#23389

Bladder neck obstruction: The change in urodynamic parameters with time

Stephens R1, Malde S1, Taylor C1, Sahai A1, Solomon E1

1. Guy's and ST Thomas'

KEYWORDS: Bladder Outlet Obstruction , Male, Voiding Dysfunction , Prevention

Primary bladder neck obstruction (PBNO) is thought to account for ~50% of bladder outlet obstruction (BOO) diagnoses in men under 50 years of age(1).

The three possible interventions for PBNO include: watchful waiting (till patient completes family) +/- pharmacotherapy or surgical intervention. Pharmacotherapy through the use of α – blockers only reports variable success. The most effective treatment for PBNO is surgical intervention through bladder neck incision (BNI). Retrograde ejaculation, which occurs in 10-50% of BNI cases, deters many patents till they have completed their family.

Bladder outlet obstruction can cause tissue changes in the bladder wall through increased oxidative stresses and smooth muscle hypertrophy, resulting in bladder dysfunction (BD)(2). The natural history of PBNO is not well characterised, therefore clinicians aren’t able to confidently counsel a patient on how untreated BOO may result in BD and ultimately renal impairment.
The aim of our study is to retrospectively analyse and compare bladder parameters for patients diagnosed with PBNO who have undergone two urodynamic (UDS) investigations following a decision of ‘watchful waiting’; to see if we can evaluate the presence and progression of BD.