To assess the correspondence in female bladder outlet obstruction (BOO) diagnosis between
Blaivas-Groutz (BG) and Solomon-Greenwell (SE) nomograms.

This was a multicentric study (6 centers) with data retrospectively collected in 2024 on neurological
and non-neurological females with suggested clinical BOO underwent videourodynamics (VUD).
BOO diagnosis was assessed by VUD criteria. We compared the BOO diagnosis of the two
nomograms with each other and with the VUD diagnosis. We compared BG classes (no BOO:0;
mild BOO: 1, Moderate BOO:2, Severe BOO:3) to SG criteria (<1 no BOO; 6-18 risk BOO >50%,
>18 risk BOO >90%), considering also SG score 1-5 for a further sub analysis.

Data on 125 women (mean age 59.9 y.o.) were available: 63.2% (79) non neurological, 36.8% (46)
neurological. At BG, 4.8% (6) females were obstructed (mild BOO) but unobstructed at VUD. At
SG, 1 patient (0.8%) was obstructed but unobstructed at VUD, 9.6% (12) women were
unobstructed at SG but at VUD BOO was found. Overall, BOO diagnosis was coexistent in the two
nomograms in 84.8% (106). Women with BG 0 were 29 (23.2%), with a correspondent diagnosis at
SG (SG <1) in 96.6% (28/29); all these patients were unobstructed at VUD. In the 67 females with
BG 1, BOO at SG was in 70.7% (49/67): SG 1-5 28.6% (14), SG 6-18 36.7% (18), SG >18 34.7%
(17), intermediate SG class (1-18) 65.3% (32). Among 18 patients with BOO at BG and
unobstructed at SG, 12 (66.7%) were obstructed at VUD, 6 (33.3%) weren’t. Women of BG classes
2 and 3 were all obstructed at VUD and at SG. Of the 18 females with BG 2, 11.1% (2) had a SG
score 6-18 and 88.9% >18. All 11 women who showed BG 3 corresponded to a SG score >18.
Median SG score in BG 0 was -13.8, in BG 1 8.1, in BG 2 33.6, in BG 3 96.6.

An overall correspondence in BOO diagnosis between the two nomograms was found, but with
relevant differences regarding BOO severity. High relation was obtained in case of lack of BOO,
and in severe BOO. The greatest disagreement was found in case of mild BOO at BG, because
more than a quarter of these females were unobstructed at SG. In this group, a greater
concordance with BOO diagnosis at VUD was obtained by BG, while SG overestimated the
unobstruction. For these challenging patients, great care must be taken and VUD results remain
guides. The vast majority of patients with moderate BOO on BG showed very high scores on SG
with very increased likelihood of BOO (>90%, >18). It is like that in case of moderate/intermediate
BOO, the BG nomogram might underestimate the severity of obstruction. Regarding the diagnosis
of VUD, BG tends to overestimate BOO diagnosis, while SG to underestimate BOO.

A high correspondence was found between CG and SG nomograms in the BOO diagnosis.
However, in mild BOO a relevant disagreement was found. Respect to VUD, BG tends to
overestimate BOO diagnosis, while SG to underestimate BOO. VUD diagnosis is still the guide in
BOO diagnosis.

Continence 19S (2026) 102629
DOI: 10.1016/j.cont.2026.102629