Unravelling detrusor underactivity: Development of a bladder outlet resistanceBladder contractility nomogram for adult male patients with lower urinary tract symptoms

Matthias Oelke*, Kevin L. J. Rademakers, Gommert A. van Koeveringe

*Corresponding author for this work

Research output: Contribution to journalArticleAcademicpeer-review

26 Citations (Web of Science)


Aims Voiding dysfunction in adult men may be caused by bladder outlet obstruction (BOO) and/or detrusor underactivity (DU). Until now, it is only possible to classify BOO and DU by pressure-flow analysis. Low values of the maximum Watts factor (W-max) indicate DU but thresholds for the diagnosis have not been established. Purpose of this study was to construct a nomogram using bladder outlet resistance and detrusor contractility in order to classify BOO and DU simultaneously. MethodsTreatment naive men aged 40 years with uncomplicated lower urinary tract symptoms (LUTS) were prospectively evaluated. Patients were assessed with IPSS, prostate volume, uroflowmetry, post-void residual, and pressure-flow measurement. The bladder outlet obstruction index (BOOI) was used to determine BOO-grade and W-max to calculate detrusor contractility. Individual BOOI-W-max values were plotted in a graph. Linear interpolation was applied to determine the 10th, 25th, 50th, 75th, and 90th percentiles. ResultsRetrospective analysis of 822 male patients with means of 64 years, IPSS 16, and prostate volume of 40 cc. Patient and clinical parameters of the
Original languageEnglish
Pages (from-to)980-986
JournalNeurourology and Urodynamics
Issue number8
Publication statusPublished - Nov 2016


  • benign prostatic hyperplasia
  • bladder outlet obstruction
  • detrusor underactivity
  • impaired bladder contractility
  • lower urinary tract symptoms

Cite this