Transurethral incision of the bladder neck using KTP in the treatment of bladder neck obstruction in women.
OBJECTIVE
To study the results and complications of the potassium-titanyl-phosphate (KTP, green) laser during transurethral incision of the bladder neck in the treatment of female voiding dysfunction due to bladder neck obstruction.


METHODS
A total of 40 women (43-79 years of age) with obstruction were identified. Patients with neurogenic, traumatic, or iatrogenic causes of obstruction were excluded. Preoperative investigations included a full urodynamic examination and urethrocystoscopy. Transurethral bladder neck incision with KTP was performed in all patients. Urodynamic results, clinical improvements in voiding symptoms, and volume of bleeding were assessed.


RESULTS
Of the 40 patients, 12 had chronic urinary retention and 28 had difficult micturition. The most common findings on urodynamic study were a high voiding pressure plus low flow rate and high urethral pressure. After treatment, the lower urinary tract symptoms were resolved or improved in all patients. Urodynamic study revealed decreased voiding pressure, post-void residual urine volume, and increased maximal flow rate.


CONCLUSIONS
Transurethral incision of the bladder neck is effective in relieving voiding difficulties owing to anatomic or functional bladder neck obstruction in women. KTP has great efficacy in the treatment of female voiding dysfunction due to bladder neck obstruction.
Fu
Qiang
Q
Department of Urology, Sixth People's Hospital, Shanghai Jiaotong University, Shanghai, PR China. jamesqfu@yahoo.com.cn
Xu
Yue-Min
YM
D000328:Adult; D000368:Aged; D003558:Cystoscopy; D005260:Female; D006801:Humans; D053685:Laser Therapy / Q000009:adverse effects; D053844:Lasers, Solid-State; D008875:Middle Aged; D018579:Patient Selection; D011312:Pressure; D011788:Quality of Life; D013997:Time Factors; D016896:Treatment Outcome; D014521:Urethra / Q000503:physiopathology / Q000601:surgery*; D001748:Urinary Bladder Neck Obstruction / Q000150:complications / Q000503:physiopathology / Q000601:surgery*; D014555:Urination Disorders / Q000209:etiology / Q000503:physiopathology / Q000601:surgery*; D014563:Urodynamics; D013520:Urologic Surgical Procedures / Q000009:adverse effects / Q000379:methods*