Can urodynamics distinguish between urethral strictures and Benign Prostatic Hyperplasia (BPH)?

Abstract

Objectives:

We tested whether pressure flow studies could distinguish between patients with Benign Prostatic Hyperplasia (BPH) and urethral strictures and hypothesised that urethral strictures were associated with a lower closure pressure and increased slope of the passive urethral relation compared to benign prostatic obstruction.

Patients and method:

Ninety patients who had Transurethral Resection of Prostate (TURP) and 45 male patients who had an optical urethrotomy or urethral dilatation for urethral stricture disease, who had a prior urodynamics study, were evaluated.

Results:

Patients with urethral stricture disease had lower closure pressures than those undergoing TURP (22.07 vs. 28.4 cmH₂O, p=0.0039, r=0.61). However, the slope of the passive urethral relation was indistinguishable between the two groups. Only 60% of patients with symptomatic urethral strictures were categorised as unequivocally obstructed by the Abrams-Griffiths nomogram.

Conclusion:

Urethral strictures are associated with lower closure pressures than prostatic obstruction; however, there was no difference in the urethral resistance relation.