The urodynamic profile of prostatodynia

Objective To evaluate urodynamically patients with prostatodynia, and thus define a specific urodynamic pattern that might add to the pathophysiology of the syndrome and possibly aid definitive treatment. Patients and methods Forty-three patients (mean age 38.1 years, SD 9.25, ra nge 24-59) with symptoms suggestive of chronic prostatitis, e.g, dysuria, f requency of micturition and a burning sensation in the perineum, were class ified as having prostatodynia after excluding prostatic infection by standa rd bacteriological methods. Thereafter. the patients were evaluated urodyna mically, including the measurement of free flow-rate, filling (water) cysto metry, a pressure/flow study of micturition, with fluoroscopy and electromy ography of the external urethral sphincter, Results Twenty-eight patients (65%) had a low maximum free flow rate (Q(max )), with a mean (SD) of 10.91 (1.26) mL/s. Of the 42 patients who underwent filling cystometry, 26 (62%) had a first sensation of filling, and 28 (67% ) a first desire to void, at low volumes (<150 ml and <300 mL, respectively ). Of the 25 patients who underwent a pressure/flow study, 16 (64%) had an obstructive pattern of micturition, as defined by a low Q(max) of 10.04 (1. 38) mL/s and a high intravesical pressure at Q(max) of 83.3 (5.3) cmH(2)O. The site of obstruction was at the level of the bladder neck, as confirmed by fluoroscopy. Conclusion A significant proportion of these patients had a particular urod ynamic pattern of functional infravesical obstruction at the level of the b ladder neck and sensory disturbances.