To describe the urodynamic characteristics of men with urinary retention, and to show the diverse treatment plans based on urodynamic findings.

As there is not a standardized definition for urinary retention, we defined urinary retention in two ways.First, we classified men who required a urinary catheter for bladder drainage and failed a subsequent voiding trial as being in “overt” urinary retention. We also classified men who had an office post-void residual of >500 mL (documented by bladder scan), along with the sensation of incomplete emptying, as being in “covert” reten- tion. Additional data including age, history of diabetes, prior urological surgeries and post-evaluation treatment were noted .

Men with voiding dysfunction associated with documented neurological disorders (including, but not limited to, spinal cord injury and multiple sclerosis) were excluded, as were those who had undergone radical prostatectomy or major pel- vic surgery, such as abdominoperineal resection.

We carried out a 6 years  retrospective review of men with urinary retention who were referred to our clinic for urodynamic evaluation. Men with a history of neurogenic voiding dysfunction or major pelvic surgery were excluded. Urodynamics  studies were carried out, and the subsequent treatment modality offered was recorded.
All urodynamics studies were carried out 
In private Hospitals of Lahore and Islamabad pakistan.

A total of  100 men with urinary retention and a median age of  56 years underwent urodynamic evaluation. The median maximum flow rate was 3 mL/s, and the median detrusor pressure at maximum flow was 54 cm H2O. Bladder outlet obstruction was diagnosed in 50 %. Detrusor underactivity was present in 66 % according to the bladder contractility index; however, just 22 % were classified as having detrusor underactivity according to isometric detrusor pressure, an alternative measure of contractility. A total of 76% of patients had low detrusor reserve (<20 cm H2O). Based on urodynamic findings, just 45 % of patients were offered de-obstructive surgery.

A total of 76% of patients had low detrusor reserve (<20 cm H2O). Based on urodynamic findings, just 45 % of patients were offered de-obstructive surgery.

In the present cohort, just 50 % of men with urinary retention showed urodynamic evidence of bladder outlet obstruction. Depending on how contractility is measured (bladder contractility index vs isometric detrusor pressure), the rate of detrusor underactivity varies. The majority of men with retention had a low detrusor reserve. Given the wide spectrum of urodynamic findings in men with retention, surgical intervention might not be necessary for all. Furthermore, a careful consideration of urodynamics can assist in the selection of optimal treatment.

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