The Long-term Effects of Transurethral Bladder Neck Incision in the Treatment of Female Bladder Neck Obstruction
Vol. 20 No. 01 (2023),
25 December 2022
Purpose: To investigate the long-term effects of transurethral bladder neck incision (TUBNI) for female primary
bladder neck obstruction (PBNO).
Materials and Methods: We retrospectively reviewed seventy women diagnosed with bladder neck obstruction
by video-urodynamic study (VUDS). TUBNI was performed for each patient, with incisions made at 2 different
sites on the bladder neck. Postoperatively, patients were assessed by international prostate symptom score (IPSS),
quality of life (QOL) and uroflowmetry.
Results: Follow-up data were available for 4-108 months (median 42 months) postoperatively. During follow-up,
the IPSS, QOL, time to maximum uroflow rate, postvoid residual urine volume decreased significantly after TUBNI
compared with preoperative [13.0 (10.0, 15.0) versus 3.0 (3.0, 8.0), P ＜ .001], [5.0 (5.0, 5.0) versus 2.0 (1.0,
3.0), P ＜ .001], [9.0 (5.0, 37.0) versus 6.1 (4.2, 8.7), P ＜ .001], [77.5 (23.5, 165.8) versus 0.0 (0.0, 30.0), P ＜
.001]. The maximum uroflow rate, average uroflow rate and the voided volume increased significantly compared
with preoperative [7.0 (4.0, 10.3) versus 19.8 (12.8, 25.2), P ＜ .001], [3.0 (2.0, 5.0) versus 8.0 (4.9, 10.7), P ＜
.001] and [156.5 (85.0, 211.3) versus 261.3 (166.2, 345.6), P ＜ .001]. Several complications were identified after
surgery, including bladder neck reobstruction, urethral stricture, and stress urinary incontinence, the corresponding
number was 5 (7.1%), 7(10%) and 7(10%). Successful operation was achieved in 60/70 (85.7 %) patients.
Conclusion: PBNO is a very rare yet easily treatable condition. VUDS is the primary diagnostic tool for the diagnosis
of bladder neck obstruction in women, while TUBNI can effectively relieve obstruction symptoms and
improve the quality of life for patients.
- Female bladder neck obstruction; Video-urodynamic study; Transurethral bladder neck incision; Urinary incontinence; Urethral stricture
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