Purpose: The purpose of this study was to investigate the predictive values of combining symptom scores, prostatic parameters, uroflowmetry parameters, intravesical prostatic protrusion, and prostatic urethral angle for the establishment of a bladder outlet obstruction (BOO) risk score for diagnosing BOO in men with lower urinary tract symptoms. Materials and Methods: A total of 355 men with lower urinary tract symptoms were enrolled and divided into a training set (N = 285) and validation set (N = 70). Videourodynamic studies were used to diagnose lower urinary tract dysfunction subtypes, which were subdivided into a non-BOO and BOO group, which included bladder neck dysfunction and benign prostate obstruction. The parameters were categorized as 0, 1, 2, or 3 according to their cutoff value regarding the specificity of predicting BOO. The BOO risk score was constructed by summing scores of seven variables of symptoms and prostate and uroflowmetry parameters. The area under the curve (AUC) was used to select appropriate cutoff values for predicting lower urinary tract dysfunctions. Results: Among the 355 men examined, 234 (65.9%) had BOO, including 136 (38.3%) with bladder neck dysfunction and 98 (27.6%) with benign prostate obstruction. Other lower urinary tract dysfunctions included detrusor overactivity in 37 patients (10.4%), dysfunctional voiding in 28 patients (7.9%), poor relaxation of the external sphincter in 26 patients (7.3%), detrusor underactivity in 14 patients (3.9%), stable bladder in 9 patients (2.5%), and a hypersensitive bladder in 7 patients (2%). With the summation of the BOO risk scores from each variable, a BOO risk score of ≥10 could yield a sensitivity of 0.822 and specificity of 0.656 for benign prostate obstruction in the training set [AUC = 0.800 (0.741–0.859)] and a sensitivity of 0.80 and specificity of 0.64 in the validation set [AUC = 0.813 (0.701–0.925)]. Conclusions: With office-based diagnostic tools, including symptom scores and uroflowmetry and prostate parameters, a BOO risk score was established. A BOO risk score of ≥10 can predict the presence of benign prostate obstruction in >80% of men with lower urinary tract symptoms refractory to initial medication.

Women commonly experience urinary tract infection (UTI) recurrence. However, there is no effective tool for predicting recurrent UTI after the first UTI episode. Hence, this study aimed to investigate potential urinary inflammatory biomarkers and specific biomarkers for predicting UTI recurrence or persistence after antibiotic treatment in women. Forty women who had a history of recurrent UTI within 1 year after the initial episode and acute bacterial cystitis were treated with broad-spectrum antibiotics for 1 week. To measure inflammatory biomarker levels, urine samples were collected at the baseline and after 1 week, 1 month, and 3 months. The levels of urinary pro-inflammatory proteins such as neutrophil gelatinase-associated lipocalin (NGAL), nerve growth factor, CXC-motif chemokine ligand (CXCL)-1, interleukin-8, CXCL-10, monocyte chemoattractant protein-1, and tumor necrosis factor-alpha were measured using commercial kits. Seven healthy age-matched women were included as controls. The changes in urinary biomarker levels at the baseline and various time points were compared between women with and without UTI recurrence within 1 month or within 3 months after the initial antibiotic therapy. At the baseline, patients with a higher urinary white blood cell count had a significantly higher NGAL level than the controls and those with a low white blood cell count. Of the 40 patients with a history of recurrent UTI, 12 presented with UTI persistence or recurrence within 1 month and 19 within 3 months after the initial antibiotic treatment. Among the 28 patients without UTI recurrence at 1 month after treatment, 7 had UTI recurrence within 3 months. Compared with patients without UTI recurrence, those with UTI recurrence had significantly higher urinary NGAL levels at 1 week, 1 month, and 3 months after the initial treatment. This study concludes that persistent elevation in urinary NGAL levels after the initial antibiotic treatment indicated persistent bladder inflammation. Further, it could be a predictor of UTI persistence or recurrence within 1 or 3 months after the initial antibiotic treatment. Patients with a history of recurrent UTI and high urinary NGAL levels after antibiotic treatment might require a longer treatment duration to completely eradicate or prevent UTI recurrence.

Purpose: To investigate predictive values of combining symptom scores, prostatic parameters, uroflowmetry parameters, intravesical prostatic protrusion, and prostatic urethral angle for the establishment of a bladder outlet obstruction (BOO) risk score for diagnosing BOO in men with lower urinary tract symptoms. Materials and Methods: A total of 355 men with lower urinary tract symptoms were enrolled and divided into a training set (N = 285) and validation set (N = 70). Videourodynamic studies were used to diagnose lower urinary tract dysfunction subtypes, which were subdivided into a non-BOO and BOO group, which included bladder neck dysfunction and benign prostate obstruction. The parameters were categorized as 0, 1, 2, or 3 according to their cutoff value regarding the specificity of predicting BOO. The BOO risk score was constructed by summing scores of seven variables of symptoms and prostate and uroflowmetry parameters. The area under the curve (AUC) was used to select appropriate cutoff values for predicting lower urinary tract dysfunctions. Results: Among the 355 men examined, 234 (65.9%) had BOO, including 136 (38.3%) with bladder neck dysfunction and 98 (27.6%) with benign prostate obstruction. Other lower urinary tract dysfunctions included detrusor overactivity in 37 (10.4%), dysfunctional voiding in 28 (7.9%), poor relaxation of external sphincter in 26 (7.3%), detrusor underactivity in 14 (3.9%), stable bladder in 9 (2.5%), and hypersensitive bladder in 7 (2%). With the summation of the BOO risk scores from each variable, a BOO risk score of ≥10 could yield a sensitivity of 0.822 and specificity of 0.656 for benign prostate obstruction in the training set [AUC = 0.800 (0.741–0.859)] and a sensitivity of 0.80 and specificity of 0.64 in the validation set [AUC = 0.813 (0.701–0.925)]. Conclusions: With office-based diagnostic tools, including symptom scores and uroflowmetry and prostate parameters, a BOO risk score was established. A BOO risk score of ≥10 can predict the presence of benign prostate obstruction in >80% of men with lower urinary tract symptoms.