Prostatodynia: Clinical and Urodynamic Characteristics

Choi, In Kyu; Oh, Chung Hwan; Moon, Woo Chul

Abstract

Sixteen patients with prostatodynia underwent clinical studies including urodynamic study, MMPI, and endoscopy. As a control group, another 19 patients with nonbacterial prostatitis and 16 normal man of 20-40 years of age also underwent urodynamic study. The most characteristic urodynamic findings in patients with prostatodynia was a significant increase in maximum urethral closing pressure as compared to control group (mean, 140.9 : 92.1 : 84.1 cmH20). In prostatodynia group, peak urinary flow rate was also significantly decreased as compared to the control group (mean, 12.0: 17.8 : 23.9cc / sec). 11 of 16 patients with prostatodynia was found to have functional outlet obstruction, probably at sympathetically innervated urethral sphincter. And they were treated with minipress and diazepam, of whom 7 showed significant improvement both symptomatically and urodynamically. On MMPI 7patients with prostatodynia showed significant underlying psychiatric disorders, and were treated by psychiatric treatment, of whom 4 showed significant clinical improvement. 2 patients with prostatodynia showed vermontanal pseudopolyp suggestive of prostatitis, were treated with long term TMF-SMX administration, and showed significant improvement. It is suggested that prostatodynia may develop from urethral sphincter overactivity and underlying psychiatric disorders, and that at least some cases with prostatodynia are in fact prostatitis. Uroflowmetry, urethral pressure profile, MMPI study and repeated EPS study may be of help in deciding the treatment plan of prostatodynia.