Researchers compared a diagnostic method called penile cuff test (PCT) to the conventional pressure-flow study (PFS) to detect obstructions in patients with lower urinary tract symptoms (LUTS) to find PCT is the more powerful of the two. The study, published in the Korean Journal of Urology, is titled “The role of noninvasive penile cuff test in patients with bladder outlet obstruction.”
An average of 50% to 60% of elderly men suffer from LUTS commonly caused by bladder outlet obstruction (BOO), a blockage at the base of the bladder that renders evacuation of urine difficult. BOO is induced by an enlarged prostate that could be corrected by surgery if proper and accurate diagnosis is performed. Several diagnostic methods exist for LUTS, and pressure-flow study is considered the gold standard technique for BOO detection.
Researchers compared PCT with PFS to evaluate patients with BOO. Fifty one male patients suffering with LUTS of various disease severities were selected from a total of 58 participants. The patients were subjected to both diagnostic methods, PCT and PFS, and the results were compared. PCT strength is measured in terms of sensitivity (SE), specificity (SP), positive predictive value (PPV), and negative predictive value (NPV).
PCT identified 24 patients as being obstructed and 27 patients as unobstructed. The follow-up with the standard PFS technique confirmed obstructions in 16 of the 24 patients detected by PCT, found 4 unobstructed, and the other 4 were equivocal. Of the 27 patients shown by PCT not to be obstructed, 12 were confirmed, 13 were equivocal, and 2 patients were found obstructed.
“The PCT is a beneficial instrument for assessing patients with LUTS and in comparison with other noninvasive methods and PFS has a higher diagnostic power. Another advantage of the PCT in addition to the economical benefits and decreased complications resulting from surgery is that patient satisfaction will be met with a high rate of correctly classified patients overall. Also, this instrument has acceptable reliability in ruling out obstruction caused by benign prostatic hyperplasia,” the authors wrote in their study. In the future, the team suggest that large-scale studies be conduct to clarify the mechanism and understand if PCT should be considered as an alternative method to conventional PFS.