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Interventions for Bladder Neck/Urethra

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Handbook of Neurourology

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Abstract

Balloon dilatation of the external urethral sphincter was developed as a less-invasive alternative to sphincterotomy in patients with detrusor-sphincter dyssynergia, with no negative effect on sexual function and a low complication rate. However, its high recurrence rate has prevented the general approval of the technique. Surgical procedures involving the bladder neck or the urethra can resolve both outflow resistance or urinary incontinence. Sphincterotomy with or without bladder neck incision is preferred when the patient suffers refractory detrusor-sphincter dyssynergia and cannot perform clean intermittent catheterization. Alternatively, temporary urethral stents can be used. When targeting urinary stress incontinence, the artificial urinary sphincter and autologous sings are the techniques mostly performed in neurourological patients, although midurethral synthetic slings and bulking agents have also been used. When urinary incontinence persists after correct anticholinergic treatment and clean intermittent catheterization, bladder neck reconstruction is recommended.

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Authors and Affiliations

  1. Department of Urology, Hospital Universitario de Canarias, Tenerife, Spain

    David Manuel Castro-Diaz

  2. Departamento de Cirugía, Universidad de La Laguna, Tenerife, Spain

    Barbara Padilla-Fernandez

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  1. David Manuel Castro-Diaz
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  2. Barbara Padilla-Fernandez
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Correspondence to David Manuel Castro-Diaz .

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  1. Department of Urology Department of Neurourology, China Rehabiliation Research Center China Rehabilitation Science InstituteCapital Medical University, Beijing, China

    Limin Liao

  2. Department of Urology, Medical University Innsbruck, University Hospital, Innsbruck, Austria

    Helmut Madersbacher

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Castro-Diaz, D.M., Padilla-Fernandez, B. (2023). Interventions for Bladder Neck/Urethra. In: Liao, L., Madersbacher, H. (eds) Handbook of Neurourology. Springer, Singapore. https://doi.org/10.1007/978-981-99-1659-7_48

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