We evaluated 60 patients placed on a clean intermittent catheterization program more than 10 years ago to determine their outcome. To date 27 patients still are performing self-catheterization, 18 have discontinued the procedure and 15 have been lost to followup. No patient has had deterioration in renal function. Prior incontinence was alleviated completely in 10 of the 27 patients still on the program and 10 of the 18 patients no longer on catheterization have returned to normal voiding. Clean intermittent catheterization is an effective treatment modality in properly selected patients, with few complications and excellent long-term results.
Bladder neck obstruction in women is rare. Recently, we encountered 3 cases with similar findings. Clinically, the patients had chronic bladder symptoms of obstruction and irritation. The bladder showed trabeculation, diverticula and/or vesicoureteral reflux. Urinary flow rates were poor or absent. Endoscopy was unreliable in evaluating the outlet. The voiding pressure-flow cystourethrography study established the diagnosis. Specific operations to relieve bladder neck obstruction may be justified with proper urodynamic documentation.
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