[Diagnosis and treatment of functional disorders of the lower urinary tract in younger men].
BACKGROUND
Functional disorders of the lower urinary tract can manifest by different symptoms. This could be caused by inaccurate diagnosis and non-causal treatment in young men. Urodynamics is helpful in the differential diagnosis and treatment of such cases.


OBJECTIVE
Examination of lower urinary tract functions in young men and causal treatment of both bladder neck obstruction or impaired bladder.


METHODS
In a prospective study, a group of 38 young men were treated at mean age of 42 years (range 19-50 yrs). Chronic abacterial prostatitis was treated in all cases unsuccessfully. Patients with positive urinary infection, previous surgery of the lower urinary tract and neurogenic bladder were excluded. Urodynamics confirmed a bladder neck obstruction or impaired bladder, the symptom score revealed subjective difficulties (maximum 35 points). Patients with the obstruction underwent transurethral incision of the bladder neck. Patients with impaired bladder were administrated with distigmine bromid (Ubretid) 5 mg for 1 year, every other day. All patients were re-examined one year following the treatment.


RESULTS
Bladder neck obstruction occurred in 18 cases, and impaired bladder in 20 cases. Significant differences were found in relation to age (47 vs. 31 years, p < 0.01) and detrusor pressure at maximum flow (62 vs. 30 cmH2O, p < 0.01). There were no differences in peak flow rate (9 vs. 10 ml/s, p = 0.75), symptom score (19 vs. 18, p = 0.46), residual urine (45 vs. 100, p = 0.08) and maximum cystometric capacity (341 vs. 383 ml, p = 0.10). Transurethral bladder neck incision or distigmine administration improved the symptom score by 68.4% vs. 33.3%, peak flow rate 50.0% vs. 23.1% and residual urine 100% vs. 75%.


CONCLUSIONS
Treatment of lower urinary tract disorders is successful in causal treatment of bladder neck obstruction and impaired bladder. (Tab. 2, Fig. 2, Ref. 12.)
Svihra
J
J
Department of Urology, Jessenius School of Medicine, Comenius University, Martin, Slovakia. svihra@sco.medicalh.sk
Elias
B
B
Javorka
K
K
Kliment
J
J
D000328:Adult; D006801:Humans; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D001745:Urinary Bladder Diseases / Q000175:diagnosis* / Q000628:therapy*; D001748:Urinary Bladder Neck Obstruction / Q000175:diagnosis / Q000628:therapy; D014563:Urodynamics