Urodynamic evaluation of bladder neck obstruction in chronic prostatitis

Urodynamic assessment was performed in 50 patients with symptoms which supported a diagnosis of chronic prostatitis and commonly suggested outflow obstruction. Twenty-three patients had bladder instability with an equal incidence with or without obstruction; this was demonstrated in 30 patients and was localised to the bladder neck in 24 and to the prostate in 6. A sensory problem presented on urodynamic testing in 26 patients (52% of the entire series), with a lower incidence (43%) in the obstructed group. Posterior urethritis was found in 28 (78%) of 36 patients subjected to cystourethroscopy. Endoscopic findings were suggestive of obstruction in 20 (95%) of 21 patients with urodynamic evidence of outflow obstruction and the sites of obstruction generally corresponded. The studies have provided urodynamic evidence that bladder neck obstruction could be a significant though not a predominant factor in the aetiology of the clinical syndrome of chronic prostatitis.