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Female urethral syndrome is one of the most common urologic disease in middle age women, but much remains to be known about its etiology and management. For the purpose of identifying underlying voiding dysfunction of this disease, urodynamic studies were done on 28 patients with female urethral syndrome seen in Urologic Department of Seoul National University hospital during the past 14 months from January 1983 to February 1984. Results were as follows: 1. Twenty cases showed normal urodynamic findings, and no significant findings were found in urethral pressure profile studies. 2. Three cases showed functional bladder outlet obstruction due to failure of urethral sphincter relaxation during voiding, two of which were treated by diazepam, and one of which by diazepam and phenoxybenzamine, and all three cases showed improvement of symptoms and maximum roflow rate. 3. Six cases showed detrusor instability, and three were sensory detrusor instability, other three were idiopathic detrusor hyperreflexia. 4. We conclude that routine whole urodynamic study is unnecessary in evaluation of female urethral syndrome, but uroflowmetry can be used as a simple screening study. when uroflowmetry curve shows interrupted pattern, maximum uroflow rate is less than 15 cc/sec., and urethral calibration and castopandoscopy reveals no anatomical bladder outlet obstruction, combined cystometry-urethral sphincter electromyography is necessary to rule out functional obstruction due to failure of relaxation of urethral sphincter during voiding. A new flow chart for the management of female urethral syndrome is presented.
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