Mesane çıkış obstrüksiyonu bulunan hastalarda non-invaziv yöntem olan ?near-ınfrared spectroscopy? (NIRS) uygulaması

Abstract

Objective: : Near infrared spectroscopy (NIRS) is a non-invasive optical technique able to monitor changes in the concentration of oxygenated and deoxygenated hemoglobin in the bladder detrusor during bladder ? lling and emptying. To evaluate the ability of a new NIRS instrument and algorithm to classify male patients with LUTS as obstructed or unobstructed based on comparison with classi ? cation via conventional invasive urodynamics (UDS).Method: Male patients with LUTS were recruited and underwent uro ? ow and urodynamic pressure ? ow studies with simultaneous transcutaneous NIRS monitoring following measurement of post residual volume (PVR) with ultrasound. Data analysis ? rst classi ? ed each subject as obstructed or unobstructed using the standard pressure ? ow data and nomogram, then compared these results with a classi ? cation derived a customized algorithm which analyzed the pattern of change of the NIRS data plus measurements of PVR and Qmax.Results: Fiftyfive subjects enrolled: 53 data sets had all required parameters [2 incomplete sets due to: communication error between NIRS and urodynamics instruments]. Thus data from 53 subjects was analyzed. The NIRS algorithm correctly identi ? ed those diagnosed as obstructed by conventional urodynamic classi ? cation in 28 of 29 subjects (sensitivity = 86.2%) and, and those diagnosed as unobstructed in 24 of 25 subjects (speci ? city = 87.5%).Conclusion: Scores derived from NIRS data plus PVR and Qmax are able to correctly identify > 85% of subjects classi ? ed as obstructed using UDS.