Critical Analysis of the Use of Uroflowmetry for Urethral Stricture Disease Surveillance

Christopher A Tam; Bryan B Voelzke; Sean P Elliott; Jeremy B Myers; Christopher D McClung; Alex J Vanni; Benjamin N Breyer; Bradley A Erickson

doi:10.1016/j.urology.2015.12.070

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Critical Analysis of the Use of Uroflowmetry for Urethral Stricture Disease Surveillance

Journal article

Open access

Peer reviewed

Critical Analysis of the Use of Uroflowmetry for Urethral Stricture Disease Surveillance

Christopher A Tam, Bryan B Voelzke, Sean P Elliott, Jeremy B Myers, Christopher D McClung, Alex J Vanni, Benjamin N Breyer and Bradley A Erickson

Urology (Ridgewood, N.J.), Vol.91, pp.197-202

05/2016

DOI: 10.1016/j.urology.2015.12.070

PMCID: PMC4896139

PMID: 26873640

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Abstract

To critically evaluate the use of uroflowmetry (UF) in a large urethral stricture disease cohort as a means to monitor for stricture recurrence. This study included men that underwent anterior urethroplasty and completed a study-specific follow-up protocol. Pre- and postoperative UF studies of men found to have cystoscopic recurrence were compared to UF studies from successful repairs. UF components of interest included maximum flow rate (Qm), average flow rate (Qa), and voided volume, in addition to the novel post-UF calculated value of Qm minus Qa (Qm-Qa). Area under the receiver operating characteristic curves (AUC) of individual UF parameters was compared. Qm-Qa had the highest AUC (0.8295) followed by Qm (0.8241). UF performed significantly better in men ≤40 with an AUC of 0.9324 and 0.9224 for Qm-Qa and Qm respectively, as compared to 0.7484 and 0.7661 in men >40. Importantly, of men found to have anatomic recurrences, only 41% had a Qm of ≤15 mL/s at time of diagnostic cystoscopy, whereas over 83% were found to have a Qm-Qa of ≤10 mL/s. Qm rate alone may not be sensitive enough to replace cystoscopy when screening for stricture recurrence in all patients, especially in younger men where baseline flow rates are higher. Qm-Qa is a novel calculated UF measure that appears to be more sensitive than Qm when using UF to screen for recurrence, as it may be a better numerical representation of the shape of the voiding curve.

Urodynamics

Recurrence

Prospective Studies

Urethral Stricture - diagnosis

Rheology

Humans

Sensitivity and Specificity

Cystoscopy

Urethral Stricture - physiopathology

Adult

Male

Population Surveillance

Details

Title: Subtitle: Critical Analysis of the Use of Uroflowmetry for Urethral Stricture Disease Surveillance
Creators: Christopher A Tam - Department of Urology, University of Iowa, Iowa City, IA
Bryan B Voelzke - Deparment of Urology, University of Washington, Seattle, WA
Sean P Elliott - Department of Urology, University of Minnesota, Minneapolis, MN
Jeremy B Myers - Division of Urology, University of Utah, Salt Lake City, UT
Christopher D McClung - Department of Urology, Ohio State University, Columbus, OH
Alex J Vanni - Institute of Urology, Lahey Hospital and Medical Center, Burlington, MA
Benjamin N Breyer - Department of Urology, University of California, San Francisco, San Francisco, CA
Bradley A Erickson - Department of Urology, University of Iowa, Iowa City, IA. Electronic address: brad-erickson@uiowa.edu
Resource Type: Journal article
Publication Details: Urology (Ridgewood, N.J.), Vol.91, pp.197-202
DOI: 10.1016/j.urology.2015.12.070
PMID: 26873640
PMCID: PMC4896139
NLM abbreviation: Urology
ISSN: 0090-4295
eISSN: 1527-9995
Publisher: United States
Grant note: T35 HL007485 / NHLBI NIH HHS K12 DK083021 / NIDDK NIH HHS
Language: English
Date published: 05/2016
Academic Unit: Urology
Record Identifier: 9984051586902771

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