{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,12]],"date-time":"2026-10-12T11:46:00Z","timestamp":1791805560594,"version":"4.3.4"},"reference-count":20,"publisher":"Wiley","license":[{"start":{"date-parts":[[2026,10,12]],"date-time":"2026-10-12T00:00:00Z","timestamp":1791763200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"},{"start":{"date-parts":[[2026,10,12]],"date-time":"2026-10-12T00:00:00Z","timestamp":1791763200000},"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"],"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Objectives<\/jats:title>\n                    <jats:p>The aim of this study was to assess the concordance between three classification systems (bladder contractility index, Maximum Watt's factor and Maastricht\u2013Hannover nomogram) in allocating men to bladder contractility subgroups. Secondary aim was to explore whether preoperative contractility classification was associated with short\u2010term flowmetry outcomes after BOP.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Materials and Methods<\/jats:title>\n                    <jats:p>This multicenter retrospective cohort study included men who underwent BOP (2010\u20132016) for lower urinary tract symptoms with available baseline urodynamic study and 6\u2010week postoperative flowmetry. Patients were classified according to BCI, Wmax and MH\u2010nomogram into very weak (BCI\u2009&lt;\u200950, Wmax\u2009&lt;\u20095, MH\u2010nomogram\u2009&lt;\u200910th percentile), weak (BCI: 50\u2013100, Wmax: 5\u201310, MH\u2010nomogram 10\u201325th percentile) and normal detrusor contractility (BCI\u2009&gt;\u2009100, Wmax\u2009&gt;\u200910, MH\u2010nomogram\u2009&gt;\u200925th percentile) subgroups. Concordance was quantified using percentage agreement and Cohen's linear weighted kappa (\u03ba). Postoperative flowmetry outcomes were compared between subgroups within each classification and pre\u2010postoperative differences were determined for each subgroup.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      One hundred and thirty three patients were included (median age 69 years). Agreement was highest between BCI and Wmax (78.9%,\n                      <jats:italic>\u03ba<\/jats:italic>\n                      \u2009=\u20090.61, substantial), while agreement was weak between Wmax and MH\u2010nomogram (48.9%,\n                      <jats:italic>\u03ba<\/jats:italic>\n                      \u2009=\u20090.31) and negligible between BCI and MH\u2010nomogram (37.6%,\n                      <jats:italic>\u03ba<\/jats:italic>\n                      \u2009=\u20090.05). All subgroups showed improvement Qmax and PVR parameters after BOP, with no significant association found between preoperative contractility grade and postoperative outcomes.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>BCI, Wmax and the MH\u2010nomogram show only limited concordance, particularly involving the MH\u2010nomogram, and cannot be regarded as interchangeable. Contractility classification was not associated with postoperative outcomes, and all subgroups improved after BOP. These findings underscore the need for a clinically relevant urodynamic consensus definition of DU and support shared decision\u2010making over classification\u2010based patient selection alone.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/nau.70489","type":"journal-article","created":{"date-parts":[[2026,10,12]],"date-time":"2026-10-12T11:01:21Z","timestamp":1791802881000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Bladder Contractility Classification Before Bladder Outlet Surgery: Do BCI, Wmax and the Maastricht\u2013Hannover Nomogram Agree and Does It Matter for Outcome?"],"prefix":"10.1002","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-5744-0141","authenticated-orcid":false,"given":"Selma","family":"Palthe","sequence":"first","affiliation":[{"name":"Department of Urology Isala Clinics Zwolle the Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9209-8030","authenticated-orcid":false,"given":"Nadine A. M.","family":"van Merode","sequence":"additional","affiliation":[{"name":"Department of Urology Isala Clinics Zwolle the Netherlands"},{"name":"Department of Urology Maastricht University