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Videourodynamics identifies the causes of young men with lower urinary tract symptoms and low uroflow
Chung Cheng Wang1, Stephen Shei Dei Yang, Yung Tai Chen
1Department of Urology, En Chu Kong Hospital, College of Medicine, National Taiwan University and Taipei Medical University, 399 Fushing Road, Sanhsia Town, Taipei Hsien, Taipei 237, Taiwan, ROC.
Objectives:
Using videourodynamics (VUDS) we prospectively investigated the etiologies of lower urinary tract symptoms (LUTS) and low uroflow in young men and correlated the results with clinical symptoms and noninvasive exams.
Methods:
From 1999 to 2001, 90 men 18-50 years old with LUTS and low uroflow were enrolled. Patients with active urinary tract infection, congenital urogenital diseases, neurological diseases, diabetes mellitus or urinary tract malignancy were excluded. Evaluation included International Prostate Symptom Score (I-PSS), renosonography, transrectal ultrasonography of prostate and VUDS. The clinical parameters were compared in the different diagnostic groups of patients classified by VUDS.
Results:
Mean patient age was 37.5+/-7.8 years and mean symptom duration was 28.3+/-21.3 months. Mean total I-PSS was 19.8, voiding 11.1 and storage 8.7. VUDS showed dysfunctional voiding in 39 (43%), primary bladder neck obstruction in 37 (41%), impaired detrusor contractility in 9 (10%) and benign prostatic obstruction in 5 (6%). Patients with impaired detrusor contractility had higher symptoms scores and poorer quality of life than those in the other diagnostic groups. Mean age and size of prostate in patients with benign prostatic obstruction were greater than those in the remaining groups. The remaining clinical symptoms or noninvasive tests could not predict a specific urodynamic diagnosis.
Conclusions:
VUDS is recommended to make an accurate diagnosis in young men with LUTS and low uroflow because few clinical symptoms or noninvasive tests were helpful in this regard.