Multisite Evaluation of Noninvasive Bladder Pressure Flow Recording Using the Penile Cuff Device: Assessment of Test-Retest Agreement

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We performed a pragmatic study of the penile cuff test, a noninvasive method of categorizing bladder outlet obstruction, at a number of United Kingdom urology centers remote from the originating site. We report the agreement of the test and the subsequent retest using the cuff test in the short term.

Materials and Methods:

Men requiring urodynamic investigation for lower urinary tract symptoms were recruited from 6 sites to perform a penile cuff test twice at an interval of approximately 4 weeks. Tests were analyzed by a single interpreter to assess differences in the flow rate, cuff interruption pressure and diagnostic categorization in an individual between the 2 tests due to measurement and physiological error.


A total of 136 men (69%) performed 2 suitable cuff tests at a median of 20 days (IQR 8-31). The mean ± SD difference between the 2 tests in the maximum flow rate was 0.2 ± 3.7 ml per second and in cuff interruption pressure was 4.0 ± 26 cm H2O. Of the men 33% changed diagnostic category on the Newcastle nomogram, while 47% maintained a consistent diagnosis of obstruction or no obstruction.


Diagnostic category repeatability was similar to that of conventional urodynamics, although there was greater variability in pressure measurements. This supports widespread routine use of the penile cuff test.

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