Maastricht the Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4473-579X","authenticated-orcid":false,"given":"Jeroen","family":"Kolenburg","sequence":"additional","affiliation":[{"name":"Department of Urology Maastricht University Maastricht the Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4823-1062","authenticated-orcid":false,"given":"Tom","family":"Marcelissen","sequence":"additional","affiliation":[{"name":"Department of Urology Maastricht University Maastricht the Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Martijn G.","family":"Steffens","sequence":"additional","affiliation":[{"name":"Department of Urology Isala Clinics Zwolle the Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2328-8265","authenticated-orcid":false,"given":"Gommert A.","family":"van Koeveringe","sequence":"additional","affiliation":[{"name":"Department of Urology Maastricht University Maastricht the Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1570-1945","authenticated-orcid":false,"given":"John P.","family":"Heesakkers","sequence":"additional","affiliation":[{"name":"Department of Urology Maastricht University Maastricht the Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1567-4847","authenticated-orcid":false,"given":"Lambertus P. W.","family":"Witte","sequence":"additional","affiliation":[{"name":"Department of Urology Isala Clinics Zwolle the Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,10,12]]},"reference":[{"key":"e_1_2_12_2_1","doi-asserted-by":"publisher","DOI":"10.1111\/J.1464-410X.2003.04719.X"},{"key":"e_1_2_12_3_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.juro.2017.07.079"},{"key":"e_1_2_12_4_1","doi-asserted-by":"publisher","DOI":"10.1002\/NAU.25336"},{"key":"e_1_2_12_5_1","doi-asserted-by":"publisher","DOI":"10.1002\/NAU.25253"},{"key":"e_1_2_12_6_1","doi-asserted-by":"publisher","DOI":"10.1002\/NAU.23124"},{"key":"e_1_2_12_7_1","doi-asserted-by":"publisher","DOI":"10.1002\/NAU.23096"},{"key":"e_1_2_12_8_1","doi-asserted-by":"publisher","DOI":"10.11613\/bm.2012.031"},{"key":"e_1_2_12_9_1","doi-asserted-by":"publisher","DOI":"10.1016\/J.EUF.2025.12.018"},{"key":"e_1_2_12_10_1","doi-asserted-by":"publisher","DOI":"10.1002\/NAU.1930100102"},{"key":"e_1_2_12_11_1","doi-asserted-by":"publisher","DOI":"10.1002\/NAU.21097"},{"key":"e_1_2_12_12_1","doi-asserted-by":"publisher","DOI":"10.1002\/NAU.22841"},{"key":"e_1_2_12_13_1","doi-asserted-by":"publisher","DOI":"10.1007\/S00345-014-1358-6"},{"key":"e_1_2_12_14_1","doi-asserted-by":"publisher","DOI":"10.1002\/nau.23260"},{"key":"e_1_2_12_15_1","doi-asserted-by":"publisher","DOI":"10.4111\/ICU.2017.58.4.247"},{"key":"e_1_2_12_16_1","doi-asserted-by":"publisher","DOI":"10.1007\/978-1-4899-1585-6_3"},{"key":"e_1_2_12_17_1","doi-asserted-by":"publisher","DOI":"10.1186\/S12894-018-0329-4"},{"key":"e_1_2_12_18_1","doi-asserted-by":"publisher","DOI":"10.1002\/nau.24122"},{"key":"e_1_2_12_19_1","doi-asserted-by":"publisher","DOI":"10.1038\/s41598-021-04237-0"},{"key":"e_1_2_12_20_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.neurom.2022.04.042"},{"key":"e_1_2_12_21_1","doi-asserted-by":"publisher","DOI":"10.1016\/J.JURO.2012.08.010"}],"container-title":["Neurourology and Urodynamics"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/nau.70489","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1002\/nau.70489","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/nau.70489","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,10,12]],"date-time":"2026-10-12T11:01:22Z","timestamp":1791802882000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1002\/nau.70489"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,10,12]]},"references-count":20,"alternative-id":["10.1002\/nau.70489"],"URL":"https:\/\/doi.org\/10.1002\/nau.70489","archive":["Portico"],"relation":{},"ISSN":["0733-2467","1520-6777"],"issn-type":[{"value":"0733-2467","type":"print"},{"value":"1520-6777","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,10,12]]},"assertion":[{"value":"2026-08-25","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-10-05","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-10-12","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}],"article-number":"nau.70489"}}