[Paraclinical explorations of urination disorders in men]

The uroflowmetry is still the only criteria to show and analyse a dysuria unknown by the patient two times out of three. This analysis will allow us to appreciate the follow-up of the desobstruction regarding the therapeutic which has been chosen. The ultrasonography (renal ultrasonography and prostate) can easily detect bladder and renal failures. It provides good information on anatomical and shape of the prostate but less information on urethral obstruction because dynamic ultrasonography is carried out in a few cases. The intravenous pyelography seems to be out of date but it will give the most important parameters to appreciate the urinary problems allowing the analysis of the physiological micturation by voiding urethrography. The retrograd urethrography provides good imaging diagnosis but gives a better image of urethral stenosis in a very important dysuria. It is not appropriate to say that it is an invasive procedure. The endoscopy is very convenient. It could be used during an examination and need no anesthetic to be performed with an optical fibroscope. The urodynamic examination is needed only in a major dysuria without real obstruction or detrusor instability. First the obstruction has to be evaluated by the previous examinations. It could point out that some bladders are hypocontractile and in these cases, surgery will be inappropriate. Also it allows us to test the effectiveness of external sphincter pressure to determine the prognostic of continence and even to treat the incontinence by biofeedback.