Transurethral Incision of the Bladder Neck with or without Additional Procedure Resumes Spontaneous Voiding in Female Voiding Dysfunction—A Long-Term Retrospective Follow-Up
Aim: This study evaluated the long-term effectiveness of transurethral incision of the bladder neck (TUI-BN) with or without an additional procedure for female voiding dysfunction. Methods: Women with voiding difficulty who underwent TUI-BN in the last 12 years were included. All patients underwent...
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| Format: | Article |
| Language: | English |
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MDPI AG
2023-02-01
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| Series: | Journal of Clinical Medicine |
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| Online Access: | https://www.mdpi.com/2077-0383/12/4/1514 |
| _version_ | 1797620170304258048 |
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| author | Hueih-Ling Ong Hann-Chorng Kuo |
| author_facet | Hueih-Ling Ong Hann-Chorng Kuo |
| author_sort | Hueih-Ling Ong |
| collection | DOAJ |
| description | Aim: This study evaluated the long-term effectiveness of transurethral incision of the bladder neck (TUI-BN) with or without an additional procedure for female voiding dysfunction. Methods: Women with voiding difficulty who underwent TUI-BN in the last 12 years were included. All patients underwent a videourodynamics study (VUDS) at baseline and after TUI-BN. A successful outcome was defined as having a voiding efficiency (VE) increase by ≥50% after treatment. Patients with insufficient improvement were chosen for repeated TUI-BN, urethral onabotulinumtoxinA injection, or transurethral external sphincter incision (TUI-ES). The current voiding status, surgical complications, and additional surgeries were evaluated. Results: A total of 102 women with VUDS evidence of a narrow bladder neck during voiding were enrolled. The long-term success rate of the first TUI-BN was 29.4% (30/102) and increased to 66.7% (34/51) after combining TUI-BN and an additional procedure. The overall long-term success rates were 74.6% in women with detrusor underactivity (DU), 52.0% in detrusor overactivity and low contractility, 50.0% in bladder neck obstruction, 20.0% in hypersensitive bladder, and 75% in stable bladder (<i>p</i> = 0.022). Patients with a lower maximum flow rate (Qmax), (<i>p</i> = 0.002), lower voided volume (<i>p</i> < 0.001), lower corrected Qmax (<i>p</i> < 0.001), lower ladder contractility index (<i>p</i> = 0.003), lower voiding efficiency (<i>p</i> < 0.001), but larger post-void residual volume (<i>p</i> < 0.001) had a satisfactory surgical outcome. Spontaneous voiding was achieved in 66 (64.7%) patients, de novo urinary incontinence in 21 (20.6%), and vesicovaginal fistula in 4 (3.9%), all were repaired. Conclusions: TUI-BN alone or in combination with an additional procedure was safe, effective, and durable in patients with DU to resume spontaneous voiding. |
| first_indexed | 2024-03-11T08:37:17Z |
| format | Article |
| id | doaj.art-04173ab47de1480cac33502aeae8b992 |
| institution | Directory Open Access Journal |
| issn | 2077-0383 |
| language | English |
| last_indexed | 2024-03-11T08:37:17Z |
| publishDate | 2023-02-01 |
| publisher | MDPI AG |
| record_format | Article |
| series | Journal of Clinical Medicine |
| spelling | doaj.art-04173ab47de1480cac33502aeae8b9922023-11-16T21:20:38ZengMDPI AGJournal of Clinical Medicine2077-03832023-02-01124151410.3390/jcm12041514Transurethral Incision of the Bladder Neck with or without Additional Procedure Resumes Spontaneous Voiding in Female Voiding Dysfunction—A Long-Term Retrospective Follow-UpHueih-Ling Ong0Hann-Chorng Kuo1Department of Urology, Dalin Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, Chia-Yi 622, TaiwanDepartment of Urology, Hualien Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, Tzu Chi University, Hualien 970, TaiwanAim: This study evaluated the long-term effectiveness of transurethral incision of the bladder neck (TUI-BN) with or without an additional procedure for female voiding dysfunction. Methods: Women with voiding difficulty who underwent TUI-BN in the last 12 years were included. All patients underwent a videourodynamics study (VUDS) at baseline and after TUI-BN. A successful outcome was defined as having a voiding efficiency (VE) increase by ≥50% after treatment. Patients with insufficient improvement were chosen for repeated TUI-BN, urethral onabotulinumtoxinA injection, or transurethral external sphincter incision (TUI-ES). The current voiding status, surgical complications, and additional surgeries were evaluated. Results: A total of 102 women with VUDS evidence of a narrow bladder neck during voiding were enrolled. The long-term success rate of the first TUI-BN was 29.4% (30/102) and increased to 66.7% (34/51) after combining TUI-BN and an additional procedure. The overall long-term success rates were 74.6% in women with detrusor underactivity (DU), 52.0% in detrusor overactivity and low contractility, 50.0% in bladder neck obstruction, 20.0% in hypersensitive bladder, and 75% in stable bladder (<i>p</i> = 0.022). Patients with a lower maximum flow rate (Qmax), (<i>p</i> = 0.002), lower voided volume (<i>p</i> < 0.001), lower corrected Qmax (<i>p</i> < 0.001), lower ladder contractility index (<i>p</i> = 0.003), lower voiding efficiency (<i>p</i> < 0.001), but larger post-void residual volume (<i>p</i> < 0.001) had a satisfactory surgical outcome. Spontaneous voiding was achieved in 66 (64.7%) patients, de novo urinary incontinence in 21 (20.6%), and vesicovaginal fistula in 4 (3.9%), all were repaired. Conclusions: TUI-BN alone or in combination with an additional procedure was safe, effective, and durable in patients with DU to resume spontaneous voiding.https://www.mdpi.com/2077-0383/12/4/1514femalevoiding dysfunctionbladder neck obstruction |
| spellingShingle | Hueih-Ling Ong Hann-Chorng Kuo Transurethral Incision of the Bladder Neck with or without Additional Procedure Resumes Spontaneous Voiding in Female Voiding Dysfunction—A Long-Term Retrospective Follow-Up Journal of Clinical Medicine female voiding dysfunction bladder neck obstruction |
| title | Transurethral Incision of the Bladder Neck with or without Additional Procedure Resumes Spontaneous Voiding in Female Voiding Dysfunction—A Long-Term Retrospective Follow-Up |
| title_full | Transurethral Incision of the Bladder Neck with or without Additional Procedure Resumes Spontaneous Voiding in Female Voiding Dysfunction—A Long-Term Retrospective Follow-Up |
| title_fullStr | Transurethral Incision of the Bladder Neck with or without Additional Procedure Resumes Spontaneous Voiding in Female Voiding Dysfunction—A Long-Term Retrospective Follow-Up |
| title_full_unstemmed | Transurethral Incision of the Bladder Neck with or without Additional Procedure Resumes Spontaneous Voiding in Female Voiding Dysfunction—A Long-Term Retrospective Follow-Up |
| title_short | Transurethral Incision of the Bladder Neck with or without Additional Procedure Resumes Spontaneous Voiding in Female Voiding Dysfunction—A Long-Term Retrospective Follow-Up |
| title_sort | transurethral incision of the bladder neck with or without additional procedure resumes spontaneous voiding in female voiding dysfunction a long term retrospective follow up |
| topic | female voiding dysfunction bladder neck obstruction |
| url | https://www.mdpi.com/2077-0383/12/4/1514 |
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