The tolerability of urodynamic studies and flexible cystourethroscopy usedin the assessment of men with lower urinary tract symptoms

Objective To determine the overall tolerability of urodynamic studies used in the assessment of men with lower urinary tract symptoms (LUTS), by asses sing the objective and subjective morbidity experienced during and after ur odynamic studies, and to assess the voiding complaints caused by the combin ation of urodynamic studies with flexible cysto-urethroscopy. Patients and methods A total of 103 men with LUTS, who underwent a urodynam ic study combined with flexible cysto-urethroscopy, completed a questionnai re designed to assess objective and subjective symptoms and degree of bothe r, with emphasis on the urodynamic study. In addition, a urine specimen was analysed and cultured, In all, 78 patients who underwent a second urodynam ic study completed the questionnaire twice, Results The results of the first questionnaire showed that more than half o f the patients experienced some urge after the urodynamic study and cysto-u rethroscopy (56%), 35% of the patients experienced little and 19% experienc ed severe voiding discomfort after the combined investigations, compared wi th 24% and 5%, respectively, after a urodynamic study alone. Three patients (3%) had a symptomatic urinary tract infection. Haematuria, increased void ing frequency and increased nocturia occurred occasionally. Most of the pat ients found the urodynamic study less bothersome than they had expected (64 %) and only 9% found it worse than expected, The overall degree of discomfo rt, experienced during and after the urodynamic study combined with cysto-u rethroscopy, was low, and after a second urodynamic study was even lower. Conclusion In contrast with earlier results, this clinic-based urodynamic i nvestigation was associated with a low proportion of urinary tract infectio n, and low objective and subjective morbidity. The combination of a urodyna mic study with a flexible cysto-urethroscopy does not cause significant add itional voiding complaints. Most patients find urodynamic studies tolerable and not very bothersome.