Urodynamic evaluation

Over the past decade, distinction among the terms benign prostatic hyperplasia, benign prostatic enlargement, and bladder outlet obstruction has led to the recognition that not all patients with 'benign prostatic hyperplasia' or lower urinary tract symptoms have prostatic enlargement or outlet obstruction. The definition of bladder outlet obstruction relies primarily on the urodynamic evaluation. However, the indications for such an evaluation, its extent and methodology, the reproducibility of certain measurements such as the detrusor pressure at maximum flow, and the interpretation of the urodynamic curves using various existing nomograms are still intensely debated. This article reviews these controversial issues and attempts to define the future role of the urodynamic evaluation in the management of benign prostatic hyperplasia.