RESUMEN
The purpose of diagnostic evaluation in bladder outlet, obstruction is to identify precisely the pathophysiology underlying the patient's symptoms so that rational therapy directed at relieving the most related cause of the symptoms can be initiated. One hundred, patients diagnosed by clinical, radiological and endoscopic means as having bladder outflow obstruction were evaluated by 1] Detailed symptom score, 2] Uroflowmetry, 3] Cystometry 4] EMG of perianal muscles and 5] Pressure-Flow. The pressure-flow data were applied the pressure and flow diagram constructed by Schafer [1990]. Another twenty non obstructed controls were evaluated by the same procedures. Symptom score was higher in the OBS group, but no correlation was found between symptom score and urethral resistance in the OBS group. Detrusor instability [DI] was found in 43% of patients. Significantly higher opening pressure [56.83 +/- 40.01] and residual urine [170.26 +/- 129.94] were found in the OBS group versus those of controls, [3l.65 +/- 95.2] and [23.5 +/- 14.06] successively. We concluded that the pressure flow study remains to be the corner-stone for diagnosis of outflow obstruction, and that symptoms of prostatism are not totally related to simple outlet obstruction as they may be caused by weak detrusor and DI in addition