Neurourology and urodynamics
June 19, 2026 · via Europe PMC
Are Age and Voided Volume Sufficient to Predict Detrusor Underactivity in Women? An External Validation Study.
Levin N, Yosef E, Vainrib R, Linevitz M, Shaked Y, Neheman A, Vainrib M, Schwarztuch Gildor O.
AI summary — for doctors, generated from the abstract only
A simple age and voided-volume model failed to predict detrusor underactivity in women on external validation.
What was studied
Retrospective validation in 450 women who had uroflowmetry and multichannel urodynamics (2014-2025) of a non-invasive prediction model.
Key findings
- Detrusor underactivity prevalence was 16.2%.
- Discrimination was poor (AUC 0.575 vs 0.82 originally), with sensitivity 78% and specificity 32%.
- Calibration was poor and decision curve analysis showed negligible net benefit.
Clinical relevance
Warns against using a non-invasive shortcut to diagnose underactivity in women.
Who should care
Limitations
Single tertiary center, retrospective, with a different underactivity prevalence than the development cohort.
Do not use age and voided volume to screen for female detrusor underactivity; use urodynamics when diagnosis matters.
This is an AI-generated summary of the published abstract, not a clinical recommendation. It may not reflect the full text or subsequent updates — verify against the original source before acting on it.
Abstract
Purpose
Detrusor underactivity (DU) is a significant cause of female lower urinary tract symptoms. We aimed to externally validate a non-invasive prediction model using age and voided volume (VV) in a tertiary center cohort.
Methods
This retrospective study included 450 consecutive women who underwent uroflowmetry and subsequently multichannel urodynamics (UDS) between 2014 and 2025. DU was defined by pressure-flow criteria as in the development study. Model performance was assessed via AUC-ROC, calibration plots, Brier scores, and Decision Curve Analysis (DCA).
Results
The prevalence of DU in our cohort was 16.2% (73/450), compared to 10% in the original development study. The model demonstrated poor discrimination with an AUC of 0.575 (95% CI 0.50-0.65), a significant decrease from the original reported AUC of 0.82. At the suggested cut-off, sensitivity was 78%, but specificity was only 32%. Calibration was poor (slope = 0.134; intercept = -1.397), indicating a systematic overestimation of risk. The Brier Skill Score was negative (-0.154), and DCA confirmed that the model provided negligible net clinical benefit over the default "test-all" or "test-none" strategies.
Conclusion
Validation of the proposed model failed to demonstrate statistical reliability in our cohort. These findings suggest that the model lacks the necessary transportability to serve as a clinical screening tool for female DU, underscoring the continued need for invasive testing to ensure diagnostic accuracy.
DOI
10.1002/nau.70352
PMID
42318874
Research metadata (titles, abstracts, authors, publication dates) is sourced from Europe PMC, which aggregates content from PubMed/MEDLINE, PubMed Central, and other providers under the U.S. National Library of Medicine (NLM/NCBI). NLM does not claim copyright on abstracts; the original journal publishers or authors may hold rights to the full articles. AI-generated summaries are derived only from the abstract, never the full text, and are always labeled as AI-generated.
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