The Long-term Effect of Superficial Bladder Neck Incision on Ejaculation and Incontinence in Boys with Primary and Secondary Bladder Neck Obstruction
نویسندگان
چکیده
OBJECTIVE Superficial bladder neck incision (SBNI) is controversial at young age, with retrograde ejaculation after puberty as main concern. The aim of the study is to investigate the long-term effect of SBNI on ejaculation and incontinence in boys with primary and secondary bladder neck obstruction (BNO). MATERIALS AND METHODS In boys with infravesical obstruction, SBNI was performed in case of a persistent BNO after earlier desobstruction or in case of primary severely obstructive bladder neck. SBNI was performed with a diathermy hook, always superficially (2-3 mm) and unilaterally at 7 O'clock. Males that had SBNI during childhood after posterior urethral valve incision or relief of other obstruction between 1986 and 2003 were included. Evaluation was done by International Continence Society male sex questionnaire, International Prostate Symptom Score, developmental International Consultation Modular Questionnaire on Urinary Incontinence, frequency volume chart, and uroflowmetry. RESULTS Of 79 traceable patients, 40 (50.6%) participated. Of these, 37 (92.5%) completed all questionnaires and 28 (70%) performed uroflowmetry. Median age at SBNI was 4.7 years [interquartile range (IQR) 0.6-8.5] and was 19.6 years (IQR 17.3-20.9) at follow-up. All men had antegrade ejaculation, 4/37 (10.8%) reported possibly reduced ejaculatory volume. Eight (22%) had moderate lower urinary tract symptoms and two (5.4%) had moderate incontinence. Median maximum flow rate was 30.1 mL/s (IQR 24.4-42.6). CONCLUSION SBNI in boys with severe infravesical obstruction can be done safely with preservation of antegrade ejaculation and no additional lower urinary tract dysfunction.
منابع مشابه
EXPERIENCE WITH BLADDER NECK INCISION TO RELIEVE BLADDER OUTLET OBSTRUCTION VERSUS TRANSURETHRAL RESECTION OF THE PROSTATE IN SHIRAZ
TUR is cited as the treatment of choice for relief of bladder outflow tract obstruction in the male, but bladder neck incision (BNI) is an acceptable alternative when the gland is smalI.1,2,3 Sixty cases of BNIfTUR have been reviewed (BNI=35, TUR=25) from March, 1986 to April, 1988. BNI was done when the glands were less than 30 gr , and when there was no clinical suspicion of malignancy t...
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