Urinary flow rates and voiding pressures in elderly men living in a community

We reported that difficult bladder emptying symptoms are prevalent in elderly men. Urodynamic tests were conducted among 94 volunteer male respondents identified from our Medical Epidemiologic and Social Aspects of Aging Study in Washtenaw County, Michigan. Urine flow rates were significantly slower among men with symptoms compared to those without symptoms; however, significant overlap exists. Voiding pressures were not significantly different between respondents with and without difficult bladder emptying symptoms. The results of voiding pressure flow studies on all respondents regardless of whether they have symptoms revealed 41% with an obstructive pattern (high pressure and poor flow), 28.2% with an underactive pattern (low pressure and low flow), 20.5% with a mixed pattern (high pressure and normal flow) and 10.3% with a normal pattern. Symptoms hesitancy was more reflective of weaker detrusor pressure and straining pattern. From these results we conclude that symptoms and flow rates should not be used as the sole criterion to diagnose obstruction but, rather, they should be included in the entire spectrum of clinical information needed to arrive at a clinical diagnosis.