title: Efficacy of bladder neck incision on urodynamic abnormalities in patients with posterior urethral valves.
abstract: OBJECTIVE
  This study aims to study the efficacy of simultaneous endoscopic bladder neck incision (BNI) and primary endoscopic valve incision (PEVI) in patients with posterior urethral valves (PUV).
  
  
  METHODS
  Nine PUV patients underwent PEVI and BNI over a year. They were compared to nine comparable historical controls that had undergone only PEVI. Trends in renal function tests, urodynamics and changes in the upper urinary tracts were evaluated after 3 months during which no pharmacotherapy was given.
  
  
  RESULTS
  The incidence of bladder dysfunction in the two groups was similar-55.5 % in case group and 66.6 % in control group. Hypocompliant, high-pressure bladder was the predominant cystometric finding in both groups. Three patients in the case group and two patients in the control group had high end infusion pressure (EIP) with poor compliance. Detrusor overactivity (DOA) was seen in 23.1 % patients in the case group as compared to 55.5 % patients in the control group (P = 0.3348). Five patients in both groups were later started on anticholinergics due to raised EIP, small capacity bladder and/or DOA.
  
  
  CONCLUSIONS
  Although BNI should theoretically improve the outcome of PUV patients, the current pilot study failed to demonstrate any significant difference. A larger sample size and longer follow-up are required to prove or disprove its efficacy.
authors: Department of Pediatric Surgery, Maulana Azad Medical College and Associated Lok Nayak Hospital, University of Delhi, New Delhi, India. yksarin@hotmail.com
authors: Yogesh K
authors: YK
authors: Sarin
authors: Shalini
authors: S
authors: Sinha
mesh_terms: D004724:Endoscopy; D006801:Humans; D006984:Hypertrophy; D007677:Kidney Function Tests; D008297:Male; D010865:Pilot Projects; D014521:Urethra / Q000002:abnormalities* / Q000503:physiopathology*; D001743:Urinary Bladder / Q000473:pathology / Q000503:physiopathology; D001748:Urinary Bladder Neck Obstruction / Q000601:surgery*; D014563:Urodynamics