BPH with coexisting overactive bladder dysfunction - An everyday urological dilemma

The aim of this study was to use a systematic schedule, including urodynami cs, to describe the rate of coexisting overactive bladder (OB) in patients with bladder outlet obstruction (BOO) caused by benign prostatic hyperplasi a (BPH). We also identified differences between the patients with pure BOO compared with those with BOO combined with OB (BOO + OB). One hundred and s ixty-two men referred to our clinic due to LUTS were included. Patients wit h a history that might affect their bladder function were excluded. After c ystometry and pressure-Row studies, the patients were divided into pure BOO and BOO + OB. Of the 162 men, 55% had pure BOO. BOO + OB was found in 45%. Age, s-PSA, voided volume, and obstruction grade differed significantly be tween the groups. The patients with BOO + OB were older, had a higher s-PSA , voided smaller volumes, and were more obstructed. We found no differences in TRUS-volume. Q-max, IPS score, or PVR. There was a strong association b etween OB and BOG, the percentage of OB increasing with increased obstructi on. TRUS-volume, Q-max, IPS score, and PVR did not predict whether the pati ents had a combined BOO + OB or not. These findings indicate that BOO is a progressive disease, which in time causes pronounced obstruction and perhap s in itself contributes to the development of OB. Neurourol. Urodynam. 20:2 37-247, 2001. (C) 2001 Wiley-Liss, Inc.