Feasibility of Bladder Neck Incision in Female Patients With Primary Bladder Neck Obstruction: Our Experience

Area of Science:

• Urology
• Surgical Innovation
• Female Lower Urinary Tract Symptoms

Background:

• Primary bladder neck obstruction in women is a challenging condition.
• Conservative treatments often yield suboptimal results.
• Surgical intervention may be necessary for refractory cases.

Purpose of the Study:

• To evaluate the feasibility and efficacy of bladder neck incision (BNI) in female patients with primary bladder neck obstruction.
• To assess the safety and outcomes of a specific endoscopic BNI technique.

Main Methods:

• A cohort of 48 female patients with confirmed bladder neck obstruction underwent endoscopic BNI.
• Preoperative and postoperative assessments included uroflowmetry, voiding cystometrogram, cystourethroscopy, and symptom scores.
• The surgical technique involved endoscopic incisions at the five and seven o'clock positions using bipolar diathermy.

Main Results:

• Postoperative maximum flow rate (Qmax) significantly improved from 7.14 mL/sec to 19.37 mL/sec.
• International Consultation on Incontinence Questionnaire - Female Lower Urinary Tract Symptoms Long Form (ICIQ-FLUTS LF) scores decreased from 19.4 to 7.6.
• Post-void residual urine (PVRU) reduced from 139 mL to 32 mL, with improved quality of life scores.

Conclusions:

• Bladder neck incision (BNI) is a safe, effective, and minimally invasive treatment for female bladder neck obstruction.
• The described endoscopic technique is straightforward to perform with a low complication rate.
• BNI offers a valuable therapeutic option for women unresponsive to conservative management.