Prostatism. III. Detrusor hyperreflexia and residual urine. Clinical and urodynamic aspects and the influence of surgery on the prostate.

Detrusor reflex function and residual urine were assessed in 104 consecutive patients referred to hospital with prostatism. 53% of the patients had detrusor hyperreflexia, whereas a decompensated bladder was found in only 10% of the patients. A longer duration of symptoms was found among the patients with decompensated bladder, suggesting two different clinical courses of bladder outlet obstruction. Detrusor hyperreflexia did not bear any statistically significant correlation to urodynamic parameters of intravesical obstruction, but in 26 of the patients with detrusor hyperreflexia undergoing surgery on the prostate, 69% (95% confidence limits, 48-86%) gained normal detrusor reflex function 6 months after surgery. Residual urine volume was statistically significantly correlated to urodynamic parameters reflecting the function of the detrusor muscle, but not to the maximum flow rate.