Diagnosis and treatment of primary bladder neck obstruction in men

Although primary bladder neck obstruction was first described approximately 70 years ago, it is within the past 20 years that the symptoms, signs, and methods of diagnosis and treatment have been elucidated. This article describes its typical presenting symptoms and signs that commonly may lead to a missed diagnosis for a number of years in many cases. The treatments typically available are pharmacologic or surgical. Unfortunately, most treatments have not been studied in prospective, randomized trials to assess true efficacy. The natural history of this disorder, both treated and untreated, demands much further study to determine its effect on progression of symptoms and bladder and renal function.