Audit of bladder neck resection in spinal cord injured patients

“…This is indicated only for secondary changes at the bladder neck (fibrosis) (1,9,152,155). When the detrusor is hypertrophied and causes thickening of the bladder neck, this procedure makes no sense (1).…”

Section: Bladder Neck Incisionmentioning

confidence: 99%

Forty-five-year follow-up on the renal function after spinal cord injury

et al. 2016

View full text Add to dashboard Cite

“…In those who fail medical treatment, TUI‐BN can be managed successfully. Similarly, alpha‐blockers have been used for treating functional BOO in women 26 . It is believed that alpha‐blocker agents may indeed decrease the dynamic competence of obstruction through blocking alpha‐adrenergic receptors on the urethral smooth muscle and by decreasing activity of sympathetic nerves innervating the bladder neck and urethra.…”

Section: Discussionmentioning

confidence: 99%

Female bladder neck dysfunction—A video‐urodynamic diagnosis among women with voiding dysfunction

Ong¹,

Lee

Kuo

2020

LUTS

View full text Add to dashboard Cite

Objective To investigate bladder neck dysfunction (BND) in women with voiding dysfunction by video‐urodynamic study (VUDS) and to examine the therapeutic results of different BND subtypes. Materials and Methods We retrospectively reviewed consecutive women who had undergone VUDS for investigation of voiding dysfunction at our institution. The diagnosis of BND was made based on a nonfunneling bladder neck with or without high voiding detrusor pressure. Patients diagnosed as BND were retrieved, and the urodynamic parameters were compared with patients with dysfunctional voiding (DV) and other bladder outlet obstructions (BOO). Results Among 810 women with bladder outlet dysfunction, BND was noted in 100 (12.3%), poor pelvic floor relaxation in 336 (41.5%), DV in 325 (40.1%), cystocele in 19 (2%), and urethral stricture in 30 (4%). Compared with the normal tracing group, BND patients had a significantly smaller volume of bladder filling sensation (included first sensation of filling, full sensation and cystometric bladder capaicity) and a greater BOO index (BOOI) (all P < .05). Detrusor overactivity was noted in 46 (46%) BND patients. These urodynamic parameters in BND were not significantly different from patients with DV or other BOO. High‐pressure BND had a greater BOOI, but low‐pressure BND had a lower voiding efficiency. Both alpha‐blocker therapy and transurethral incision of the bladder neck improved uroflow parameters in BND patients. Conclusions BND includes 12.3% of women with bladder outlet dysfunction. High‐pressure BND can cause anatomical BOO, whereas low‐pressure BND is likely to affect micturition through inhibiting detrusor contractility. VUDS is the mainstay diagnostic tool to diagnose BND in women.

show abstract

“…A videourodynamic study is essential to make an accurate diagnosis of bladder neck obstruction in SCI patients with DSD [27]. Blind bladder neck resection without prior urodynamic evaluation has been found to be useless in achieving therapeutic effect in these patients [40].…”

Section: Surgical Management Of Bladder Neck Dysfunction In Spinal Comentioning

confidence: 99%

Bladder Neck Dysfunction in Spinal Cord Injury

Kuo

2011

Curr Bladder Dysfunct Rep

View full text Add to dashboard Cite

Spinal cord injury (SCI) impairs the voluntary and autonomic control of storage and emptying functions of the urinary bladder, leading to a marked remodulation of the micturition reflex. Autonomic dysreflexia (AD) is found in SCI patients with a lesion level above T6. The occurrence of AD in SCI patients may also result in bladder neck dysfunction, which is often associated with AD and may cause bladder neck obstruction or inhibit detrusor contractility. Patients with bladder neck dysfunction may present with normal or underactive detrusor contractility, resulting in inefficient bladder emptying and prolonged AD. Using videourodynamic study, bladder neck dysfunction can be clearly demonstrated as a narrow bladder neck associated with a narrow external urethral sphincter and normal detrusor contractility. Medical treatment with α-adrenergic agents is the first-line treatment for patients with bladder neck dysfunction. If medical treatment fails, transurethral incision of the bladder neck is indicated to relieve bladder outlet obstruction and to resume spontaneous detrusor contractility.

show abstract

Audit of bladder neck resection in spinal cord injured patients

Cited by 7 publications

References 7 publications

Forty-five-year follow-up on the renal function after spinal cord injury

Forty-five-year follow-up on the renal function after spinal cord injury

Female bladder neck dysfunction—A video‐urodynamic diagnosis among women with voiding dysfunction

Bladder Neck Dysfunction in Spinal Cord Injury

Contact Info

Product

Resources

About