Careful clinical and investigative protocols allow the identification of a homogeneous group of patients with prostatodynia or ‘anxious bladder syndrome’ (underactive detrusor function). Psychophysiological studies and urodynamic measurements in such patients demonstrate remarkably consistent results, which, whilst lending support to the hypothesis that the sympathetic nervous system may affect bladder and urethral function, do not offer objective proof that adrenergic mechanisms are directly responsible for the observed dysfunctional state.