Introduction: Urodynamics study is the gold standard diagnosing bladder outlet obstruction (BOO) in patients with prostate enlargement [1]. It is invasive and costly procedure. LUTS alone is not a good indicator for BOO. MIST has gained popularity as alternatives to TURP with acceptable functional outcomes. Rosier et al [2] promoted a novel clinical prostate score based on prostate volume (PV) and 3x maximum flow rate (Qmax) with a sensitivity of 88% for patients with no evidence of BOO based on urodynamics study. PV would not change after MIST. We aimed to evaluate the utility of CLIPS to determine functional voiding outcomes and uroflow (UF) parameters for patients treated with MIST. Methods: From 2020 to 2022, we collected prospective single-centre data of consecutive patients who underwent MIST (Prostate Urethral Lift (PUL) and REZUM). Assessment was done at 1,3 and 12 months for PV, International Prostate Symptom Score (IPSS), Quality of life (QOL) and International Index of Erectile Function (IIEF) questionnaires and UF parameters - QMax, voided volume (VV) and post void residual volume (PVRU). Patients were stratified according to CLIPS - Patients were considered to have BOO if 3xQMax was less than the prostate volume and vice vera. Analysis was done using student t-test. Results: 117 patients underwent MIST (median age 62 yrs) of which 50.4% of patients had failed medical therapy, 26.4% medical side effects and 22.2% declined medical therapy. At pre-op, PSA 2.29±2.24, PV 40.14±14.91, IPSS 18.58±6.92, QoL 3.89±1.31, IIEF 11.93±7.52, Qmax 10.64±4.34, VV 238.10±107.70 and PVRU 49.56±52.29. CLIPS identified 69.2% (n=81) patients were obstructed and 30.8% (n=31) not obstructed. Table 1 showed results at 1, 3 and 12 months. Significant differences between BOO and no BOO were found for PV, Qmax and VV. No significant differences were found for IPSS, QoL and IIEF. Conclusions: Functional questionnaires were unable to differentiate between patients with or without BOO. As there were clinically significant improvement in UF parameters between these 2 groups, CLIPS provided a useful novel tool to assess patient’s suitability for MIST without doing urodynamics studies. Further longer term studies would be required to determine the usefulness of CLIPS.
References: 1. Neurourol Urodyn 2002 2. Rosier et al, Abstract 263 ICS 2021 SOURCE OF Funding: None
