Urodynamic profile of lower urinary tract symptoms in young men: A testimony of the truth?

Aim: To evaluate the impact of urodynamic study (UDS) in the management of young men presenting with lower urinary tract symptoms (LUTSs). Materials and Methods: This is a retrospective, observational study of urodynamic findings of 128 patients presented with LUTS at the Department of Urology, Institute of Nephrourology, Bangalore, over a period of 5 years (August 2014 to July 2019). Pre- and post-UDS diagnoses as well as treatment modalities were compared to evaluate the usefulness of UDS. Results: A total of 110 patients (86%) had abnormal UDS findings. Before UDS, 55 (43%) patients were clinically diagnosed for overactive bladder; after UDS, bladder outlet obstruction (BOO) was seen in 32 (25%) patients and detrusor overactivity in 18 (14.1%). Clinically, BOO was diagnosed in 36 (28.1%) patients; however, urodynamic findings of BOO were seen only in 23 (18%) patients. Pre-UDS, bladder underactivity was suspected in 23 (18%); however, underactive detrusor was noted in 20 (15.6%) patients, and 3 (2.4%) patients were normal on UDS. Post-UDS, antibiotics were not prescribed to anyone. 18 (14%) patients underwent surgery after UDS confirmation of BOO. 67 patients (52.3%) had their clinical diagnosis changed following UDS. Concomitant changes in the management were required for 59 patients (46%). Conclusion: Etiologies of LUTSs in young men are more varied. Clinical diagnosis and treatment are often empirical and inaccurate. UDS is useful to achieve accurate diagnosis and to guide appropriate treatment. Video urodyanamics should be used to evaluate LUTS in young men.