Urodynamics in Benign Prostatic Hypertrophy: Arguments “against”

Abstract

Many of our colleagues believe that in the evaluation of patients with BPH-related cervico-urethral obstruction, pressure-flow urodynamics should only be performed as an optional test and should not be considered as part of the routine diagnostic process. They argue that correct diagnosis is based on accurate medical history, rectal examination, uroflow measurements and post-voiding residual volume. They also object that urodynamics literature is largely retrospective and is based on the experience of individual Centres. It reports a reduction in incorrect indications for TURP in patients subjected to routine pressure-flow evaluation; this reduction, however, is only minimal. They argue that despite pressure-flow urodynamics now being a standardized procedure, the data it provides and their analysis vary among the different Centres, thus producing discrepancies in performance and reproducibility. The invasiveness and high costs related to this procedure do not justify its routine use.