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Endoscopic incision for functional bladder neck obstruction in men: long-term outcome
Amit Suri1, Aneesh Srivastava, Kamal Jeet Singh
1Department of Urology, Sanjay Gandhi Post Graduate Institute of Medical Sciences, Lucknow, India.
Urology
|July 26, 2005
Summary
Endoscopic bladder neck incision (BNI) effectively treats functional bladder neck obstruction unresponsive to medication. This procedure offers durable relief for lower urinary tract symptoms in men, with sustained improvements in flow rate and symptom scores.
Area of Science:
- Urology
- Surgical Innovation
Background:
- Functional bladder neck obstruction causes lower urinary tract symptoms in men.
- Alpha-blockers are the initial treatment but often fail to resolve symptoms.
Purpose of the Study:
- To evaluate the long-term outcomes of endoscopic bladder neck incision (BNI) for functional bladder neck obstruction.
- Assess the efficacy and durability of BNI in patients refractory to medical management.
Main Methods:
- Retrospective review of 45 men with obstructive voiding symptoms treated between 1988-1996.
- Included patients had specific urodynamic criteria and failed initial treatment with alpha-blockers or clean intermittent catheterization.
- BNI was performed on 18 patients, with outcomes assessed via symptom scores, uroflowmetry, and postvoid residual urine volume.
Main Results:
- After BNI, all 18 patients showed significant improvement in symptom scores (26.9 to 3.6, P < 0.001) and peak flow rate (8.5 to 19.6 mL/s, P < 0.001).
- Symptom and flow rate improvements persisted in over 80% of patients at a mean follow-up of 96 months.
- Two patients required a second BNI and maintained positive outcomes.
Conclusions:
- Endoscopic bladder neck incision (BNI) is an effective treatment for functional bladder neck obstruction.
- BNI provides durable, long-term relief for patients unresponsive to alpha-blockers.