Transurethral bladder neck incision in women with primary bladder neck obstruction.
BACKGROUND
Bladder outlet obstruction is an uncommon condition in women. Primary bladder neck obstruction is one of the functional causes of bladder outlet obstruction. We evaluated surgical treatment in our patients with primary bladder neck obstruction.


METHODS
We retrospectively evaluated the medical data of 47 female patients from the Department of Urology who underwent transurethral incision of the bladder neck from January 2000 to December 2012. All patients underwent transurethral bladder neck incision at the vesical neck and proximal urethra at the 5- and 7-o'clock positions. We compared symptoms and urodynamic parameters before and after the operation.


RESULTS
Out of 47 female patients who underwent the operation, primary bladder neck obstruction was diagnosed in 42. The mean age was 44.3 ± 16.8 (range: 21-78) years. The postoperative maximal flow rates were significantly increased (20.6 ± 3.9 vs. 7.6 ± 3.2 mL/s, P < 0.0001), and the postvoid residual urine was decreased (31.3 ± 7.8 vs. 132.1 ± 22.24 mL, P = 0.0002) compared with preoperative findings. Improvement was evident in most patients (83.3 %). A repeat operation had to be performed in seven patients (16.7 %). Operative therapy failed in one patient (2.4 %).


CONCLUSIONS
The diagnosis of primary bladder neck obstruction in women is based on typical symptoms, uroflowmetry and multichannel urodynamics, including electromyography. Videourodynamics is obligatory in doubtful cases. Transurethral bladder neck incision is an effective therapy for female patients with primary bladder neck obstruction, and if necessary, a second procedure can be safely performed.
Department of Urology, University Hospital Rijeka, Tome Strižića 3, 51000, Rijeka, Croatia, dean.markic@ri.htnet.hr.
Dean
D
Markić
Anton
A
Maričić
Romano
R
Oguić
Josip
J
Spanjol
Dražen
D
Rahelić
Nino
N
Rubinić
Maksim
M
Valenčić
D000328:Adult; D000368:Aged; D015653:Cystectomy / Q000379:methods*; D005260:Female; D006801:Humans; D008875:Middle Aged; D016896:Treatment Outcome; D014521:Urethra / Q000601:surgery*; D001748:Urinary Bladder Neck Obstruction / Q000175:diagnosis* / Q000601:surgery*; D055815:Young Adult