Prediction of Bladder Prostatic Obstruction: Development of a Simplified Clinical Nomogram

In a study conducted between 1996-2000 involving 300 men with lower urinary tract symptoms (LUTS) and benign prostatic enlargement (BPE), researchers developed a simplified clinical nomogram to predict benign prostatic obstruction (BPO) without the need for invasive urodynamic studies. The base model, which included the International Prostate Symptom Score (IPSS), maximal urinary flow rate (Qmax), and post-void residual urine (PVR), found that only Qmax was a statistically significant predictor of BPO with a predictive accuracy (PA) of 82%. The addition of transitional volume (TV) to Qmax in a multivariable model slightly increased the PA to 83.2%. Clinical parameters such as prostate-specific antigen (PSA) and bladder wall thickness (BWT) were not significant predictors and did not improve PA. The study concluded that a nomogram based on Qmax and TV could be a non-invasive tool for determining surgical treatment decisions in patients with bladder outlet obstruction (BOO) related to LUTS/BPE, but external validation of the findings is necessary.