Department of Urology, Peking University People's Hospital, 11
Xizhimen South Street, Beijing, 100044, China
Purpose: We reported the outcomes of transurethral resection
of bladder neck (TURBN) in 22 women who were diagnosed as
primary bladder neck obstruction (PBNO).
Materials and Methods: As many as 22 women, who presented
with difficulty of urination and failed in medical therapy were
recruited between 2001 and 2007. All the patients were excluded
the neurogenic, traumatic, anatomical or iatrogenic causes of
obstruction by urodynamics and cystoscopy. All the patients
were then diagnosed with PBNO according to the Blaivas-
Groutz nomogram, and underwent TURBN. The parameters
before and after operation were analyzed.
Results: 22 patients were diagnosed with PBNO. Age was 35-78
(54.2±12.4) years. All of the patients presented with symptoms
of obstruction, including a weak or intermittent stream and
urinary hesitancy. All patients had overt urethral obstruction on
urodynamic study and the following cystoscopy ruled out the
possibility of urethral disease. All of the obstruction of patients
was clearly at the bladder neck. These patients were treated or had
previously been treated pharmacologically with α-blockers. All
patients then underwent TURBN at the bladder neck and the 1/3
proximal urethra. Surgical specimens showed urethral fragments,
fibromuscular tissue or hypertrophy of the paraurethral gland.
Follow-up was 12 months and it included physical examination,
uroflowmetry, post-void residual urine measurement and
urodynamic study. 16 patients considered themselves cured of
lower urinary tract symptoms, and the satisfaction rate reached
72.7%. The average change in AUA score was 27.0±3.5 vs. 12.0±5.2
(P<0.001). The average change in flow was 10.9±5.8 mL/s vs.
16.2±3.3 mL per second (P<0.001). The average change in voided
volume was 360.2±124.9 mL vs. 385.0±115.2 mL (P<0.01). The
average change in post-void residual urine was 178.9±166.8 mL vs.
68.2±43.9 mL (P<0.01). The average change in detrusor pressure
was 58.9±20.3 vs. 46.1±11.7 cmH2O (P<0.001).
Conclusions: TURBN is a useful and safe method for the relief
of the primary bladder neck obstruction.