title: [Primary bladder neck obstruction in males].
abstract: 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.
authors.affiliation: Unidad de Urodinámica, Servicio de Urología, Hospital Casa de Salud, Valencia, España. pedronavalon@yahoo.com
authors.forename: Pedro
authors.initials: P
authors.lastname: Navalón Verdejo
authors.forename: Yoni
authors.initials: Y
authors.lastname: Pallás Costa
authors.forename: Joaquín
authors.initials: J
authors.lastname: Juan Escudero
authors.forename: Felipe
authors.initials: F
authors.lastname: Ordoño Domínguez
authors.forename: Francisco
authors.initials: F
authors.lastname: Sánchez Ballester
authors.forename: Luis
authors.initials: L
authors.lastname: de la Torre Abril
authors.forename: Elisa
authors.initials: E
authors.lastname: Monllor Peidro
authors.forename: Milagros
authors.initials: M
authors.lastname: Fabuel Deltoro
authors.forename: José Antonio
authors.initials: JA
authors.lastname: Cánovas Ivorra
mesh_terms: D000328:Adult; D006801:Humans; D008297:Male; D008875:Middle Aged; D001748:Urinary Bladder Neck Obstruction / Q000175:diagnosis / Q000628:therapy