Urodynamics in benign prostatic hyperplasia: a survey.

Urodynamic investigations have been used in the diagnosis of prostatic obstruction for the last 30 years. The methods have changed, and the emphasis is now more on diagnosing borderline cases and ruling out obstruction than actually demonstrating the obstruction. The philosophy surrounding the clinical management of benign prostatic hyperplasia (BPH) is changing. Three concepts are useful in this context: the presence of actual prostatic enlargement, the symptomatology, and the presence of urodynamic obstruction. These items are not always present together. It is of extreme importance for our understanding of BPH to realize the way these concepts interrelate. The paper stresses the importance of detrusor-related phenomena in the symptomatology and urodynamics.