Abstract

NAVALON VERDEJO, Pedro et al. Primary bladder neck obstruction in males. Arch. Esp. Urol. [online]. 2006, vol.59, n.3, pp.253-260. ISSN 0004-0614.

Objetives: To report our experience on the diagnosis and treatment of this rare type of infravesical functional obstruction. Methods: Over the last ten years we diagnosed and treated 32 males with this entity. We evaluate previous treatments and time to diagnosis. Clinical , radiological, endoscopic, and urodynamic features are evaluated, as well as results obtained with the administration of alpha-adrenergic blockers and endoscopic transurethral incision of the bladder neck. Results: Patient age ranged from 26 to 48 years (Mean 38.2). All patients presented significant long-lasting lower urinary tract symptoms, having received various non-specific treatments. Uroflowmetry showed a peak of mean flow of 9.8+- 3.2 cc/s, being the voiding detrusor pressure 98+- 25 cm H2O, with significant post void residual volume in 21 patients (188+- 62 cc). Medical treatment with alpha-adrenergic blockers only achieved significant subjective improvement in four patients. Twenty one patients underwent unilateral endoscopic bladder neck incision, obtaining objective and subjective improvements all of them. Conclusions: Endoscopic bladder neck incision is the treatment of choice of this dysfunction, being imperative to inform the patient of the risk of retrograde ejaculation as a postoperative sequel, since this entity appears in young males, for whom fertility may be a priority.

Keywords : Bladder neck obstruction; Urodynamics; Urinary disorders.

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