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Prospective validation of a novel visual analogue uroflowmetry score (VAUS) in 1000 men with lower urinary tract symptoms (LUTS)

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Abstract

Introduction and aims

Family physicians are limited by lack of tools to monitor benign prostate hyperplasia. VAUS provides a cost-effective, easily administered non-invasive tool. Our primary aim was to validate VAUS correlation with uroflowmetry measured maximal flow rate (Qmax), voided volume and International Prostate Symptom Scores (IPSS) symptom scores. Secondary aim was to study how the VAUS fared at predicting poor flow (Qmax < 10 ml/s) compared to age, voided volume and IPSS. Tertiary aim was to predict the best VAUS as a cutoff for poor flow.

Methods

After IRB approval, 1000 patients were prospectively recruited. They had VAUS, uroflowmetry and IPSS performed. VAUS is a novel five-point visual analogue scoring of urine flow, with one being the weakest and five the strongest. Data were analysed using SPSS where spearman’s correlation coefficient and logistic regression analysis were performed looking for significance. Receiver operating curves (ROC) curves were used to identify best VAUS cutoff.

Results

1000 patients were studied with mean age of 68.99 (50–95). VAUS showed good correlation with Qmaxp < 0.001, voided volume p = 0.006 and IPSS p <0.001. On multivariate analysis both VAUS and voided volume predicted poor flow significantly with p value of<0.001 and p =0.001, respectively. On ROC analysis VAUS of 2.5 was identified as best value for predicting poor flow with p value <0.001.

Conclusion

VAUS is a validated tool for monitoring of lower urinary tract symptoms in our patients showing significant correlation with uroflowmetry, voided volume and IPSS.

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Acknowledgements

We would like to acknowledge the support of Sing health Academic Clinical Program Innovation Grant for funding this project. In addition we acknowledge our urology clinical laboratory nurses led by Senior Staff Nurse Esther Ho for the groundwork in running the project (Grant No. 2017).

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Authors and Affiliations

  1. Department of Urology, Singapore General Hospital, Singapore, Singapore

    Raj Tiwari, M. Y. Ng, S. H. Neo, R. Mangat & H. Ho

Authors
  1. Raj Tiwari
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  2. M. Y. Ng
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  3. S. H. Neo
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  4. R. Mangat
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  5. H. Ho
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Contributions

RT: project development, data collection, manuscript writing. MYN: data management, data analysis. SHN: data collection, project development. RM: project development. HH: project development.

Corresponding author

Correspondence to Raj Tiwari.

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Conflict of interest

The authors declare that they have no conflict of interest.

Ethics approval

All procedures in the studies involving human participants were in accordance with ethical standards of the institution (Singhealth IRB 2016/2746) and with the 1964 Helsinki Declaration and its later amendments or comparable ethical standards.

Human and animal rights

This article does not contain any studies with animals performed by any of the authors.

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Informed consent was obtained from all individual participants included in the study.

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This project has been presented and awarded at several conferences. Best abstract presentation UAA 2017 meeting Hong Kong, Best poster SIU 2018 Seoul and Best poster at Urofair 2019 Singapore. It was also presented as a moderated poster at EAU 2019 Barcelona.

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Tiwari, R., Ng, M.Y., Neo, S.H. et al. Prospective validation of a novel visual analogue uroflowmetry score (VAUS) in 1000 men with lower urinary tract symptoms (LUTS). World J Urol 38, 1267–1273 (2020). https://doi.org/10.1007/s00345-019-02909-1

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  • DOI: https://doi.org/10.1007/s00345-019-02909-1

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