[Value of functional examination techniques for the assessment of the clinical aspects of benign prostatic...

The urodynamic relevance of benign prostatic hyperplasia (BPH) is determined by evaluation of the symptoms of prostatism, the degree of infravesical obstruction and the size of adenoma. The combination of all three findings, but also the presence of at least of two of these findings suggest a diagnosis of clinical BPH. Standard diagnostic procedures consist in elicitation of the history, evaluation of symptoms, physical examination, urinalysis and laboratory examination of serum creatinine; with evaluation of residual urine and uroflowmetry in addition, surgical therapy can be expected to be successful in 93%. Urinary flow rates exceeding 15 ml/s and/or discrepancies between symptoms and findings need further assessment by synchronous pressure-flow studies for differential diagnosis between unobstructed flow and high-flow outflow obstruction. Complete videourodynamic investigation is indicated both in patients with combined BPH and urinary incontinence without residual urine and in patients with BPH and suspected or known neurological disorder. Surgical treatment of BPH involves the risk of postoperative incontinence in patients with detrusor hyperreflexia combined with a functional or morphological lesion of the external urinary sphincter.