Dobberfuhl AD, et al. - A total of 614 men who underwent an outlet procedure at from 2005 to 2014 were recruited in this study by the researchers in order to recognize clinical and urodynamic factors resulting in spontaneous voiding in men with detrusor underactivity (DU) and suspected bladder outlet obstruction who underwent an outlet de-obstruction procedure. In contrast with 82% of men with bladder contractility index (BCI) ≥ 100, DU was recognized in 54%, of whom only 68% voided spontaneously prior to the surgery. At a mean follow-up of 6.4 months postoperatively, 79% of men with DU were able to void spontaneously as that of 96% of men with BCI ≥ 100. Nearly 57% of men recovered spontaneous voiding following surgery, of men with a BCI < 100 who were unable to void prior to the surgery. Important preoperative features and urodynamic factors included preoperative spontaneous voiding, elevated maximum flow rate, raised detrusor pressure at maximum flow, DU with BCI < 100, and obstruction with bladder outlet obstruction index > 40. Thus, in men with DU, outlet de-obstruction was concluded to improve spontaneous voiding and may profit men who do not meet the urodynamic threshold for obstruction.