{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,17]],"date-time":"2026-08-17T05:25:04Z","timestamp":1786944304721,"version":"build-2736575974"},"reference-count":17,"publisher":"Wiley","issue":"6","license":[{"start":{"date-parts":[[2026,4,16]],"date-time":"2026-04-16T00:00:00Z","timestamp":1776297600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2026,4,16]],"date-time":"2026-04-16T00:00:00Z","timestamp":1776297600000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Neurourology and Urodynamics"],"published-print":{"date-parts":[[2026,8]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Lower urinary tract symptoms (LUTS) in young men are heterogeneous, and symptom\u2010based management often fails to identify the underlying dysfunction, particularly in treatment\u2010resistant cases.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>To assess the impact of multichannel urodynamic studies (UDS) on clinical management decisions and identify urodynamic predictors of treatment modification in men under 50 years with chronic LUTS.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>In this prospective cross\u2010sectional study, men aged 18\u201349 years with LUTS persisting for \u2265\u20096 months despite prior guideline\u2010concordant therapy underwent standardized multichannel UDS. Clinical management plans were recorded immediately before and after UDS interpretation. Management changes were classified as major or minor. Associations between urodynamic diagnoses, objective parameters, symptom scores, and management changes were evaluated using multivariable logistic regression.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>A total of 723 men (mean age 38.4\u2009\u00b1\u20098.9 years) were included. Overall, 63.3% experienced a UDS\u2010guided management change, including 41.6% with major treatment modifications. Major changes occurred predominantly in patients with abnormal urodynamic findings, especially underactive detrusor, low compliance, bladder neck dysfunction, and combined abnormalities, while no major changes occurred in patients with normal UDS. Bladder compliance, bladder contractility index, bladder outlet obstruction index, and urodynamic diagnosis were the strongest predictors of management change (AUC\u2009=\u20090.954). Symptom scores and post\u2010void residual alone were poor discriminators of underlying pathology.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Urodynamic studies play a pivotal role in guiding individualized management in young men with treatment\u2010resistant LUTS, providing objective information that meaningfully alters clinical decision\u2010making.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/nau.70293","type":"journal-article","created":{"date-parts":[[2026,4,16]],"date-time":"2026-04-16T09:53:52Z","timestamp":1776333232000},"page":"1188-1195","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Impact of Urodynamic Parameters on Treatment Decision\u2010Making in Men Under 50 With Treatment\u2010Resistant Chronic Lower Urinary Tract Symptoms"],"prefix":"10.1002","volume":"45","author":[{"given":"Hossein","family":"Karami","sequence":"first","affiliation":[{"name":"Urology Department, Shohada\u2010e\u2010Tajrish Hospital Shahid Beheshti University of Medical Sciences Tehran Iran"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4536-6404","authenticated-orcid":false,"given":"Farzad","family":"Allameh","sequence":"additional","affiliation":[{"name":"Men's Health &amp; Reproductive Health Research Center Shahid Beheshti University of Medical Sciences Tehran Iran"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0002-6125-471X","authenticated-orcid":false,"given":"Sina","family":"Samenezhad","sequence":"additional","affiliation":[{"name":"Urology Department, Shohada\u2010e\u2010Tajrish Hospital Shahid Beheshti University of Medical Sciences Tehran Iran"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mohammad","family":"Seifipoor","sequence":"additional","affiliation":[{"name":"Urology Department, Shohada\u2010e\u2010Tajrish Hospital Shahid Beheshti University of Medical Sciences Tehran Iran"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,4,16]]},"reference":[{"key":"e_1_2_12_2_1","doi-asserted-by":"publisher","DOI":"10.4111\/kju.2014.55.5.341"},{"key":"e_1_2_12_3_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1442-2042.2006.01347.x"},{"key":"e_1_2_12_4_1","doi-asserted-by":"publisher","DOI":"10.1001\/jama.2025.17854"},{"key":"e_1_2_12_5_1","doi-asserted-by":"publisher","DOI":"10.1177\/2377960818811773"},{"key":"e_1_2_12_6_1","doi-asserted-by":"publisher","DOI":"10.4103\/iju.iju_160_22"},{"key":"e_1_2_12_7_1","doi-asserted-by":"publisher","DOI":"10.1002\/14651858.CD011179.pub2"},{"key":"e_1_2_12_8_1","doi-asserted-by":"publisher","DOI":"10.1186\/s12894-025-01722-w"},{"key":"e_1_2_12_9_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.sipas.2025.100322"},{"key":"e_1_2_12_10_1","doi-asserted-by":"publisher","DOI":"10.1002\/nau.21095"},{"key":"e_1_2_12_11_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00345-013-1134-z"},{"key":"e_1_2_12_12_1","doi-asserted-by":"publisher","DOI":"10.5152\/tud.2019.82783"},{"key":"e_1_2_12_13_1","doi-asserted-by":"publisher","DOI":"10.1590\/s1677-5538.ibju.2019.0402"},{"key":"e_1_2_12_14_1","doi-asserted-by":"publisher","DOI":"10.3390\/biomedicines10112954"},{"key":"e_1_2_12_15_1","doi-asserted-by":"publisher","DOI":"10.1007\/s11255-024-04093-7"},{"key":"e_1_2_12_16_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.euros.2022.08.013"},{"key":"e_1_2_12_17_1","doi-asserted-by":"publisher","DOI":"10.4103\/tcmj.tcmj_25_17"},{"key":"e_1_2_12_18_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.urols.2011.08.007"}],"container-title":["Neurourology and Urodynamics"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/nau.70293","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1002\/nau.70293","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/nau.70293","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,8,17]],"date-time":"2026-08-17T04:54:45Z","timestamp":1786942485000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1002\/nau.70293"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,4,16]]},"references-count":17,"journal-issue":{"issue":"6","published-print":{"date-parts":[[2026,8]]}},"alternative-id":["10.1002\/nau.70293"],"URL":"https:\/\/doi.org\/10.1002\/nau.70293","archive":["Portico"],"relation":{},"ISSN":["0733-2467","1520-6777"],"issn-type":[{"value":"0733-2467","type":"print"},{"value":"1520-6777","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,4,16]]},"assertion":[{"value":"2026-02-02","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-04-09","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-04-16","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}