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[Endoscopic cervicotomy: elective treatment in bladder neck sclerosis]
F Martín-Laborda y Bergasa1, J Vallejo Herrador, P L Sánchez de la Muela Naverac
1Servicio de Urología, Hospital Universitario del Aire, Madrid, España.
Objectives:
The present study compared the efficacy of perimetric resection of the sclerotic ring (TR) and two-incision endoscopic cervicotomy (TC) for bladder neck sclerosis.
Methods:
Fourteen cases (11 primary and 3 recurrence) underwent perimetric TR using a conventional 24 F curved loop resectoscope to excise the sclerotic diaphragm completely. In 11 cases (9 primary and 2 recurrence following previous perimetric (TR) two deep incisions were made at 5 and 7 o'clock with the Collins blade. Occasionally, the Sachse urethrotome had to precede the insertion of the conventional 24 F sheath.
Results:
Of the 14 cases with bladder neck sclerosis that underwent perimetric TR, 5 (36%) recurred, while no recurrence was observed in the 11 patients treated by double TC. The results were assessed on the basis of the clinical findings and control flowmetry.
Conclusions:
Dysuria was the most common clinical symptom and was confirmed by flowmetry. Confirmation must be done endoscopically and preferably under anesthesia to permit treatment, if required, during the same session. TC is more reliable and TR is not advocated because of the high recurrence rate.