Introduction and Objectives
The purpose of the investigation was to conduct urodynamic evaluation on patients with chronic pelvic pain syndrome (CPPS) and thus define a specific urodynamic profile that might add to the pathophysiology of the syndrome. This profile may also aid definitive treatment.
Material and Methods
Participants were 34 men with mean age 34.2 (SD = 8.5; range, 24–45 years). All patients presented with symptoms of chronic prostatitis (eg, dysuria, frequency of micturition, burning perineal sensation, lower abdominal discomfort and/or suprapubic pain). They were classified as having CPPS after excluding prostatic infection by standard bacteriological methods. The patients were then evaluated with urodynamic measures including free-flow rate, filling (water) cystometry, a pressure-flow study of micturition, and electromyography of the external urethral sphincter.
Of the 34 total patients, 22 (64.7%) had a low mean Qmax of 10.4±1.6 mL/s (range, 4–14 mL/s); 25 (73.5%) had a first sensation of filling and 27 (79.4%) a first desire to void at low volumes (<150 and <250, respectively). Nine patients (26.5%, 7 obstructed and 2 unobstructed) had idiopathic detrusor overactivity. Regarding pressure-flow measures, 25 (73.5%) had an obstructive pattern of micturition, as defined by a low Qmax of 9.7±1.44 mL/s, a high intravesical pressure at maximum flow of 87.4±4.5 cmH2O, and an increased opening intravesical pressure of 76.7±4.5 cmH2O. The EMG of the external sphincter was normal in all patients.
A significant proportion of the patients with CPPS had a particular urodynamic pattern of functional infravesical obstruction and sensory bladder deficit.
© 2009 European Association of Urology. Published by Elsevier Inc. All rights reserved.