Log in

Clinical features of supervoiders who suffer from lower urinary tract symptoms: a propensity score-matching study

  • Original Article
  • Published:
World Journal of Urology Aims and scope Submit manuscript

Abstract

Purpose

To evaluate the clinical characteristics of patients with maximal urine flow rate (Q max) ≥ 25 ml/s complaining of lower urinary tract symptoms (LUTS), using propensity score-matching analysis to compare with the control group.

Methods

Medical records from a prospectively maintained database for first visit male patients with LUTS/benign prostatic hyperplasia between 2010 and 2012 were used to select 818 patients. Of these patients, 68 men with Q max ≥ 25 ml/s were defined as the supervoider group, and 68 patients were selected for the control group using propensity scores, which were calculated for each patient using multivariable logistic regression model based on the following covariates: age, prostate volume, voided urine volume, and post-voided residual volume. International Prostate Symptom Score (IPSS), quality of life score, and Overactive Bladder Symptom Score (OABSS) were also analyzed.

Results

Mean Q max was 30.82 ± 5.13 in supervoiders and 15.95 ± 4.88 ml/s in controls (p < 0.001). There were statistical differences in IPSS between supervoiders and controls (12.63 ± 5.81 vs. 16.13 ± 6.90; p = 0.002). Although the IPSS voiding symptom sub-score in supervoiders was lower than controls (5.09 ± 3.35 vs. 7.40 ± 4.00; p < 0.001), there were no significant differences in storage symptom and post-micturitional symptom sub-scores. In OABSS and subdomain scores for frequency, nocturia, and urgency, there were no significant differences between the groups. However, the urge incontinence subdomain score was significantly higher in supervoiders versus controls (0.69 ± 1.26 vs. 0.18 ± 0.52; p = 0.003).

Conclusions

Supervoiders experience comparable levels of storage and post-micturition symptoms, but display more severe urge incontinence despite milder voiding symptoms and better uroflowmetric measurements than propensity score-matched controls.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Subscribe and save

Springer+ Basic
EUR 32.99 /Month
  • Get 10 units per month
  • Download Article/Chapter or Ebook
  • 1 Unit = 1 Article or 1 Chapter
  • Cancel anytime
Subscribe now

Buy Now

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Fig. 1

Similar content being viewed by others

References

  1. Abrams P, Cardozo L, Fall M, Griffiths D, Rosier P, Ulmsten U, Van Kerrebroeck P, Victor A, Wein A (2003) The standardisation of terminology in lower urinary tract function: report from the standardisation sub-committee of the International Continence Society. Urology 61:37–49

    Article  PubMed  Google Scholar 

  2. Schafer W, Abrams P, Liao L, Mattiasson A, Pesce F, Spangberg A, Sterling AM, Zinner NR, van Kerrebroeck P (2002) Good urodynamic practices: uroflowmetry, filling cystometry, and pressure-flow studies. Neurourol Urodyn 21:261–274

    Article  PubMed  Google Scholar 

  3. Ko DS, Fenster HN, Chambers K, Sullivan LD, Jens M, Goldenberg SL (1995) The correlation of multichannel urodynamic pressure-flow studies and American Urological Association symptom index in the evaluation of benign prostatic hyperplasia. J Urol 154:396–398

    Article  PubMed  CAS  Google Scholar 

  4. Ezz el Din K, Kiemeney LA, de Wildt MJ, Debruyne FM, de la Rosette JJ (1996) Correlation between uroflowmetry, prostate volume, postvoid residue, and lower urinary tract symptoms as measured by the International Prostate Symptom Score. Urology 48:393–397

    Article  PubMed  CAS  Google Scholar 

  5. Tanagho EA, Deng DY (2008) Urodynamic studies. In: Tanagho EA, Jack WM (eds) Smith's general urology, 17th edn. The McGraw-Hill companies, New York, NY, USA

  6. Akikwala TV, Fleischman N, Nitti VW (2006) Comparison of diagnostic criteria for female bladder outlet obstruction. J Urol 176:2093–2097

    Article  PubMed  Google Scholar 

  7. Parsons KF, O’Boyle PJ, Gibbon NO (1977) A further assessment of bladder transection in the management of adult enuresis and allied conditions. Br J Urol 49:509–514

    Article  PubMed  CAS  Google Scholar 

  8. Homma Y, Yoshida M, Obara K, Seki N, Yamaguchi O (2005) Development and validity of the Overactive Bladder Symptom Score (OABSS). Jpn J Urol 96:182

    Google Scholar 

  9. Jeong SJ, Homma Y, Oh SJ (2011) Korean version of the overactive bladder symptom score questionnaire: translation and linguistic validation. Int Neurourol J 15:135–142

    Article  PubMed  Google Scholar 

  10. Lee HH, Lee JY, Yu HS, Diaz RR, Ham WS, Rha KH, Choi YD, Cho KS (2013) Impact of bent distortion on accuracy of measurement during transrectal ultrasonography for prostatic imaging: a preliminary study. Urology 81:915–919

    Google Scholar 

  11. Slim K, Nini E, Forestier D, Kwiatkowski F, Panis Y, Chipponi J (2003) Methodological index for non-randomized studies (minors): development and validation of a new instrument. ANZ J Surg 73:712–716

