Prospective evaluation of the American Urological Association symptom index and peak urinary flow rate for the followup of men with known urethral stricture disease

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dc.contributor.authorHeyns C.F.
dc.contributor.authorMarais D.C.
dc.date.accessioned2011-05-15T16:17:14Z
dc.date.available2011-05-15T16:17:14Z
dc.date.issued2002
dc.description.abstractPurpose: We prospectively evaluated the American Urological Association (AUA) symptom index and maximum urine flow for predicting urethral stricture recurrence in men with a previous diagnosis of urethral stricture disease. Materials and Methods: Patients were recruited at our urethral stricture clinic, where all newly diagnosed and previously treated men with urethral stricture present and are treated. The AUA symptom index was completed and uroflowmetry was done. The stricture was calibrated using Jacques catheters. If an 18Fr catheter could not be passed, a retrograde urethrogram was performed. Patients were treated with filiform dilation or direct vision internal urethrotomy. Uroflowmetry was repeated when the catheter was removed 3 days later and the AUA symptom index was repeated 1 month later. Results: Data on 49 patients (170 consultations) between March 2000 and August 2001 were analyzed. Average patient age was 48 years. There was a significant negative correlation of urethral diameter with AUA symptom index and of AUA symptom index with maximum urine flow as well as a significant positive correlation of urethral diameter with maximum urine flow. We evaluated the usefulness of AUA symptom index and maximum urine flow at different cutoff levels for predicting urethral stricture in our study group. Using an AUA symptom index of greater than 10 or maximum urine flow of less than 15 ml. per second as cutoff values provided 93% sensitivity, 68% specificity, 78% positive predictive value, 89% negative predictive value and 82% overall accuracy. This method could have prevented further invasive studies in 34% of patients, while a clinically significant stricture would have been missed in only 4.3%. Conclusions: AUA symptom index combined with maximum urine flow is an accurate, time-saving and cost-effective tool for predicting recurrent stricture in patients with a known urethral stricture. It can be used to direct decision making on further invasive studies and treatment.
dc.description.versionArticle
dc.identifier.citationJournal of Urology
dc.identifier.citation168
dc.identifier.citation5
dc.identifier.issn00225347
dc.identifier.urihttp://hdl.handle.net/10019.1/14130
dc.subjectadult
dc.subjectaged
dc.subjectarticle
dc.subjectcalibration
dc.subjectconsultation
dc.subjectcontrolled study
dc.subjectcorrelation analysis
dc.subjectdiagnostic accuracy
dc.subjectevaluation
dc.subjecthuman
dc.subjectmajor clinical study
dc.subjectmale
dc.subjectprediction
dc.subjectpriority journal
dc.subjectprospective study
dc.subjectrating scale
dc.subjectsurgical technique
dc.subjecturethra stricture
dc.subjecturethrography
dc.subjecturethrotomy
dc.subjecturine catheter
dc.subjecturine flow rate
dc.subjecturodynamics
dc.subjecturoflowmetry
dc.subjectAdult
dc.subjectAged
dc.subjectAged, 80 and over
dc.subjectFollow-Up Studies
dc.subjectHumans
dc.subjectMale
dc.subjectMiddle Aged
dc.subjectProspective Studies
dc.subjectRecurrence
dc.subjectUrethral Obstruction
dc.subjectUrodynamics
dc.titleProspective evaluation of the American Urological Association symptom index and peak urinary flow rate for the followup of men with known urethral stricture disease
dc.typeArticle
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