Managing Bladder-Neck Stenosis With "Cystoscopy and Proceed" Method: Our Experience

Bladder-neck stenosis (BNS) is characterized by obstruction of urine flow due to improper relaxation of the bladder neck. Accurate diagnosis through cystoscopy and treatment via bladder-neck incision (BNI) can restore urinary flow and reduce the risk of related complications. Our experience suggests that cystoscopy for diagnosis is underused due to various patient and physician-related factors.

The primary objective of this study was to evaluate the effectiveness of the "cystoscopy and proceed" method in managing BNS, measured by improvement in uroflowmetry (Qmax). Secondary objectives included assessing recurrence rates, urinary symptom burden using International Prostate Symptom Score (IPSS), patient-reported quality of life Short Form-36 (SF-36), and procedural complications at 10-18 months of follow-up.

We conducted a retrospective observational study at a private urology center involving 10 patients with cystoscopically confirmed BNS. Data collection included preoperative and postoperative records and follow-up between 10 and 18 months after surgery to assess long-term outcomes in urinary symptoms and satisfaction using IPSS and SF-36, respectively. Statistical analysis was done using Student's t-test and Pearson's correlation.

The mean age of participants was 64 years. All 10 patients experienced improvements in uroflowmetry, with an average Qmax increase of 14.33 (738.1%), reflecting a 7.4-fold improvement after BNI. A paired t-test revealed a significant difference between preoperative and postoperative Qmax p < 0.001. At 10-18 months follow-up, six patients had satisfaction scores above 80%, and eight scored 70% or higher.

Cystoscopy and BNI effectively manage BNS, leading to significant improvements in patient outcomes and satisfaction.