Trial reportEuropean urology focus2022
Prostate Surgery for Men with Lower Urinary Tract Symptoms: Do We Need Urodynamics to Find the Right Candidates? Exploratory Findings from the UPSTREAM Trial.
Trial report in European urology focus, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 13 papers, 1 of them a synthesis that pooled it.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
13 citing papers in PubMed, 1 synthesis or guideline pooled it, 37 citations in OpenAlex.
- Beyond urodynamics: non-invasive approaches to diagnosing detrusor underactivity in men with lower urinary tract symptoms - a systematic review.BMC urology · 2025Pooled it
- Urodynamics tests for the diagnosis and management of male bladder outlet obstruction: long-term follow-up of the UPSTREAM non-inferiority RCT.Health technology assessment (Winchester, England) · 2025Trial
- Review
- Determinants of surgical procedure selection for LUTS/BPH: a survey of brazilian urologists.World journal of urology · 2026Article
- Tackling the progression of benign prostatic hyperplasia/benign prostatic obstruction progression: Deobstructing within the "window of curability" (a hypothesis-generating review).Current urology · 2025Article
- Clinical predictors of bladder outlet obstruction in men consulting for routine urological screening.International urology and nephrology · 2025Article
- [Relief of bladder outlet obstruction and improvement of symptoms following drug therapy vs. surgery for lower urinary tract symptoms indicative of benign prostatic hyperplasia: a systematic review].Urologie (Heidelberg, Germany) · 2025Article
- Efficacy and durability of holmium laser enucleation of the prostate in the management of acute and chronic urinary retention A retrospective study.Canadian Urological Association journal = Journal de l'Association des urologues du Canada · 2024Article
- MRI-based radiomic features of the urinary bladder wall identify patients with moderate-to-severe international prostate symptom score.World journal of urology · 2024Article
- The Use of Uroflowmetry as a Diagnostic Test.Current urology reports · 2024Review
- Efficacy of GreenLight laser prostatectomy in urinary retention.Canadian Urological Association journal = Journal de l'Association des urologues du Canada · 2024Article
- Nomogram predicting the efficacy of transurethral surgery in benign prostatic hyperplasia patients.Aging clinical and experimental research · 2024Article
- When is the best surgical time for benign prostate hyperplasia treatment?Asian journal of andrology · 2024Article
Corrections and comments
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Authors and funding
9 authors at 3 institutions in 1 country.
Funding
Abstract
backgroundIdentifying men whose lower urinary tract symptoms (LUTS) may benefit from surgery is challenging.
objectiveTo identify routine diagnostic and urodynamic measures associated with treatment decision-making, and outcome, in exploratory analyses of the UPSTREAM trial. DESIGN, SETTING, AND
participantsA randomised controlled trial was conducted including 820 men, considering surgery for LUTS, across 26 hospitals in England (ISCTRN56164274).
interventionMen were randomised to a routine care (RC) diagnostic pathway (n = 393) or a pathway that included urodynamics (UDS) in addition to RC (n = 427). OUTCOME MEASUREMENTS AND STATISTICAL ANALYSIS: Men underwent uroflowmetry and completed symptom questionnaires, at baseline and 18 mo after randomisation. Regression models identified baseline clinical and symptom measures that predicted recommendation for surgery and/or surgical outcome (measured by the International Prostate Symptom Score [IPSS]). We explored the association between UDS and surgical outcome in subgroups defined by routine measures. RESULTS AND LIMITATIONS: The recommendation for surgery could be predicted successfully in the RC and UDS groups (area under the receiver operating characteristic curve 0.78), with maximum flow rate (Q
conclusionsTreatment decisions were informed with UDS, when available, but without evidence of change in the decisions reached. Despite the small group sizes, exploratory analyses suggest that selective use of UDS could detect obstructive pathology, missed by routine measures, in certain subgroups. PATIENT SUMMARY: Baseline clinical and symptom measurements were able to predict treatment decisions. The addition of urodynamic test results, while useful, did not generally lead to better surgical decisions and outcomes over routine tests alone.
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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.