The Long-term Effects of Transurethral Bladder Neck Incision in the Treatment of Female Bladder Neck Obstruction
Urology Journal,
Vol. 20 No. 01 (2023),
25 December 2022
,
Page 41-47
https://doi.org/10.22037/uj.v20i01.7174
Abstract
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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References
Blaivas JG, Flisser AJ, Tash JA. Treatment of primary bladder neck obstruction in women with transurethral resection of the bladder neck. The Journal of urology. 2004;171(3):1172-5.
Zhang P, Wu Z-J, Xu L, Yang Y, Zhang N, Zhang X-D. Bladder neck incision for female bladder neck obstruction: long-term outcomes. Urology. 2014;83(4):762-6.
King AB, Goldman HB. Bladder outlet obstruction in women: functional causes. Current urology reports. 2014;15(9):436.
Goldman HB, Zimmern PE. The treatment of female bladder outlet obstruction. BJU Int. 2006;98 Suppl 1.
Markic D, Maricic A, Oguic R, et al. Transurethral bladder neck incision in women with primary bladder neck obstruction. Wien Klin Wochenschr. 2014;126(7-8):217-22.
Brucker BM, Fong E, Shah S, Kelly C, Rosenblum N, Nitti VW. Urodynamic differences between dysfunctional voiding and primary bladder neck obstruction in women. Urology. 2012;80(1):55-60.
Padmanabhan P, Nitti VW. Primary bladder neck obstruction in men, women, and children. Current urology reports. 2007;8(5):379-84.
Groutz A, Blaivas JG, Chaikin DC. Bladder outlet obstruction in women: definition and characteristics. Neurourology and urodynamics. 2000;19(3):213-20.
Zhang P, Yang Y, Wu Z-j, Zhang X-d, Zhang C-h. Video-urodynamics study on female patients with bladder neck obstruction. Chin Med J (Engl). 2012;125(8):1425-8.
Huckabay C, Nitti VW. Diagnosis and treatment of primary bladder neck obstruction in men. Current urology reports. 2005;6(4):271-5.
Drake MJ, Doumouchtsis SK, Hashim H, Gammie A. Fundamentals of urodynamic practice, based on International Continence Society good urodynamic practices recommendations. Neurourol Urodyn. 2018;37(S6):S50-S60.
Kuo H-C. Videourodynamic characteristics and lower urinary tract symptoms of female bladder outlet obstruction. Urology. 2005;66(5):1005-9.
Nitti VW, Tu LM, Gitlin J. Diagnosing bladder outlet obstruction in women. The Journal of urology. 1999;161(5):1535-40.
Chassagne S, Bernier PA, Haab F, Roehrborn CG, Reisch JS, Zimmern PE. Proposed cutoff values to define bladder outlet obstruction in women. Urology. 1998;51(3):408-11.
Gammie A, Kirschner-Hermanns R, Rademakers K. Evaluation of obstructed voiding in the female: how close are we to a definition? Current opinion in urology. 2015;25(4):292-5.
Jin X-b, Qu H-w, Liu H, Li B, Wang J, Zhang Y-d. Modified transurethral incision for primary bladder neck obstruction in women: a method to improve voiding function without urinary incontinence. Urology. 2012;79(2):310-3.
Turner-Warwick R, Whiteside CG, Worth PH, Milroy EJ, Bates CP. A urodynamic view of the clinical problems associated with bladder neck dysfunction and its treatment by endoscopic incision and trans-trigonal posterior prostatectomy. Br J Urol. 1973;45(1):44-59.
Kumar A, Mandhani A, Gogoi S, Srivastava A. Management of functional bladder neck obstruction in women: use of alpha-blockers and pediatric resectoscope for bladder neck incision. The Journal of urology. 1999;162(6):2061-5.
Peng CH, Kuo HC. Transurethral incision of bladder neck in treatment of bladder neck obstruction in women. Urology. 2005;65(2):275-8.
Kumar A, Banerjee GK, Goel MC, Mishra VK, Kapoor R, Bhandari M. Functional bladder neck obstruction: a rare cause of renal failure. The Journal of urology. 1995;154(1):186-9.
Bedretdinova D, Fritel X, Panjo H, Ringa V. Prevalence of Female Urinary Incontinence in the General Population According to Different Definitions and Study Designs. European urology. 2016;69(2):256-64.
Newman DK. Stress urinary incontinence in women. Am J Nurs. 2003;103(8).
Reynolds WS, Dmochowski RR, Penson DF. Epidemiology of stress urinary incontinence in women. Current urology reports. 2011;12(5):370-6.
Cavkaytar S, Kokanali MK, Topcu HO, Aksakal OS, Doganay M. Effect of home-based Kegel exercises on quality of life in women with stress and mixed urinary incontinence. J Obstet Gynaecol. 2015;35(4):407-10.
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