Data concerning learned voiding dysfunction (Hinman syndrome; non-neurogeni
c, neurogenic bladder) in adults are scarce. The present study was conducte
d to assess the pre valence and clinical characteristics of this dysfunctio
n among adults referred for evaluation of lower urinary tract symptoms. Lea
rned voiding dysfunction was suggested by a characteristic clinical history
and intermittent "free" uroflow pattern and by the absence of any detectab
le neurological abnormality or anatomic urethral obstruction. A definitive
diagnosis was made by the demonstration of typical external urethral sphinc
ter contractions during micturition by EMG or fluoroscopy. A urodynamic dat
abase of 1,015 consecutive adults was reviewed. Twenty-one (2%) patients (a
ge, 24-76 years) met our strict criteria of learned voiding dysfunction. Ob
structive symptoms were the most common presenting symptoms, followed by fr
equency, nocturia, and urgency. Eight (35%) patients had recurrent urinary
tract infections, seven of these being women. None of the patients had any
clinically significant upper urinary tract damage. First sensation volume w
as significantly lower in women than in men. Both detrusor pressure at maxi
mum Row and maximum detrusor pressure during voiding were found to be signi
ficantly higher in men than in women. Further differentiation between adult
women and men failed to reveal any other clinically significant difference
s. In conclusion, by strict video-urodynamic criteria, 2% of our patients h
ad learned voiding dysfunction. Other patients, with presumed learned voidi
ng dysfunction, who did nor undergo video-urodynamics were not included in
the present series. Thus, the prevalence of learned voiding dysfunction amo
ng adults referred for evaluation of lower urinary tract symptoms is likely
to be even higher. Neurourol. Urodynam. 20:259-268, 2001. (C) 2001 Wiley-L
iss, Inc.