Unilateral transurethral incision for primary bladder neck obstruction: symptom relief and fertility preservation

Our aim was to review the results of unilateral transurethral incision (TUI) of the bladder neck for the treatment of primary bladder neck obstruction. A total of 35 patients with the mean age of 40.31 years were included in the study. The international prostate symptom score (I-PSS), quality of life (QoL) score, uroflowmetry and sperm count were determined. The mean preoperative I-PSS was 32.1 points, peak urine flow rate was 7.8 cc/s and sperm count was 59.2 million/cc. There was a 28% reduction of I-PSS at 3 months, 38% at 6 months and 55% at 1 year. The urine peak flow rate increased by 54% at 3 months, 83% at 6 months and 95% at 1 year. The reduction in the sperm count was 63% at 6 months and 69% at 1 year. The QoL score improved significantly after 1 year compared with the preoperative period. Unilateral TUI of the bladder neck is an effective treatment for primary bladder neck obstruction. However, the postoperative sperm count is significantly reduced at 6-12 months (18-21 million/cc) but is probably sufficient for adequate fertility.