Primary bladder neck obstruction is one of the rare causes for renal failure in young adult males

Abstract

Background Primary bladder neck obstruction (PBNO) is one of the causes of bladder outlet obstruction (BOO) and rarely results in renal failure. We are presenting the clinical characteristics of young male patients with PBNO and renal failure. Methods Medical records of patients between 18 and 40 years old with PBNO and renal failure were retrospectively reviewed (2014–2020). Patients with anatomical cause of BOO, and any urological or systemic disease or previous history of any surgical procedure associated with renal failure and/or lower urinary tract dysfunction were excluded. Serum creatinine measurement, ultrasonography, uroflowmetry, cystoscopy, and videourodynamics were performed. Results Seven male patients were identified, and the mean age of the patients was 28.8 years. Symptom duration was > 5 years in all patients. Two patients presented with difficult voiding, and five patients presented with both storage and voiding lower urinary tract symptoms (LUTS). Three patients were previously misdiagnosed as overactive bladder. At presentation, serum creatinine levels were between 1.7 and 2.4 mg/dl. One patient was under hemodialysis treatment and waiting for renal transplantation. Mean detrusor pressure at maximum measured flow rate, mean maximum flow rate (Qmax), and mean average flow rate (Qave) was 67.6 cm H2O, 9.5 ml/s, and 5.5 ml/s, respectively. With α-blocker treatment, serum creatinine levels were stable or decreased after 12 months follow-up and mean Qmax and Qave were increased to 14.8 ml/s and 10.1 ml/s, respectively. Conclusions PBNO is a common disease in young men presenting with a long history of LUTS. Videourodynamics is mandatory for accurate diagnosis, but having a high clinical suspicion for PBNO is key to ensure the diagnosis. Clinicians should pay more attention to PBNO in young male patients with a long history of LUTS to prevent misdiagnosis, incorrect treatment, and possible decrease in renal function by years.

Bladder Outlet Obstruction: Etiological Pattern in Southwestern Nigeria

“…These may subsequently lead to secondary changes in the bladder as well as upper urinary tract with attendant storage symptoms such as frequency, urgency, and nocturia (16). It may be complicated by renal failure, as noted in this study and some similar series (17). the duration of symptoms of bladder outlet obstruction BOO was not determined in this study the clinical features at presentation are a strong pointer to delayed presentation and its attendant burden.…”

Comparison of Outcome of Unilateral Modified Bladder Neck Incision and Tamsulosin Therapy in the Treatment of Primary Bladder Neck Obstruction in Young Men

“…Primary bladder neck obstruction (PBNO) is a urological condition affecting both sex in which the bladder neck fails to open adequately during voiding, resulting in obstruction of urinary flow in the absence of anatomic obstruction, such as benign prostatic hypertrophy (BPH) in men. 1 The incidence of PBNO in female patients with obstructive symptoms and in male patients younger than 55 years of age with chronic voiding dysfunction is reported to be between 4.6-16% and 33-54%, respectively. 2 Treatments for PBNO varies from watchful waiting to medical therapy byadrenergic blockers like prazosin 2 mg twice daily, terazosin 2 mg daily, doxazosin 4 mg daily, tamsulosin 0.4 mg daily.…”