Bladder neck anesthesia and resection in women with detrusor hyperreflexia

Nineteen women with detrusor hyperreflexia were investigated urodynamically before and 3 months after bladder neck resection. In the case of the first 10 patients bladder neck anesthesia was performed before resection. In only 2 patients urodynamic reactions to anesthesia and to resection were similar and related to the effect of the resection. In 11 patients bladder neck resection improved voiding symptoms and a significant reduction in the urinary incontinence was found. Bladder neck resection was followed by a significant increase in the effective bladder volume and the bladder volume at first detrusor hyperreflexia. An insignificant reduction in the residual urine of 13% was observed after bladder neck resection but the distance to maximal urethral closure pressure and the area of the functional part of the urethral pressure profile was significantly reduced.