Clinical Observations on the Bladder Neck Contracture of Adult Males

Lee, Ho Youn; Kim, Tae Jin

Abstract

The bladder neck contracture is not uncommon in children and adult. The etiology remains controversial despite extensive studies, however it is usually accepted that bladder neck contracture is congenital in children and is due to previous lower urogenital infections in most of adult males. In spite of various modalities of treatment its high recurrence rate has been a perplexing problem. During the period from January 1, 1973 to December 31, 1976, 90 cases of adult male bladder neck contractures were studied clinically. Transurethral vesical neck resection was performed on 15 cases and phenoxybenzamine treatment was taken on 9 cases. The following results were obtained. 1) The age range of the patients in this study was from 17 to 79 years. 27.8% of the cases were between 30 and 39 years old and the most patients of group III were observed beyond 40 years of age. 2) The patients of group III usually has longer history of symptoms than group I and II patients. 55.6% of the cases had the onset of one year to 5 years. 3) Analysis of the 90 cases shows that common urinary symptoms were frequency(70%), diminished and weak stream(66.7%) and tenesmus(44.4%). 4) 88% of the cases was associated with the one or more diseases of chronic prostatitis, posterior urethritis or verumontanitis. 5) The bladder trabeculation was the most common finding(91.1%). In 73.3% of the cases interureteric ridge was elevated. Vesical outlet was narrowed as reversed V shape in almost all cases. 6) In 68.8% of the cases urine findings was normal, Pyuria was observed in 20% and microscopic hematuria in 16.6%. 7) Transurethral vesical neck resection was performed in 15 cases; All preoperative symptoms were relieved in 10 cases, but no improvement was observed in 5 cases. 8) 9 cases were treated with sympatholytic drug, phenoxybenzamine and significant improvement of all obstructive symptoms was obtained after 10 days or 2 weeks of treatment in all cases.