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Related Experiment Videos

Functional bladder neck obstruction in males: a progressive disorder?

V K Mishra1, A Kumar, R Kapoor

  • 1Department of Urology, Sanjay Gandhi Postgraduate Institute of Medical Sciences, Lucknow, India.

European Urology
|January 1, 1992
PubMed
Summary

Functional bladder neck obstruction in young men can lead to serious urinary retention and renal failure. Synchronous pressure flow electromyography (EMG) accurately diagnoses this condition, enabling effective treatment.

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Area of Science:

  • Urology
  • Nephrology
  • Physiology

Background:

  • Functional bladder neck obstruction is an often-overlooked cause of male lower urinary tract symptoms.
  • Delayed diagnosis can result in acute or chronic urinary retention and potentially end-stage renal disease.
  • Accurate diagnosis is crucial for preventing irreversible kidney damage.

Purpose of the Study:

  • To report on a series of young men diagnosed with functional bladder neck obstruction.
  • To highlight the diagnostic utility of synchronous pressure flow electromyography (EMG).
  • To describe treatment outcomes for this patient cohort.

Main Methods:

  • Retrospective analysis of 16 male patients under 45 years old.
  • Diagnosis confirmed via synchronous pressure flow electromyography (EMG) and video urodynamics.

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  • Assessment of detrusor pressure, flow rate, and bladder neck opening during voiding.
  • Main Results:

    • All patients exhibited high detrusor pressure (mean 157 cm H2O) with poor flow (mean 9.89 ml/s).
    • EMG and video studies showed quiescent external sphincter activity and inadequate bladder neck opening.
    • Three patients presented with renal failure, which improved in two following treatment.

    Conclusions:

    • Functional bladder neck obstruction is a treatable cause of bladder outlet obstruction in young men.
    • Synchronous pressure flow EMG is a valuable diagnostic tool.
    • Treatment options include clean intermittent catheterization, alpha-blockers, and endoscopic bladder neck incision, with potential for renal function recovery.