Severe urinary tract damage secondary to primary bladder neck obstruction in women.
<h4>Objective</h4>To present the clinical and radiological characteristics of women with severe structural deterioration of the bladder and upper urinary tract secondary to Primary Bladder Neck Obstruction (PBNO), and their outcomes after bladder neck incision (BNI).<h4>Methods<...
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Public Library of Science (PLoS)
2021-01-01
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| Series: | PLoS ONE |
| Online Access: | https://journals.plos.org/plosone/article/file?id=10.1371/journal.pone.0248938&type=printable |
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| author | Pedro F S Freitas Augusto Q Coelho Homero Bruschini Eric S Rovner Cristiano M Gomes |
| author_facet | Pedro F S Freitas Augusto Q Coelho Homero Bruschini Eric S Rovner Cristiano M Gomes |
| author_sort | Pedro F S Freitas |
| collection | DOAJ |
| description | <h4>Objective</h4>To present the clinical and radiological characteristics of women with severe structural deterioration of the bladder and upper urinary tract secondary to Primary Bladder Neck Obstruction (PBNO), and their outcomes after bladder neck incision (BNI).<h4>Methods</h4>Retrospective evaluation of adult women who underwent BNI for PBNO at one institution. Patients were assessed for symptoms, renal function, structural abnormalities of the urinary tract and video-urodynamics. PBNO diagnosis was confirmed with video-urodynamics in all patients. BNI was performed at the 4-5 and/or 7-8 o'clock positions. Postoperative symptoms, PVR, uroflowmetry and renal function were evaluated and compared to baseline.<h4>Results</h4>Median patient age was 56.5 years (range 40-80). All presented with urinary retention-four were on clean intermittent Catheterization (CIC) and two with a Foley catheter. All patients had bladder wall thickening and diverticula. Four women had elevated creatinine levels, bilateral hydronephrosis was present in five (83.3%). After BNI, all patients resumed spontaneous voiding without the need for CIC. Median Qmax significantly improved from 2.0 [1.0-4.0] mL/s to 15 [10-22.7] mL/s (p = 0.031). Median PVR decreased from 150 to 46 [22-76] mL (p = 0.031). There were no postoperative complications. Creatinine levels returned to normal in 3/4 (75%) patients.<h4>Conclusion</h4>PBNO in women may result in severe damage to the bladder and upper urinary tract. Despite severe structural abnormalities of the bladder, BNI was effective in reducing symptoms and improving structural and functional abnormalities of the lower and upper urinary tract. |
| format | Article |
| id | doaj-art-dfcccf4ca8934093bcac131b5f5f1c68 |
| institution | OA Journals |
| issn | 1932-6203 |
| language | English |
| publishDate | 2021-01-01 |
| publisher | Public Library of Science (PLoS) |
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| series | PLoS ONE |
| spelling | doaj-art-dfcccf4ca8934093bcac131b5f5f1c682025-08-20T02:17:50ZengPublic Library of Science (PLoS)PLoS ONE1932-62032021-01-01163e024893810.1371/journal.pone.0248938Severe urinary tract damage secondary to primary bladder neck obstruction in women.Pedro F S FreitasAugusto Q CoelhoHomero BruschiniEric S RovnerCristiano M Gomes<h4>Objective</h4>To present the clinical and radiological characteristics of women with severe structural deterioration of the bladder and upper urinary tract secondary to Primary Bladder Neck Obstruction (PBNO), and their outcomes after bladder neck incision (BNI).<h4>Methods</h4>Retrospective evaluation of adult women who underwent BNI for PBNO at one institution. Patients were assessed for symptoms, renal function, structural abnormalities of the urinary tract and video-urodynamics. PBNO diagnosis was confirmed with video-urodynamics in all patients. BNI was performed at the 4-5 and/or 7-8 o'clock positions. Postoperative symptoms, PVR, uroflowmetry and renal function were evaluated and compared to baseline.<h4>Results</h4>Median patient age was 56.5 years (range 40-80). All presented with urinary retention-four were on clean intermittent Catheterization (CIC) and two with a Foley catheter. All patients had bladder wall thickening and diverticula. Four women had elevated creatinine levels, bilateral hydronephrosis was present in five (83.3%). After BNI, all patients resumed spontaneous voiding without the need for CIC. Median Qmax significantly improved from 2.0 [1.0-4.0] mL/s to 15 [10-22.7] mL/s (p = 0.031). Median PVR decreased from 150 to 46 [22-76] mL (p = 0.031). There were no postoperative complications. Creatinine levels returned to normal in 3/4 (75%) patients.<h4>Conclusion</h4>PBNO in women may result in severe damage to the bladder and upper urinary tract. Despite severe structural abnormalities of the bladder, BNI was effective in reducing symptoms and improving structural and functional abnormalities of the lower and upper urinary tract.https://journals.plos.org/plosone/article/file?id=10.1371/journal.pone.0248938&type=printable |
| spellingShingle | Pedro F S Freitas Augusto Q Coelho Homero Bruschini Eric S Rovner Cristiano M Gomes Severe urinary tract damage secondary to primary bladder neck obstruction in women. PLoS ONE |
| title | Severe urinary tract damage secondary to primary bladder neck obstruction in women. |
| title_full | Severe urinary tract damage secondary to primary bladder neck obstruction in women. |
| title_fullStr | Severe urinary tract damage secondary to primary bladder neck obstruction in women. |
| title_full_unstemmed | Severe urinary tract damage secondary to primary bladder neck obstruction in women. |
| title_short | Severe urinary tract damage secondary to primary bladder neck obstruction in women. |
| title_sort | severe urinary tract damage secondary to primary bladder neck obstruction in women |
| url | https://journals.plos.org/plosone/article/file?id=10.1371/journal.pone.0248938&type=printable |
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