Korean J Urol.  2014 May;55(5):341-348. 10.4111/kju.2014.55.5.341.

Chronic Lower Urinary Tract Symptoms in Young Men Without Symptoms of Chronic Prostatitis: Urodynamic Analyses in 308 Men Aged 50 Years or Younger

• Jeong SJ
• Yeon JS
• Lee JK
• Jeong JW
• Lee BK
• Park YH
• Lee SC
• Jeong CW
• Kim JH
• Hong SK
• Byun SS
• Lee SE

• KMID: 1988412
• DOI: http://doi.org/10.4111/kju.2014.55.5.341

Abstract

PURPOSE
We investigated the etiologies of lower urinary tract symptoms (LUTS) and compared urodynamic characteristics between different diagnostic groups in young men with chronic LUTS.
MATERIALS AND METHODS
We reviewed the medical records of 308 men aged 18 to 50 years who had undergone a urodynamic study for chronic LUTS (> or =6 months) without symptoms suggestive of chronic prostatitis.
RESULTS
The men's mean age was 40.4 (+/-10.1) years and their mean duration of symptoms was 38.8 (+/-49.2) months. Urodynamic evaluation demonstrated voiding phase dysfunction in 62.1% of cases (primary bladder neck dysfunction [PBND] in 26.0%, dysfunctional voiding [DV] in 23.4%, and detrusor underactivity [DU]/acontractile detrusor [AD] in 12.7%) and a single storage phase dysfunction in 36.4% of cases (detrusor overactivity [DO] in 13.3%, small cystometric capacity in 17.9%, and reduced bladder sensation in 5.2%). Most of the demographic characteristics and clinical symptoms did not differ between these diagnostic groups. Whereas 53.9% of patients with voiding dysfunction had concomitant storage dysfunction, 69.6% of those with storage dysfunction had concomitant voiding dysfunction. Men with DV or DU/AD exhibited lower maximum cystometric capacity than did those with normal urodynamics. Low bladder compliance was most frequent among patients with PBND (10.0%, p=0.025). In storage dysfunctions, men with DO exhibited higher detrusor pressure during voiding than did those with other storage dysfunctions (p<0.01).
CONCLUSIONS
Because clinical symptoms are not useful for predicting the specific urodynamic etiology of LUTS in this population, urodynamic investigation can help to make an accurate diagnosis and, potentially, to guide appropriate treatment.

Keyword

Age groups; Men; Prevalence; Urinary bladder disease; Urodynamics

MeSH Terms

Compliance
Diagnosis
Humans
Lower Urinary Tract Symptoms*
Male
Medical Records
Neck
Prevalence
Prostatitis*
Sensation
Urinary Bladder
Urinary Bladder Diseases
Urodynamics*

Figure

• 

  FIG. 1 Change in incidence of each specific urodynamic etiology according to patient age. (A) Voiding phase dysfunction, (B) storage phase dysfunction. Among the total patient population, the incidence of PBND was highest among those in their 30s (p=0.04) and that of DO was highest among those in their 40s (p=0.03). SC was more prevalent in men under 40 years of age (p=0.03). PBND, primary bladder neck dysfunction; DV, dysfunctional voiding; DU, detrusor underactivity; AD, acontractile detrusor; DV, dysfunctional voiding; DU, detrusor underactivity; AD, acontractile detrusor; DO, detrusor overactivity; SC, small bladder capacity; RBS, reduced bladder sensation.

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