Document Detail


Transurethral incision of bladder neck in treatment of bladder neck obstruction in women.
MedLine Citation:
PMID:  15708037     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
OBJECTIVES: To report our preliminary experience with transurethral incision of the bladder neck in the treatment of female voiding dysfunction due to bladder neck obstruction. Bladder neck obstruction in women is an infrequently diagnosed urologic condition. METHODS: Bladder neck obstruction was diagnosed in 11 women 41 to 80 years of age, who presented with difficult micturition or urinary retention. Preoperative investigations included a full urodynamic examination and urethrocystoscopy. Transurethral bladder neck incision was performed in all patients. Urodynamic results and clinical improvement in voiding symptoms were assessed. RESULTS: Of the 11 patients, 5 had chronic urinary retention and 6 had difficult micturition; 3 also had recurrent urinary tract infection or upper urinary tract deterioration. The most frequent findings on video-urodynamic study were a high voiding pressure plus low flow rate and a narrow bladder neck during voiding on cinefluoroscopy. After treatment, the lower urinary tract symptoms were resolved or improved in all patients. Ten patients resumed spontaneous voiding with a small postvoid residual urine volume; the remaining patient was able to void by abdominal straining after adjuvant urethral botulinum A toxin injection. Urodynamic study revealed a decreased voiding pressure and postvoid residual urine volume and an increased maximal flow rate. The overall satisfactory rate was 91%. CONCLUSIONS: Transurethral incision of the bladder neck is effective in relieving voiding difficulty owing to anatomic or functional bladder neck obstruction in women. A full video-urodynamic evaluation is essential in making the correct diagnosis and formulating a treatment plan.
Authors:
Chung-Hsin Peng; Hann-Chorng Kuo
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Publication Detail:
Type:  Evaluation Studies; Journal Article    
Journal Detail:
Title:  Urology     Volume:  65     ISSN:  1527-9995     ISO Abbreviation:  Urology     Publication Date:  2005 Feb 
Date Detail:
Created Date:  2005-02-14     Completed Date:  2005-10-05     Revised Date:  2006-11-15    
Medline Journal Info:
Nlm Unique ID:  0366151     Medline TA:  Urology     Country:  United States    
Other Details:
Languages:  eng     Pagination:  275-8     Citation Subset:  IM    
Affiliation:
Department of Urology, Buddhist Tzu-Chi General Hospital, Hualien, Taiwan.
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MeSH Terms
Descriptor/Qualifier:
Adult
Aged
Aged, 80 and over
Cineradiography
Female
Follow-Up Studies
Humans
Middle Aged
Retrospective Studies
Urinary Bladder Neck Obstruction / complications,  diagnosis,  surgery*
Urinary Retention / etiology
Urination Disorders / etiology
Urodynamics

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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