Female Primary Bladder Neck Obstruction: Role of Videourodynamics and Treatment Options in a Rare Clinical Entity. Issue 2 (April 2017)

• Record Type: Journal Article
• Authors: Ammirati, Enrico; Manassero, Alberto; Giammò, Alessandro; Marson, Francesco; Gurioli, Alberto; Carone, Roberto
• Is Part Of: Urologia journal. Volume 84:Issue 2(2017)
• Page Start: 109
• Page End: 112
• Publication Date: 2017-04
• Subjects: Bladder neck obstruction -- Female -- Videourodynamics; Urology -- Periodicals; 616.6005
• DOI: 10.5301/uro.5000203
• Languages: English
• ISSNs: 0391-5603

Abstract

Introduction: Primary female bladder neck obstruction is a rare clinical condition characterized by the absence/incomplete bladder neck opening during the voiding phase of micturition. Methods: We present the cases of two women complaining dysuria, abdominal straining and sensation of incomplete bladder emptying. Videourodynamic evaluation was fundamental for a correct diagnosis. Results: Videourodynamic evaluation showed a high detrusor pressure during emptying phase, partial use of abdominal strain, very low urine flow rate and significant postvoid residual; imaging showed a defect in the physiological funneling of the bladder neck, absent or incomplete. The first step therapy is represented by oral alpha-blockers and clean intermittent self-catheterization in case of high postvoid residual. Surgical operations, such as bladder neck incision and resection, represent the last option. Conclusions: In our experience, bladder neck obstruction is a rare condition in women and only a complete clinical evaluation associated with videourodynamic study can lead to an appropriate diagnosis and treatment.