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The following is a summary of “Beyond urodynamics: non-invasive approaches to diagnosing detrusor underactivity in men with lower urinary tract symptoms – a systematic review,” published in the March 2025 issue of BMC Urology by Garbas et al. 

Researchers conducted a prospective study to evaluate non-invasive methods for diagnosing detrusor underactivity (DU) in men with lower urinary tract symptoms (LUTS), assessing feasibility and accuracy. 

They systematically searched PubMed, Scopus, and Web of Science for original articles on non-invasive DU diagnostics in men with LUTS and extracted data on study characteristics, diagnostic methods, and accuracy and assessed the risk of bias using the QUADAS-2 tool.  

The results showed that 18 studies with 7,390 patients, including 3,194 with DU, were analyzed. The DUA-SQ questionnaire had 95.8% sensitivity, while ultrasound-based detrusor wall thickness showed 100% specificity but 42% sensitivity. Models using clinical variables achieved over 75% sensitivity. Uroflowmetry parameters, including “sawtooth” and “interrupted” waveforms, had 80% sensitivity and 87% specificity. Biomarkers like serum adiponectin and urine NO/ATP ratio had sensitivities of 79% and 88.5%. Artificial intelligence (AI) models showed sensitivities from 65.9% to 79.7%. Due to poor study quality and data heterogeneity, meta-analysis was not performed. 

They found that non-invasive methods, including DUA-SQ, ultrasound measurements, and AI models, showed potential but had varying accuracies and emphasized the need for further research to standardize these methods and improve diagnostic reliability. 

Source: bmcurol.biomedcentral.com/articles/10.1186/s12894-025-01722-w