[Primary bladder neck obstruction in males].
OBJECTIVE
To report our experience on the diagnosis and treatment of this rare type of infravesical functional obstruction.


METHODS
Over the last ten years we diagnosed and treated 32 males with this entity. We evaluate previous treatments and time to diagnosis. Clinical, radiological, endoscopic, and urodynamic features are evaluated, as well as results obtained with the administration of alpha-adrenergic blockers and endoscopic transurethral incision of the bladder neck.


RESULTS
Patient age ranged from 26 to 48 years (Mean 38.2). All patients presented significant long-lasting lower urinary tract symptoms, having received various non-specific treatments. Uroflowmetry showed a peak of mean flow of 9.8 +/- 3.2 cc/s, being the voiding detrusor pressure 98 +/- 25 cm H2O, with significant post void residual volume in 21 patients (188 +/- 62 cc). Medical treatment with alpha-adrenergic blockers only achieved significant subjective improvement in four patients. Twenty one patients underwent unilateral endoscopic bladder neck incision, obtaining objective and subjective improvements all of them.


CONCLUSIONS
Endoscopic bladder neck incision is the treatment of choice of this dysfunction, being imperative to inform the patient of the risk of retrograde ejaculation as a postoperative sequel, since this entity appears in young males, for whom fertility may be a priority.
Navalón Verdejo
Pedro
P
Unidad de Urodinámica, Servicio de Urología, Hospital Casa de Salud, Valencia, España. pedronavalon@yahoo.com
Pallás Costa
Yoni
Y
Juan Escudero
Joaquín
J
Ordoño Domínguez
Felipe
F
Sánchez Ballester
Francisco
F
de la Torre Abril
Luis
L
Monllor Peidro
Elisa
E
Fabuel Deltoro
Milagros
M
Cánovas Ivorra
José Antonio
JA
D000328:Adult; D006801:Humans; D008297:Male; D008875:Middle Aged; D001748:Urinary Bladder Neck Obstruction / Q000175:diagnosis / Q000628:therapy