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Test-retest reliability of repeated voids in pressure-flow studies and the influence on maximum flow rate (Q max pQ), detrusor pressure at maximum flow rate (p det Q max ), voided volume, and residual urine were studied. Also the agreement in interpretation of pressureflow tracings between investigators and a single blinded central reader acting as a quality control center (QCC) were assessed. In addition, correlations between p det Q max and patient age, International Prostate Symptom Score (IPSS), free maximum flow rate (Q max ), and prostate volume were calculated. Using suprapubic pressure recording, 216 men with lower urinary tract symptoms (LUTS) due to benign prostatic enlargement (BPE) were investigated in 11 centers. In each pressure-flow study, three sequential voids were performed, and quality controlled recordings were analyzed for Q max pQ and p det Q max by the QCC. PROD #1031rectal ultrasound was used to measure the prostate volume. Mean Q max pQ did not change, but p det Q max decreased significantly in the second and third sequential voids. Using the Abrams-Griffiths nomogram definition of obstruction, 125 patients (67%) were classified as obstructed from the first void, but only 111 patients (59%) from the third void. The agreement between the investigator assessment and that of a single blinded reader was good.There was no significant correlation between p det Q max and patient age, IPSS, and Q max , whereas a modest correlation was found between p det Q max and prostate volume. In summary, there was no significant change in Q max pQ, but p det Q max decreased for the three consecutive voids, which can be explained by a decrease in outlet resistance. The agreement between the investigator and QCC interpretations shows the value of a standardized technique, supporting the feasibility of multicenter urodynamic studies. There is a modest, but statistically significant, correlation between detrusor pressure and prostate size, supporting the hypothesis that prostate size is a contributing factor in symptomatic BPH. Neurourol.

Finasteride treatment resulted in improvements in urodynamic parameters, which were greater in men with large prostates.

Finasteride treatment resulted in improvements in urodynamic parameters, which were greater in men with large prostates.

Objective  To determine the effectiveness and safety of transurethral electrovaporization in the treatment of benign prostatic enlargement (BPE). Patients and methods  The study comprised 91 patients (median age 65 years) with BPE (median prostate volume 61 mL). Patients were assessed with a general and urological history, the International prostate symptom score (IPSS), urinary tract and prostatic ultrasonography, uroflowmetry and biopsy of the prostate. An electrosurgical generator (cutting at 200 W and coagulating at 70 W) with grooved electrodes was used to vaporize the prostate. The variables assessed before and after treatment were the IPSS, quality‐of‐life score, uroflowmetry, complications, and the duration of hospitalization. Results  The mean operative duration was 45 min, blood loss was negligible and the mean duration of catheterization was 24 h. Recatheterization was necessary in 5.5% of patients. The median values before and after treatment were: IPSS, 19 and 5; QOL score, 4 and 2; and maximum urinary flow rate 8.3 and 22.1 mL/s (all P<0.001). In nearly all cases, the Siroky nomogram showed that patients became unobstructed. Conclusions  Electrovaporization of the prostate has many advantages over other techniques used in the treatment of BPE, including transurethral resection (TURP). It is cheaper than laser‐assisted prostatectomy in particular and is also simpler to perform. Higher‐risk patients can be treated, it uses existing electrosurgical equipment with minor modifications and only the electrodes, which are inexpensive, differ from TUR loops; the TURP resectoscope can be used and there is almost no need for blood transfusion. Intra‐ and post‐operative morbidity is very low, recatheterization rare, the hospital stay brief and the results equal to or better than those obtained with TURP. Convalescence is generally uneventful and rapid because haematuria is rare and, when present, mild. Patients can return to work earlier than after TURP. Although a promising technique, only a longer follow‐up will allow firm conclusions about its suitability.

Etofenamate and diclofenac were similarly effective and tolerated in the relief of acute renal colic.

Test‐retest reliability of repeated voids in pressure‐flow studies and the influence on maximum flow rate (QmaxpQ), detrusor pressure at maximum flow rate (pdetQmax), voided volume, and residual urine were studied. Also the agreement in interpretation of pressure‐flow tracings between investigators and a single blinded central reader acting as a quality control center (QCC) were assessed. In addition, correlations between pdetQmax and patient age, International Prostate Symptom Score (IPSS), free maximum flow rate (Qmax), and prostate volume were calculated. Using suprapubic pressure recording, 216 men with lower urinary tract symptoms (LUTS) due to benign prostatic enlargement (BPE) were investigated in 11 centers. In each pressure‐flow study, three sequential voids were performed, and quality controlled recordings were analyzed for QmaxpQ and pdetQmax by the QCC. Trans‐ rectal ultrasound was used to measure the prostate volume. Mean QmaxpQ did not change, but pdetQmax decreased significantly in the second and third sequential voids. Using the Abrams‐Griffiths nomogram definition of obstruction, 125 patients (67%) were classified as obstructed from the first void, but only 111 patients (59%) from the third void. The agreement between the investigator assessment and that of a single blinded reader was good. There was no significant correlation between pdetQmax and patient age, IPSS, and Qmax, whereas a modest correlation was found between pdetQmax and prostate volume. In summary, there was no significant change in QmaxpQ, but pdetQmax decreased for the three consecutive voids, which can be explained by a decrease in outlet resistance. The agreement between the investigator and QCC interpretations shows the value of a standardized technique, supporting the feasibility of multicenter urodynamic studies. There is a modest, but statistically significant, correlation between detrusor pressure and prostate size, supporting the hypothesis that prostate size is a contributing factor in symptomatic BPH. Neurourol. Urodynam. 18:17–24, 1999. © 1999 Wiley‐Liss, Inc.