Efficacy of Multimodal Therapy for Dysfunctional Voiding in Young Adult Male Patients: A Retrospective Observational Study

Purpose: This study evaluated the efficacy and safety of a multimodal conservative regimen, oral baclofen plus pelvic-floor muscle training (PFMT), in young adult male patients (18-40 years) with dysfunctional voiding (DV) diagnosed according to International Continence Society criteria on video-urodynamic studies (vUDS). Study Design: This was a single-center, single-arm, retrospective observational study conducted at a tertiary-care academic hospital. Methods: Between January 2022 and January 2025, all young male patients (18-40 years) diagnosed with DV on vUDS were enrolled (n = 50) and treated with oral baclofen (10 mg 3 times daily) and PFMT. Symptom scores (International Prostate Symptom Score [IPSS], Urogenital Distress Inventory-6 [UDI-6]) were recorded at baseline and 2, 4, and 6 weeks, and at 6 months, whereas uroflowmetry parameters (maximum flow rate [Qmax], average flow rate [Qavg], postvoid residual [PVR]) were recorded at baseline and 6 months of follow-up to assess treatment efficacy. Results: Significant improvement occurred by 6 months: The mean IPSS decreased from 20.1 ± 5.3 to 15.6 ± 4.8 ( P < .001) and UDI-6 from 23.5 ± 6.2 to 17.6 ± 5.9 ( P < .001). Qavg increased from 6.37 ± 2.1 to 8.12 ± 2.3 ml/s ( P < .001); changes in Qmax and PVR were not statistically significant. No major adverse events observed. Conclusion: Multimodal conservative therapy combining baclofen (10 mg 3 times daily) and PFMT significantly improves subjective symptom scores and urinary flow dynamics in young adult male patients with DV. Future randomized studies are warranted to validate these findings.