Predictive value of the penile cuff-test for the assessment of bladder outlet obstruction in men

• Published in: Progrès en urologie (Paris) Vol. 22; no. 11; p. 657
• Main Authors: Borrini, L, Lukacs, B, Ciofu, C, Gaibisso, B, Haab, F, Amarenco, G
• Format: Journal Article
• Language: French
• Published: France 01-10-2012
• Subjects: Adult; Aged; Aged, 80 and over; Diagnostic Techniques, Urological; Humans; Male; Middle Aged; Predictive Value of Tests; Prospective Studies; Urinary Bladder Neck Obstruction - diagnosis; Urination; Urodynamics; Young Adult
• ISSN: 1166-7087
• DOI: 10.1016/j.purol.2012.07.017

To assess the diagnostic performances and the acceptability of the penile cuff test (PCT) which is a non invasive method for the evaluation of bladder outlet obstruction (BOO), in comparison with the pressure flow study (PFS), the actual gold-standard.
Monocentric prospective study comparing the following subsets: "obstructed", "not obstructed" or "equivocal", deduced from PFS vs PCT, in 30 consecutive patients presenting with lower urinary tract symptoms. For the PCT, a cuff placed around the penis inflated automatically during the micturition, until flow rate interruption. The interruption cuff pressure revealed the isovolumetric bladder pressure (Pcuff-int). The data collected - Pcuff-int and maximum flow rate - were automatically reported on ICS modified nomogram.
With the PFS, 11 patients (39%) were classified "obstructed", six patients (22%) "non-obstructed" and 11 patients (39%) "equivocal". In 61% cases, the patient was classified in the same category by both techniques. The "obstructed positive predictive value" of the PCT was 82% and the "non-obstructed-equivocal negative predictive value" was 88%. The median acceptability visual analogic scale score was 1/10 (0-3) for the PCT whereas it was 5/10 (2-10) for the PFS. This difference was statistically significant (p=0.004).
The PCT was a reliable non-invasive tool for the diagnosis of BOO in male, in comparison with PFS. The predictive values of the PCT were relevant and its tolerance was better than PFS.