Association between urinary hesitancy symptoms and uroflowmetry measured urinary hesitancy time in men with lower urinary tract symptoms

Abstract

AIMS: In patients with urinary hesitancy, the standard time of urinary hesitancy has not been established. Accordingly, we have analyzed the association between urinary hesitancy and various uroflowmetric finding in the present study.

METHODS: Between April 2009 and September 2009, 163 consecutive male subjects with lower urinary tract symptoms (LUTS) were prospectively enrolled. Individuals with a taking any medications known to affect bladder function were excluded. To measure time to voiding (T2V), 1 ml of water was poured into the uroflowmeter funnel of immediately after the subjects pulled down their undergarments. This step was employed to compensate for the intrinsic disadvantage of the uroflowmeter, which works at the beginning of urination. After urination is completed, subjects were asked whether they experienced any urinary hesitancy at that time. Subjects also completed an IPSS questionnaire.

RESULTS: Mean patient age was 60.1 years, and 81 of a total of 163 patients reported experiencing urinary hesitancy. The optimal cut-off value for T2V was found to be 11.5 sec among individuals with voiding volumes greater than 150 ml (AUC = 0.919). A correlation was also found between the score of question #6 on the IPSS questionnaire and the presence of urinary hesitancy during urology clinic visits (r = 0.26, P < 0.01).

CONCLUSIONS: In men with LUTS, T2V is an effective uroflometric parameter to demonstrate urinary hesitancy. Accordingly, we contend that 11.5 sec of hesitancy is an optimal cut-off time to distinguish the presence of urinary hesitancy in voided volume of greater than 150 ml.