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When you subscribe to the Biweekly Cases mailing list, you will receive interesting but easy-to-consume patient cases every other Thursday and get challenged to mirror your decision with those of an expert panel and your peers. The biweekly cases are part of an educational programme on LUTD created by a multidisciplinary group of European experts. The programme is supported by an educational grant from Ferring. Read our privacy policy *

Richard, 67 years old, complains of increased frequency and urgency during the last 6 months and urgency urinary incontinence during the last month.  

  • Clinical examination: DRE: normal. Prostate volume: 27 ml.
  • IPSS: 21 (IPSS QoL: 5)
  • Lab: PSA: 0.8 ng/ml
  • Bladder diary: Increased frequency during daytime, 2 times/night.
  • Uroflowmetry:
    First time: voided volume: 100 ml, Qmax: 8 ml/s; PVR: 30 ml, intermittent and fluctuating flow.
    Second time: voided volume: 360 ml, Qmax: 25 ml/s; PVR: 0 ml, bell shaped flow.

What is the most likely diagnosis?

Overactive detrusor

Bladder outlet obstruction

(*) The Biweekly cases are for educational use only. The Biweekly cases are not suitable for non-healthcare professionals as it needs professional interpretation.

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