Uroflow Studies Research Articles

Evaluation of Chronic Urethritis

We determined the prevalence of structural and functional abnormalities of the lower urinary tract in a carefully defined population of 36 men with chronic urethritis who were attending a sexually transmitted disease clinic. They had experienced symptoms for an average of 12.1 months and had been treated with an average of 5.1 courses of antimicrobial drugs. All had objective evidence of urethral inflammation and negative cultures for both Neisseria gonorrhoeae and Chlamydia trachomatis. Structural abnormalities were documented in nine (25%) of 36 patients but were considered clinically significant in only four. Physical examination and uroflow testing led to clinical suspicion of anatomic abnormalities in all four patients with significant lesions, which included urethral strictures in three patients and benign prostatic hypertrophy in one patient. Additional abnormal findings included wide-bore strictures in three patients and developmental abnormalities of doubtful significance in two patients. Increased numbers of inflammatory cells in expressed prostatic secretions were associated with the presence of structural abnormalities. We conclude that among men with chronic urethritis, careful physical examination and uroflow studies can be used to screen for evidence of structural abnormalities that merit endoscopic evaluation.

Benign prostatic hypertrophy: retrograde transurethral dilation of the prostatic urethra in humans. Work in progress.

Retrograde transurethral balloon dilation of the prostatic urethra was performed in five human volunteers with benign prostatic hypertrophy. Each patient underwent cystoscopy, uroflow studies, voiding cystourethrography, retrograde urethrography, and magnetic resonance imaging before dilation and at defined intervals afterward. The longest follow-up to date is 8 months. Patients were given topical anesthetics and mild sedatives, and dilation was performed with a 25-mm urethroplasty balloon catheter inflated at 3-6 atm for 10 minutes. All catheter manipulations were done with a guide wire and under fluoroscopic control. Significant resolution of symptoms of prostatism was seen in four patients. The unsatisfactory results in the last patient were believed to be caused by ineffectual dilation of predominantly middle lobe hypertrophy--a condition that is now regarded as a contraindication to dilation. This technique has promise to replace transurethral resection of the prostate as the treatment of choice for this common male ailment.

A Carbon Dioxide Flowmeter

A simple and inexpensive uroflowmeter has been designed that uses a common carbon dioxide cystometer. The patient voids urine in a specially designed container connected at the bottom to the carbon dioxide source in the cystometer. After proper calibration (500cc fluid for a 20mm. deflection in the paper) the patient is asked to void while carbon dioxide flows through the container and the paper recording commences. Any change of volume in the container produces a change in the pressure recorded by the cystometer, which will allow us to know, following calibration, the 2 factors involved in flow: 1) volume voided and 2) time. A table of average flow is available for a quick reading of the findings only by superimposing the table on the uroflow study. The only attachment needed for the cystometer is the special container. Our results support the use of this economical new way to determine urinary flow.