DIFFERENTIAL CLUES FOR THE PATIENTS WITH IDIOPATHIC DETRUSOR INSTABILITY FOR MEN WITH NORMAL FLOW VOIDING DYSFUNCTION.

Aims of Study:
Men with idiopathic detrusor instability(IDI) may be classified to normal-flow voiding dysfunction that was frequently seen in prostatitis syndrome. The valuable clues that suggest the presence of IDI could save the time and labour to diagnose the IDI. Voiding symptoms and uroflowmetry are first line of screening tools and may offer these clues. The characteristics of symptoms and parameters of uroflowmetry of patients with IDI were compaired to those of patients with the normal-flow prostatitis syndromen.

Methods:
124 patients with prostatitis syndrome under age 40 were evaluated by physical examination, urinalysis, prostatic secretion, KUB, IPSS and uroflowmetry. Among them, 21 patients showed normal maximum flow rate(Qmax.>20 ml/s.)and bell-shaped curve. These 21 patients were evaluated by urodynamic study and resulted that 9 patients were classified to having IDI(group IDI) and 12 to urodynamically normal(group N). Parametrs of IPSS and uroflowmetry of both groups were compaired(student t-test).

Results and Conclusions:
Group IDI showed low score in obstructive symptoms such as hesitancy and weak strem, however high score in irritable symptom, urgency(table 1). In parameters of uroflowmetry, there were no difference in maximum(Qmax) and average flow rate(Qave) in both groups, however group IDI was characterized with high Qmax inspite of small voidied volume(ratio of Qmax/volume was higher in group IDI)(table 2). Symptom score and uroflowmetry may be the useful screening methods for suggesting the possibility of IDI.

Table 1. Comparison of symptom score

IPSS

Residual sense

Frequency

Interruption

Urgency

Weak stream

Hesitancy

Nocturia

Total

Group IDI

(n=9)

1.7

4.1

1.1

4.6

0.7

0.6

2.1

Group N (n=12)

(p value)

2.9

(0.334)

3.6

(0.513)

1.1

(0.985)

2.3

(0.011)

3.0

(0.009)

3.4

(0.006)

1.8

(0.566)

(0.278)

Table 2. Comparison of parameters of uroflowmetry

	Volume (ml)	Qmax(ml/s.)	Qave (ml/s.)	Qmax/volume (sec^-1)
Group IDI (n=9)	164 ±97	28 ± 7	16 ± 6	0.21
Group N (n=12)	271 ±91	27 ±2	16 ±3	0.11
(p value)	(0.049)	(0.566)	(0.917)	(0.012)