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Transurethral Resection of the Bladder Neck in Female Patients with Bladder outlet Obstruction

Mahmoud Mustafa

Abstract


Aim: To evaluate the efficacy of transurethral resection (TUR) of the bladder neck and proximal urethra in the treatment of women with urinary retention (UR) due to bladder outlet obstruction(BOO).

Material and methods: Seven female patients with median age of 37 years (range: 18-81) who underwent TUR of the bladder neck and proximal urethra between October 2013 and October 2014 were included.  Three patients had a permanent Foley catheter and 4 were on clean intermittent self catheterization (CIC). Preoperative investigations included a full urodynamic evaluation and urethrocystoscopy.  The average voiding pressure in the urodynamic study was 43.3 cm H2O (range: 22-65).  Foley catheter was left for 3 days after operation. The postoperative follow up schedule was 1/2, 1, 2, 3 months, and then every 4 months. At each visit, estimation of post voiding residue, uroflowmetry and real time abdominal ultrasound and clinical history for possible urinary leakage were done. The mean follow-up duration was 16 months (range: 9-19).

Results: Six patients (85.75%) completely benefited from the procedure and resumed spontaneous voiding. One patient with a previous history of vaginal surgery partially benefited and significant PVR was present, thus the patient continued on CIC.  One patient had a mild form of urge incontinence and she benefited from anti cholinergic therapy.   

Conclusions: Transurethral resection in women is a feasible treatment option in relieving voiding difficulties owing to anatomic or functional bladder neck obstruction. Careful evaluation and detailed history with full urodynamic evaluation are required. 


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