladder outlet obstruction.


METHODS
A total of 58 male patients with moderate to severe lower urinary tract symptoms (LUTS) were selected. Seven patients were excluded; thus, 51 patients were finally enrolled. Each of the patients underwent a PCT and a subsequent PFS. The sensitivity (SE), specificity (SP), positive predictive value (PPV), negative predictive value (NPV), and likelihood ratio were calculated. Chi-square and Fisher exact test were used to evaluate relationships between PCT results and maximal urine flow (Qmax); a p<0.05 was considered statistically significant.


RESULTS
The mean (±standard deviation) age of the study group was 65.5±10.4 years. Overall, by use of the PCT, 24 patients were diagnosed as being obstructed and 27 patients as unobstructed. At the subsequent PFS, 16 of the 24 patients diagnosed as obstructed by the PCT were confirmed to be obstructed, 4 were diagnosed as unobstructed, and the remaining 4 patients appeared equivocal. Of the 27 patients shown to be unobstructed by the PCT, 25 were confirmed to not be obstructed by PFS, with 13 equivocal and 12 unobstructed. Two patients were diagnosed as being obstructed. For detecting obstruction, the PCT showed an SE of 88.9% and an SP of 75.7%. The PPV was 66.7% and the NPV was 93%.


CONCLUSIONS
The PCT is a beneficial test for evaluating patients with LUTS. In particular, this instrument has an acceptable ability to reject obstruction caused by benign prostatic hyperplasia.
Department of Urology, Tehran University of Medical Science, Tehran, Iran.
Seyed Mohamad
SM
Kazemeyni
Department of Urology, Tehran University of Medical Science, Tehran, Iran.
Ehsan
E
Otroj
Department of Urology, Tehran University of Medical Science, Tehran, Iran.
Darab
D
Mehraban
Department of Urology, Tehran University of Medical Science, Tehran, Iran.
Gholam Hossein
GH
Naderi
Department of Urology, Tehran University of Medical Science, Tehran, Iran.
Afsoon
A
Ghadiri
Research Center for Improvement of Surgical Outcomes and Procedures, Shariati Hospital, Tehran University of Medical Sciences, Tehran, Iran.
Mahdi
M
Jafari
D000368:Aged; D000369:Aged, 80 and over; D006801:Humans; D008297:Male; D008875:Middle Aged; D049451:Nomograms; D010413:Penis / Q000503:physiopathology; D011237:Predictive Value of Tests; D011312:Pressure; D012680:Sensitivity and Specificity; D001748:Urinary Bladder Neck Obstruction / Q000175:diagnosis* / Q000503:physiopathology; D014554:Urination / Q000502:physiology; D014563:Urodynamics
Lower urinary tract symptoms; Nomograms; Penis; Urinary bladder neck obstruction; Urodynamics