Vol. 6, Issue 1, Part A (2024)

Introduction: Detrusor underactivity (DUA) and Bladder Outflow Obstruction (BOO) are prevalent conditions that present as lower urinary tract symptoms (LUTS) in elderly men but they are discriminated only by the pressure-flow component of a urodynamic examination (UDE) which has its own complications. The objective of this study was to evaluate DeltaQ (Q_max-Q_avg) which is conveniently obtained from uroflowmetry, in differentiating DUA from BOO in men presenting with LUTS.

Materials and Methods: A prospective study was conducted after ethical clearance and 80 men over 50 years of age undergoing evaluation of LUTS on out-patient or in-patient basis in Department of Urology at Chengalpattu Medical College & Hospital and satisfying inclusion and exclusion criteria were enrolled in the study. Every enrolled patient filled IPSS Questionnaire (with/without assistance), got Serum Prostate Specific Antigen (PSA), Urine Routine Examination and Urine Culture and Sensitivity done, underwent Ultrasonography (USG) for assessment of Prostate size and post void residual urine (PVR) followed by a Uroflowmetry (UFM). Finally, patients underwent a Urodynamic Examination (UDE) as per International Continence Society (ICS) standards.

Results: Amongst the 80 patients, 56 had BOO and 24 had DUA as per UDE criteria. DeltaQ was observed to be higher in the BOO group (9.02±3.64 mL/s) as compared to DUA group (5.63±2.76 mL/s) and this was significant (p <0.001). Area under curve (AUC) in ROC for ability to diagnose DUA for DeltaQ was 0.82.

Conclusion: DeltaQ can be used to differentiate DUA from BOO in men presenting with LUTS. Since DeltaQ can be obtained from uroflowmetry, it is a useful, simple and cost-effective parameter for diagnosing DUA in men with LUTS.