Bladder neck obstruction

Classification according to ICD-10
N32.0	Bladder neck obstruction
Q64.2	Other atresia and (congenital) stenosis of the urethra and bladder neck
ICD-10 online (WHO version 2019)

The bladder neck obstruction is an obstruction of the outflow of micturition (bladder emptying) at the level of the bladder neck due to mechanical or functional constriction.

root cause

The following causes are possible:

congenital (primary) (PBNO)
- Malformation of the urethral valve , ectopic ureterocele
- Fibroelastosis ( stenosis , outdated: Marion disease ), remodeling of the bladder neck muscle by elastic tissue
- muscular and neurological dysfunction ( neurogenic bladder )
acquired (secondary)
- Inflammation , e.g. B. Urethral stricture in chronic prostatitis
- postoperative scar contracture e.g. B. after prostate removal or TUR
- Prostate enlargement
- Bladder stone
- Neoplasia
- Cystocele
- foreign body
- drug
- muscular and neurological dysfunction ( neurogenic bladder )

Clinical manifestations

Clinical criteria are:

diagnosis

The diagnosis results from:

therapy

Treatment can be attempted intrauterine .

Transurethral resection is an option, or open surgical bladder neck reconstruction in the event of a relapse .

literature

P. Padmanabhan, VW Nitti: Primary bladder neck obstruction in men, women, and children. In: Current urology reports , Volume 8, Number 5, September 2007, pp. 379-384, PMID 17880837 (Review).
VW Nitti: Primary bladder neck obstruction in men and women. In: Reviews in urology , Volume 7 Suppl 8, 2005, pp. S12-S17, PMID 16985885 , PMC 1477631 (free full text).
C. Huckabay, VW Nitti: Diagnosis and treatment of primary bladder neck obstruction in men. In: Current urology reports , Volume 6, Number 4, July 2005, pp. 271-275, PMID 15978226 (review).
A. Sigel, R.-H. Ringert (Ed.): Pediatric urology . 2nd Edition. Springer, Berlin 2001, ISBN 3-662-08081-8 (print) / ISBN 978-3-662-08080-1 (e-book), chapter 8
A. Kumar, GK Banerjee, MC Goel, VK Mishra, R. Kapoor, M. Bhandari: Functional bladder neck obstruction: a rare cause of renal failure. In: The Journal of urology , Volume 154, Number 1, July 1995, pp. 186-189, doi: 10.1016 / s0022-5347 (01) 67262-8 , PMID 7776419 .
JR Woodside: Urodynamic evaluation of dysfunctional bladder neck obstruction in men. In: The Journal of urology. Volume 124, Number 5, November 1980, pp. 673-677, doi: 10.1016 / s0022-5347 (17) 55605-0 , PMID 7452795 .
GW Leadbetter, WF Leadbetter: Diagnosis and treatment of congenital bladder-neck obstruction in children. In: The New England Journal of Medicine , Volume 260, Number 13, March 1959, pp. 633-637, doi: 10.1056 / NEJM195903262601304 , PMID 13632942 .

Individual evidence

↑ ^a ^b ^c ^d ^e Pschyrembel online
↑ ^a ^b ^c Medlineplus
↑ Marcel Bettex (ed.), Max Grob (conception), D. Berger (arrangement), N. Genton, M. Stockmann: Pediatric Surgery. Diagnostics, indication, therapy, prognosis. 2nd, revised edition, Thieme, Stuttgart / New York 1982, ISBN 3-13-338102-4
^ PO Hösli: The fibro-elastosis of the bladder neck in male babies (Marion's disease). In: Urologia Internationalis. 11, 1961, p. 240, doi: 10.1159 / 000277524 .
↑ BM Brucker, E. Fong, S. Shah, C. Kelly, N. Rosenblum, VW Nitti: Urodynamic differences between dysfunctional voiding and primary bladder neck obstruction in women. In: Urology. Volume 80, Number 1, July 2012, pp. 55-60, doi: 10.1016 / j.urology.2012.04.011 , PMID 22748864 .
^ MD Kilby, RK Morris: Fetal therapy for the treatment of congenital bladder neck obstruction. In: Nature reviews. Urology. Volume 11, number 7, 07 2014, pp. 412-419, doi: 10.1038 / nrurol.2014.132 , PMID 24934451 (review).
^ A. Suri, A. Srivastava, KJ Singh, D. Dubey, A. Mandhani, R. Kapoor, A. Kumar: Endoscopic incision for functional bladder neck obstruction in men: long-term outcome. In: Urology. Volume 66, Number 2, August 2005, pp. 323-326, doi: 10.1016 / j.urology.2005.03.041 , PMID 16040090 (review).

[pschy-1] Pschyrembel online

[medline-2] Medlineplus

[3] Marcel Bettex (ed.), Max Grob (conception), D. Berger (arrangement), N. Genton, M. Stockmann: Pediatric Surgery. Diagnostics, indication, therapy, prognosis. 2nd, revised edition, Thieme, Stuttgart / New York 1982, ISBN 3-13-338102-4

[4] PO Hösli: The fibro-elastosis of the bladder neck in male babies (Marion's disease). In: Urologia Internationalis. 11, 1961, p. 240, doi: 10.1159 / 000277524 .

[5] BM Brucker, E. Fong, S. Shah, C. Kelly, N. Rosenblum, VW Nitti: Urodynamic differences between dysfunctional voiding and primary bladder neck obstruction in women. In: Urology. Volume 80, Number 1, July 2012, pp. 55-60, doi: 10.1016 / j.urology.2012.04.011 , PMID 22748864 .

[6] MD Kilby, RK Morris: Fetal therapy for the treatment of congenital bladder neck obstruction. In: Nature reviews. Urology. Volume 11, number 7, 07 2014, pp. 412-419, doi: 10.1038 / nrurol.2014.132 , PMID 24934451 (review).

[7] A. Suri, A. Srivastava, KJ Singh, D. Dubey, A. Mandhani, R. Kapoor, A. Kumar: Endoscopic incision for functional bladder neck obstruction in men: long-term outcome. In: Urology. Volume 66, Number 2, August 2005, pp. 323-326, doi: 10.1016 / j.urology.2005.03.041 , PMID 16040090 (review).