U J All Final for WEB.pdf 790 | Urology and Nephrology Research Center; Depart- ment of Urology, Shahid Labbafinejad Medical Center, Shahid Beheshti University of Medical Sci- ences, Tehran, Iran Farzaneh Sharifiaghdas, Mehdi Kardoust Parizi, Babak Ahadi Efficacy of Transurethral Bladder Neck Incision with 2-Micron Continuous Wave Laser (RevoLix) for the Management of Bladder Outlet Stricture in Women Corresponding Author: Mehdi Kardoust Parizi, MD Urology and Nephrology Research Center, No. 103, 9th Boustan St., Pasdaran Ave., Tehran, Iran Tel: +98 21 2265 7222 Fax: +98 21 2256 7282 E-mail: m.kardoust@ yahoo.com Received September 2012 Accepted November 2012 Purpose: Materials and Methods: - Results: P - P P Conclusion: term clinical outcomes. Keywords: female, laser, urinary incontinence, urodynamics, prospective studies FEMALE UROLOGY Female Urology 791Vol. 10 | No. 1 | Winter 2013 |U R O LO G Y J O U R N A L INTRODUCTION Although bladder neck obstruction is prevalent in its manage-ment has been addressed more among men in - (2) Various treatment modalities are reported for bladder neck obstruction in literature, including medical therapy, clean in- termittent catheterization (CIC), urethral dilator, and endo- scopic incision. - management of refractory bladder neck stenosis (BNS) by transurethral bladder neck incision using 2-micron continu- MATERIALS AND METHODS blockers) for more than 3 months and had undergone at least - sponse. - fore the surgery according to International Continence Soci- and Cystourethroscopic ap- - - tients had previously received medical treatment, such as - satisfactory results. All the patients had a negative urine culture before the procedure. International prostate symptom recorded. - (PVR) urine using post void urethral catheterization. Urody- - Operation Technique LISA laser products, Katlenburg, Germany) under general - the results. A P - RESULTS - - Transurethral Bladder Neck Incision with RevoLix Laser | Sharifiaghdas et al 792 | the procedure. The mean times of bladder neck dilation be- to severe trabeculation of the bladder. Mean operation time novo stress incontinence after the surgery. Median IPSS im- - P P one month after the procedure. - P in PVR urine volume (P P - gross hematuria, febrile urinary tract infection, urinary sep- sis, bladder perforation, deep venous thrombosis, or pulmo- nary emboli. DISCUSSION symptoms during their practice, mostly caused by BNS, neu- - is not as common as men. Furthermore, due to lack of univer- - 2 In another study, Zhang and associates performed transurethral incision of the bladder neck for the management of female bladder outlet obstruction. Using video-urodynamic study, radio- 2 bladder outlet obstruction. - - bladder outlet obstruction. - mended that a full video-urodynamic evaluation is essential for correct diagnosis and selection of appropriate treatment plan.(3) score, multichannel urodynamic parameters, and cystoure- Refractory cases to conservative therapy can be considered as indication for surgical intervention. After making decision for surgical intervention, patients should be informed about possible urinary incontinence. Endoscopic manage- modalities include cold-knife incision, electrocautery of the bladder neck, and mechanical dilation of the stenosis. Bladder neck incision has been reported to improve voiding - Neykov and as- sociates evaluated late results of transurethral bladder neck - - In another study, Urodynamic characteristics of patients before and one month after the procedure. Variable Pre-operative Postoperative P Median peak flow rate (range), mL/s 8 (2.7 to 12) 11 (9.1 to 16) .005 Median maximum void- ing pressure (range), cm H 2 O 67.5 (13.3 to 155.5) 55 (33 to 81.9) .59 Median post void re- sidual urine (range), mL 101 (30 to 300) 17 (0 to 100) .003 Female Urology 793Vol. 10 | No. 1 | Winter 2013 |U R O LO G Y J O U R N A L Transurethral Bladder Neck Incision with RevoLix Laser | Sharifiaghdas et al - primary bladder neck obstruction. Improvements in IPSS, - patients. Reported de-novo stress urinary incontinence rate - modality in the management of female primary bladder neck obstruction.(7) Recently, laser energy has been evaluated as a promising util- ity in management of bladder neck obstruction. Fu and Xu BNS. They reported clinical and urodynamic improvement, of female BNS.(2) - - ous cutting and coagulation of perfused, avascular, and either hardly vascularized tissues, such as scars. In another study, - cedure in the treatment of recurrent bladder neck sclerosis. - detrusor pressure before and after the surgery. There are several limitations to the present study. First, due to used combination of diagnostic modalities, including IPSS, - prevent possible postoperative incontinence. This strategy Perhaps, a deeper bladder neck incision can be performed - COCLUSION CONFLICT OF INTEREST None declared. REFERENCES 1. el-Baz MA, Yousef AA, Moustafa H. Transurethral incision of the bladder neck: an objective and subjective evaluation of its efficacy. Int Urol Nephrol. 1995;27:717-21. 2. Fu Q, Xu YM. Transurethral incision of the bladder neck using KTP in the treatment of bladder neck obstruction in women. Urol Int. 2009;82:61-4. 3. Peng CH, Kuo HC. Transurethral incision of bladder neck in treatment of bladder neck obstruction in women. Urology. 2005;65:275-8. 4. Klijer R, Bar K, Bialek W. Bladder outlet obstruction in women: difficulties in the diagnosis. 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