Gautam SHUBHANKAR, Pooja NIGADE
Journal of Urological Surgery - 2026;13(3):160-166
Objective: Benign prostatic enlargement (BPE) causes lower urinary tract symptoms (LUTS) in ageing men. While conventional diagnostic tools like the international prostate symptom score (IPSS) and uroflowmetry are routinely used, they often yield equivocal findings. Urodynamic studies, though definitive, are invasive and less accessible. This study aimed to evaluate the clinical utility of a novel, non-invasive uroflowmetry-derived parameter-flow-derived bladder outlet efficiency (FDBOE)-in assessing symptom severity and predicting treatment outcomes in BPE. Materials and Methods: A prospective observational study was conducted over four months involving 51 male patients aged >45 years presenting with LUTS due to BPE. After exclusion of confounding urological conditions, baseline IPSS and uroflowmetry assessments were performed. FDBOE was calculated using the formula: Voiding efficiency x Qavg x (flow time/total voiding time). All patients were started on silodosin (8 mg daily) and reassessed after four weeks. Results: FDBOE values ranged from 0.51 to 7.76 mL/sec, with a mean of 3.49+/-1.70 mL/sec. A strong inverse correlation between FDBOE and IPSS (r=-0.832, p<0.001) was observed. Sensitivity analysis using an FDBOE threshold of <=3.3 mL/sec yielded a sensitivity of 92.6% for detecting severe LUTS. Post-treatment analysis revealed that 95% of grade I patients, 35% of grade II patients, and none of the grade III patients required surgical intervention. Conclusion: FDBOE is a simple, reproducible, non-invasive parameter that correlates strongly with LUTS severity, and predicts treatment outcomes in BPE. It offers practical utility in clinical decision-making, especially in resource-limited settings.
