Non-Invasive Method for Determining the Need to Treat Male Lower Urinary Tract Symptoms: Post-Void Residual Urine...

The initiation of medical treatment for male patients with lower urinary tract symptoms (LUTSs) depends on their symptom scores, and subjective questionnaire forms must be supported by objective data. Our study aimed to investigate the relevance of post-void residual urine ratio (PVRR) as a marker in identifying patients who need treatment for LUTSs.

The study analysed the demographic, uroflowmetric, ultrasonographic and biochemical characteristics of 564 patients divided into two groups according to their International Prostate Symptom Scores (IPSSs). Patients with mild symptoms (IPSS = 1-7) were included in group 1; And patients with and moderate-to-severe symptoms (IPSS = 8-35), in group 2.

The mean age of the study cohort was 61.5 ± 8.4 years. The mean IPSSs of groups 1 and 2 were 4.6 ± 1.7 and 18.5 ± 7, respectively. Group 1 had significantly higher maximal flow rate (Qmax) and average flow rate (Qave) but lower PVRRs than group 2 (13.8 ± 6.3 vs. 12.3 ± 5.7, p = 0.011; 8.3 ± 4.2 vs. 7 ± 3.6, p = 0.001; 9.0% (20) vs. 16.7% (29), p < 0.001, respectively). Multivariate logistic regression analysis results showed that only PVRR is the independent predictor of moderate-to-severe symptoms, and the cutoff value was >12.9% (OR 2.67 (1.34-5.3), p = 0.005). The PVRR cutoff value was >12.9%, which predicted moderate-to-severe symptoms with 58.6% sensitivity and 64.7% specificity.

In LUTS evaluation, uroflowmetry is often used after completing the questionnaire forms and weakly correlates with IPSS. Given that the symptom score is the only factor considered when deciding whether to begin therapy, PVRR offers more useful information for making the IPSS objective than traditional instruments.