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Test-retest reliability of repeated voids in pressure-flow studies and the influence on maximum flow rate (Q max pQ), detrusor pressure at maximum flow rate (p det Q max ), voided volume, and residual urine were studied. Also the agreement in interpretation of pressureflow tracings between investigators and a single blinded central reader acting as a quality control center (QCC) were assessed. In addition, correlations between p det Q max and patient age, International Prostate Symptom Score (IPSS), free maximum flow rate (Q max ), and prostate volume were calculated. Using suprapubic pressure recording, 216 men with lower urinary tract symptoms (LUTS) due to benign prostatic enlargement (BPE) were investigated in 11 centers. In each pressure-flow study, three sequential voids were performed, and quality controlled recordings were analyzed for Q max pQ and p det Q max by the QCC. PROD #1031rectal ultrasound was used to measure the prostate volume. Mean Q max pQ did not change, but p det Q max decreased significantly in the second and third sequential voids. Using the Abrams-Griffiths nomogram definition of obstruction, 125 patients (67%) were classified as obstructed from the first void, but only 111 patients (59%) from the third void. The agreement between the investigator assessment and that of a single blinded reader was good.There was no significant correlation between p det Q max and patient age, IPSS, and Q max , whereas a modest correlation was found between p det Q max and prostate volume. In summary, there was no significant change in Q max pQ, but p det Q max decreased for the three consecutive voids, which can be explained by a decrease in outlet resistance. The agreement between the investigator and QCC interpretations shows the value of a standardized technique, supporting the feasibility of multicenter urodynamic studies. There is a modest, but statistically significant, correlation between detrusor pressure and prostate size, supporting the hypothesis that prostate size is a contributing factor in symptomatic BPH. Neurourol.

Finasteride treatment resulted in improvements in urodynamic parameters, which were greater in men with large prostates.

Finasteride treatment resulted in improvements in urodynamic parameters, which were greater in men with large prostates.