    Article  PubMed  Google Scholar 

  12. Rubin DB, Thomas N (1996) Matching using estimated propensity scores: relating theory to practice. Biometrics 52:249–264

    Article  PubMed  CAS  Google Scholar 

  13. Rubin DB (2004) On principles for modeling propensity scores in medical research. Pharmacoepidemiol Drug Saf 13:855–857

    Article  PubMed  Google Scholar 

  14. Austin PC (2008) A critical appraisal of propensity-score matching in the medical literature between 1996 and 2003. Stat Med 27:2037–2049

    Article  PubMed  Google Scholar 

  15. Djavan B (2003) Lower urinary tract symptoms/benign prostatic hyperplasia: fast control of the patient’s quality of life. Urology 62:6–14

    Article  PubMed  Google Scholar 

  16. Rosenberg MT, Staskin DR, Kaplan SA, MacDiarmid SA, Newman DK, Ohl DA (2007) A practical guide to the evaluation and treatment of male lower urinary tract symptoms in the primary care setting. Int J Clin Pract 61:1535–1546

    Article  PubMed  CAS  Google Scholar 

  17. Yamaguchi O, Aikawa K, Shishido K, Nomiya M (2009) Place of overactive bladder in male lower urinary tract symptoms. World J Urol 27:723–728

    Article  PubMed  Google Scholar 

  18. Barry MJ, Cockett AT, Holtgrewe HL, McConnell JD, Sihelnik SA, Winfield HN (1993) Relationship of symptoms of prostatism to commonly used physiological and anatomical measures of the severity of benign prostatic hyperplasia. J Urol 150:351–358

    PubMed  CAS  Google Scholar 

  19. Hyman MJ, Groutz A, Blaivas JG (2001) Detrusor instability in men: correlation of lower urinary tract symptoms with urodynamic findings. J Urol 166:550–552 discussion 553

    Article  PubMed  CAS  Google Scholar 

  20. Jorgensen JB, Jensen KM (1996) Uroflowmetry. Urol Clin North Am 23:237–242

    Article  PubMed  CAS  Google Scholar 

  21. Jepsen JV, Bruskewitz RC (1998) Comprehensive patient evaluation for benign prostatic hyperplasia. Urology 51:13–18

    Article  PubMed  CAS  Google Scholar 

  22. Girman CJ, Jacobsen SJ, Guess HA, Oesterling JE, Chute CG, Panser LA, Lieber MM (1995) Natural history of prostatism: relationship among symptoms, prostate volume and peak urinary flow rate. J Urol 153:1510–1515

    Article  PubMed  CAS  Google Scholar 

  23. Abrams P, Cardozo L, Fall M, Griffiths D, Rosier P, Ulmsten U, van Kerrebroeck P, Victor A, Wein A (2002) The standardisation of terminology of lower urinary tract function: report from the Standardisation Sub-committee of the International Continence Society. Neurourol Urodyn 21:167–178

    Article  PubMed  Google Scholar 

  24. Romanzi LJ, Groutz A, Heritz DM, Blaivas JG (2001) Involuntary detrusor contractions: correlation of urodynamic data to clinical categories. Neurourol Urodyn 20:249–257

    Article  PubMed  CAS  Google Scholar 

  25. DuBeau CE, Levy B, Mangione CM, Resnick NM (1998) The impact of urge urinary incontinence on quality of life: importance of patients’ perspective and explanatory style. J Am Geriatr Soc 46:683–692

    PubMed  CAS  Google Scholar 

  26. Yamaguchi O, Honda K, Nomiya M, Shishido K, Kakizaki H, Tanaka H, Yamanishi T, Homma Y, Takeda M, Araki I, Obara K, Nishizawa O, Igawa Y, Goto M, Yokoyama O, Seki N, Takei M, Yoshida M (2007) Defining overactive bladder as hypersensitivity. Neurourol Urodyn 26:904–907

    Article  PubMed  Google Scholar 

  27. Lee SR, Kim HJ, Kim A, Kim JH (2010) Overactive bladder is not only overactive but also hypersensitive. Urology 75:1053–1059

    Article  PubMed  Google Scholar 

  28. Takeda M, Araki I, Kamiyama M, Takihana Y, Komuro M, Furuya Y (2003) Diagnosis and treatment of voiding symptoms. Urology 62:11–19

    Article  PubMed  Google Scholar 

  29. Weitzen S, Lapane KL, Toledano AY, Hume AL, Mor V (2004) Principles for modeling propensity scores in medical research: a systematic literature review. Pharmacoepidemiol Drug Saf 13:841–853

    Article  PubMed  Google Scholar 

  30. D’Agostino RB Jr (1998) Propensity score methods for bias reduction in the comparison of a treatment to a non-randomized control group. Stat Med 17:2265–2281

    Article  PubMed  Google Scholar 

Download references

Conflict of interest

The authors declare that they have no conflict of interest.

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Kang Su Cho.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Lee, J.Y., Hah, Y.S., Lee, D.H. et al. Clinical features of supervoiders who suffer from lower urinary tract symptoms: a propensity score-matching study. World J Urol 31, 1463–1468 (2013). https://doi.org/10.1007/s00345-013-1081-8

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00345-013-1081-8

Keywords

Navigation