Functional Bladder Neck Obstruction: A Rare Cause of Renal Failure
1995; Lippincott Williams & Wilkins; Volume: 154; Issue: 1 Linguagem: Inglês
10.1016/s0022-5347(01)67262-8
ISSN1527-3792
AutoresAnant Kumar, Gautam Kumar Banerjee, Mahesh C. Goel, V.K. Mishra, Rakesh Kapoor, Mahendra Bhandari,
Tópico(s)Urological Disorders and Treatments
ResumoNo AccessJournal of UrologyClinical Urology: Urological Neurology and Urodynamics1 Jul 1995Functional Bladder Neck Obstruction: A Rare Cause of Renal Failure Anant Kumar, Gautam Kumar Banerjee, Mahesh Chand Goel, V.K. Mishra, Rakesh Kapoor, and Mahendra Bhandari Anant KumarAnant Kumar , Gautam Kumar BanerjeeGautam Kumar Banerjee , Mahesh Chand GoelMahesh Chand Goel , V.K. MishraV.K. Mishra , Rakesh KapoorRakesh Kapoor , and Mahendra BhandariMahendra Bhandari View All Author Informationhttps://doi.org/10.1016/S0022-5347(01)67262-8AboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail We studied 7 men and 6 women (average age 33 years) who presented in renal failure with obstructive voiding symptoms or retention. Of these patients 11 had a dilated upper tract and 2 had shrunken kidneys. Mean serum creatinine at presentation was 7.0 mg./dl. No abnormality was noted on cysto-panendoscopy, retrograde urethrography and voiding cystourethrography. The patients were initially treated with clean intermittent self-catheterization following 7 to 10 days of indwelling catheterization. The majority of patients had low pressure and low flow rate at initial presentation but high end filling pressure (mean 35.3 cm. water), high voiding pressure (mean 118.9 cm. water), high opening pressure (mean 95.3 cm. water) and low peak flow (mean 5.7 ml. per second) on video pressure flow electromyography. The external sphincter was relaxed during voiding but the bladder neck opened intermittently or inadequately. No proper funneling of the bladder neck was seen. Thus, functional bladder neck obstruction was considered to be responsible for obstructive voiding in these patients. Of the patients 3 void to completion with the help of alpha blockers alone, 5 underwent bladder neck incision and are voiding well, and 5 were practicing clean intermittent self-catheterization at last followup. Serum creatinine returned to near normal in 10 patients. End stage renal failure persisted in 2 patients, 1 of whom underwent renal transplantation and is voiding well but the other died without having undergone renal replacement therapy. In the remaining patient serum creatinine was stable at 3.2 mg./dl. Mean serum creatinine at 6 months of followup was 2.33 mg. percent. Bladder neck obstruction is a rare cause of renal failure which can be corrected if treated appropriately. References 1 : Functional bladder neck obstruction in females--a revisit. Arch. Esp. Urol.1991; 44: 1209. Google Scholar 2 : Functional bladder neck obstruction in males: a progressive disorder? Eur. Urol.1992; 22: 123. Google Scholar 3 : Renal function and prostatism. Lancet1957; 1: 1322. Google Scholar 4 : Practical management of patients with dilated upper tracts and chronic retention of urine. Brit. J. Urol.1984; 56: 9. Google Scholar 5 : Obstructive and functional abnormalities II. In: Obstructive Uropathy. Edited by . Berlin: Springer Verlag1986: 277. chapt. 12. Google Scholar 6 : Chronic retention of urine. The relationship between upper tract dilatation and bladder pressure. Brit. J. Urol.1986; 58: 647. Google Scholar 7 : High pressure chronic retention. Incidence, aetiology and sinister implications. Brit. J. Urol.1986; 58: 644. Google Scholar 8 : Upper urinary tract deterioration in patients with myelodysplasia and detrusor hypertonia: a followup study. J. Urol.1983; 129: 823. Link, Google Scholar 9 : Editorial: bladder compliance. J. Urol.1994; 151: 965. Link, Google Scholar 10 : The physical basis of obstructive uropathy. In: Benign Prostatic Hypertrophy. Edited by . New York: Springer Verlag1983: 433. Google Scholar 11 : Benign prostatic hyperplasia. In: . Chicago: Year Book Medical Publisher1987: 1062. chapt. 33. Google Scholar 12 : The primary megacystis syndrome. J. Urol.1981; 125: 232. Link, Google Scholar 13 : A urodynamic analysis of micturition symptoms in the female. Surg., Gynec. & Obst.1975; 141: 875. Google Scholar 14 : Bladder neck obstruction in women: a real entity. J. Urol.1984; 132: 294. Link, Google Scholar 15 : Bladder neck obstruction in women. J. Urol.1987; 137: 497. Link, Google Scholar 16 : Vesical and ureteral damage from voiding dysfunction in boys without neurologic or obstructive disease. J. Urol.1973; 109: 727. Link, Google Scholar 17 : Nonneurogenic neurogenic bladder (the Hinman syndrome)--15 years later. J. Urol.1986; 136: 769. Abstract, Google Scholar Departments of Urology and Nephrology, Sanjay Gandhi Post Graduate Institute of Medical Sciences, Lucknow, India.© 1995 by American Urological Association, Inc.FiguresReferencesRelatedDetailsCited byKumar A, Mandhani A, Gogoi S and Srivastava A (2018) MANAGEMENT OF FUNCTIONAL BLADDER NECK OBSTRUCTION IN WOMEN: USE OF α-BLOCKERS AND PEDIATRIC RESECTOSCOPE FOR BLADDER NECK INCISIONJournal of Urology, VOL. 162, NO. 6, (2061-2065), Online publication date: 1-Dec-1999. Volume 154Issue 1July 1995Page: 186-189 Advertisement Copyright & Permissions© 1995 by American Urological Association, Inc.MetricsAuthor Information Anant Kumar More articles by this author Gautam Kumar Banerjee More articles by this author Mahesh Chand Goel More articles by this author V.K. Mishra More articles by this author Rakesh Kapoor More articles by this author Mahendra Bhandari More articles by this author Expand All Advertisement PDF downloadLoading ...
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