So Marcio, what specific clues would you look for? So in a patient who presents for a TURP, is there something specifically that you look for to see whether it's possibly neurogenic?

Yes, this is an important and classic example from what we see every day in our offices.

So, yes, I do think about this in every patient and most men undergoing TRP have uncomplicated bladder outlet obstruction.

But missing neurogenic dysfunction before surgery can lead to disappointing outcomes.

Problems with the patient-physician relationship as well due to this misalignment of what can happen afterwards.

So before recommending surgery, I ask myself three questions.

First, are the symptoms proportional to the prostate? Second, Is there anything unusual in the history or neurological examination? And third, does the bladder behave as expected? If someone has a relatively small prostate but severe voiding dysfunction, a very large residual volume, impaired bladder sensation, recurrent retention without obvious obstruction, or an unusual outflow pattern, I pause before offering surgery.

So do you think it is acceptable, for instance, to have a standalone voiding sister ethogram, especially if it's a cine, you know, you've recorded it as a movie and combine that with a standard aerodynamics?