The assessment of prostatic obstruction from urodynamic measurements and from residual urine

One hundred and seventeen males over the age of 55 were investigated for possible prostatic obstruction. About half of the cases in this series could have been objectively classified as unobstructed or obstructed from the maximum flow rate alone. In about two-thirds of the cases obstruction could be satisfactorily assessed from the maximum flow rate together with the detrusor pressure at maximum flow. It was not helpful to combine these 2 measurements into a single urethral resistance factor. In the remaining one-third of the cases, obstruction could be objectively assessed only from a plot of detrusor pressure against flow rate throughout micturition. In many of these cases both the pressure and the flow rate were low and the main peculiarity was that the contractile power of the bladder was weak. Residual urine is a sign of an abnormality of bladder function rather than the direct result of urethral obstruction.