Urethral resistance factor (URA) versus Schafer's obstruction grade and Abrams-Griffiths (AG) number in the diagnosis of obstructive benign prostatichyperplasia

Different methods of analyzing pressure/flow plots to quantify bladder outl et resistance in men with lower urinary tract symptoms (LUTS) due to benign prostatic hyperplasia (BPH) were developed in the past. The aims of this s tudy were to quantify the degree of agreement between the diagnosis of obst ruction by the different methods, and to compare the applicability of the d ifferent methods in the evaluation of bladder outflow conditions, in a larg e group of these men. In consecutive men with LUTS basic initial evaluation s, recommended diagnostic tests, and urodynamic investigations were perform ed. From pressure/flow studies, the group-specific resistance factor (URA), Schafer's obstruction grade, and Abrams-Griffiths (AG) number were estimat ed. Men with 21 cm H2O less than or equal to URA less than or equal to 29 c m H2O and men with Schafer's grade equal 2 were classified as equivocal. In conformity with the provisional ICS definition, men with 20 less than or e qual to AG number less than or equal to 40 were classified as equivocal. In 78% of the 565 included men Schafer's classification agreed with URA class ification. In 82% ICS classification agreed with URA classification. Most a greement (94%) existed between Schafer's classification and ICS classificat ion. All differences were near the points of intersection of the different boundaries, and a decision whether to perform surgery on a patient is not l ikely to be influenced by this disagreement. Males with relatively low detr usor pressure at maximum Row and relatively low maximum Row had a high prev alence among those in whom URA and Schafer's classifications and among thos e in whom URA and ICS classifications differed. root Wiley-Liss. Inc.