New Model Does Good Job of Identifying Those Who Need Enlarged-prostate Surgery

New Model Does Good Job of Identifying Those Who Need Enlarged-prostate Surgery

A model that South Korean scientists developed to predict a bladder-drainage obstruction and the need for surgery in men with an enlarged prostate did a good job of identifying those who needed surgery, a study indicates.

The team based the model on information from more than 1,000 benign prostatic hyperplasia (BPH) patients. They developed it into a smartphone app, making it easy to use in a doctor’s office.

Two articles in the International Neurourology Journal described how the researchers from Hallym University Dongtan Sacred Heart Hospital and Seoul National University Hospital developed and tested the model.

One study covered the team gathering data for the model from 1,179 men with lower urinary tract symptoms caused by BPH. It was titled “Development of Decision Support Formulas for the Prediction of Bladder Outlet Obstruction and Prostatic Surgery in Patients With Lower Urinary Tract Symptom/Benign Prostatic Hyperplasia: Part I, Development of the Formula and its Internal Validation.”

The team used the data to find factors correlated with bladder obstruction and need for surgery. Measures they linked to bladder obstruction included prostate size, urine flow rate, and volume of urine left in the bladder after urination. The team linked prostate size and severity of bladder-drainage obstruction to surgery.

Researchers validated the model with 253 other patients. They learned that the model could indeed predict a bladder-drainage obstruction and need for surgery.

The model had a positive predictive value of 76.6 percent for bladder obstruction and 81.6 percent for need for surgery. A positive predictive value indicates the probability that a condition is present when a test signals that it is.

In an additional validation, the team tested the model on 642 patients in a real-world setting: two clinics. That study was titled “Development of Decision Support Formulas for the Prediction of Bladder Outlet Obstruction and Prostatic Surgery in Patients With Lower Urinary Tract Symptom/Benign Prostatic Hyperplasia: Part II, External Validation and Usability Testing of a Smartphone App.”

Again the model predicted both bladder-drainage obstruction and need for surgery. The researchers labeled the model’s performance “excellent.”

The team then recruited eight young urologists to test whether the smartphone application was user-friendly — and found that it was. Importantly, none of the urologists made errors when using the app, indicating it was safe to use as a decision-making aid.

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Magdalena is a writer with a passion for bridging the gap between the people performing research, and those who want or need to understand it. She writes about medical science and drug discovery. She holds an MS in Pharmaceutical Bioscience and a PhD — spanning the fields of psychiatry, immunology, and neuropharmacology — from Karolinska Institutet in Sweden.

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