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Is Sacral Neuromodulation a Treatment Option for Primary Bladder Neck Obstruction?
Ibrahim Alzahrani1, Hossam S El-Tholoth2, Ali Alsulihem2
1Urology, Security Forces Hospital, Riyadh, SAU.
Cureus
|January 26, 2023
Summary
Sacral neuromodulation offers a novel treatment for primary bladder neck obstruction (PBNO). This case study shows significant symptom improvement in a patient unresponsive to other therapies.
Area of Science:
- Urology
- Neuromodulation
- Lower Urinary Tract Symptoms
Background:
- Primary bladder neck obstruction (PBNO) presents with storage and voiding symptoms.
- Conservative and medical treatments, including chemodenervation, are often unresponsive.
- Surgical options like bladder neck incision carry risks such as retrograde ejaculation.
Observation:
- A 48-year-old male with refractory PBNO was considered for sacral neuromodulation.
- The patient opted for sacral neuromodulation to avoid risks associated with bladder neck incision.
- Diagnostic workup included urodynamic study, voiding cystourethrography, and cystoscopy.
Findings:
- Sacral neuromodulation was successfully implemented as a treatment for PBNO.
- The patient reported significant improvement in lower urinary tract symptoms.
- Follow-up uroflowmetry at six months showed no obstructive pattern.
Implications:
- Sacral neuromodulation represents a potential new therapeutic avenue for PBNO.
- This approach may be suitable for patients who are not candidates for or decline traditional surgical interventions.
- Further research is warranted to establish the long-term efficacy and safety of sacral neuromodulation for PBNO.
