Prostatism. I. The correlation between symptoms, cystometric and urodynamic findings

Area of Science:

• Urology
• Nephrology
• Physiology

Background:

• Bladder outlet obstruction (BOO) presents with diverse lower urinary tract symptoms (LUTS).
• Accurate diagnosis is crucial for effective treatment selection, particularly surgical intervention.
• Conventional urological assessments may not always correlate with urodynamic findings.

Purpose of the Study:

• To investigate the correlation between patient-reported symptoms of BOO and objective urodynamic findings.
• To identify the prevalence of bladder neck dyssynergia (BND) in patients with LUTS.
• To determine the necessity of objective urodynamic assessment for surgical candidate selection.

Main Methods:

• Cystometry and combined pressure-flow-electromyography were performed on 107 patients with suspected BOO.
• Analysis focused on correlations between infravesical obstruction symptoms and hydrodynamic parameters.
• Assessment included evaluation for detrusor hyperreflexia and bladder neck dyssynergia.

Main Results:

• Infravesical obstruction symptoms showed no significant correlation with urodynamically determined bladder outlet resistance.
• Irritative LUTS (frequency, nocturia, urgency, urge incontinence) were significantly correlated with detrusor hyperreflexia.
• Bladder neck dyssynergia was diagnosed in 5% of patients, a condition not detectable by conventional urological methods.

Conclusions:

• Objective urodynamic evidence of infravesical obstruction is essential for selecting patients with LUTS for prostate or bladder neck surgery.
• Urodynamic investigation is critical for diagnosing conditions like detrusor hyperreflexia and BND.
• Relying solely on symptom presentation can lead to misdiagnosis and inappropriate treatment selection.