Evoked response studies in detrusor hyperreflexia due to infravesical obstruction in neurological patients

Urodynamic evaluation was performed on 80 patients with urological disorders identified as benign prostatic hypertrophy whose main complaints ranged from irritation to urine loss owing to urgency. Detrusor hyperreflexia was detected in 40 patients, of whom 24 were operated on either by the transurethral or the retropubic approach. At repeat urodynamic evaluation about 1 year postoperatively function had returned to normal in 14 patients and the hyperreflexia persisted in 10. The preoperative evoked response in these latter 10 patients was less than 60 msec. It is possible that apart from the diagnosis of detrusor hyperreflexia by cystometric examination in patients with benign prostatic hypertrophy an abbreviated evoked response could indicate deterioration in neural function with or without an accompanying neurological disease. If this is the cause of detrusor hyperreflexia then prostatectomy will not ameliorate the condition but can only subject the patient to the risk of urine loss.