BLADDER OUTLET OBSTRUCTION AND URODYNAMIC EVALUATION IN PATIENTS WITH BENIGN PROSTATIC HYPERPLASIA

Bladder outlet obstruction is one of the most important factors determining voiding symptomatology in patients with benign prostatic hyperplasia (BPH) and urodynamic studies remain the best tool to diagnose and measure bladder outlet obstruction. It also enables the evaluation of other important aspects of bladder physiology like the presence of instability, changes in bladder compliance and detrusor contractility, which may be important in patients’ symptomatology and prognosis. However, controversies exist in the role of urodynamics as a diagnostic tool in BPH, and it is considered an optional exam in the investigation of the majority of patients with BPH. The advent of effective non-invasive treatment alternatives for BPH has restricted surgery for patients with overt bladder obstruction and for those who fail conservative treatment. This makes urodynamic studies even more important in the evaluation of BPH patients. The objective of this review article is to discuss the applications and limitations of different urodynamic modalities in the diagnosis and treatment of BPH and discuss the impact of bladder outlet obstruction.