Huang W-C, Yang S-H, Yang J-M
Department of Obstetrics and Gynecology, Cathay General Hospital, Mackay Memorial Hospital, Taipei, Taiwan.
Ultrasound Obstet Gynecol. 2006 Jun;27(6):697-700. doi: 10.1002/uog.2787.
Female bladder outlet obstruction is uncommon. We report a case of bladder outlet obstruction secondary to urethral stenosis leading to bladder wall trabeculation. The patient presented at our clinic because of lower urinary tract symptoms including nocturia, urgency, bed wetting, hesitancy, straining to void, and incomplete emptying. Urodynamic study revealed a low maximum free uroflow rate, high residual urine volume, and low compliance on filling phase cystometry. Introital ultrasonography with two- and three-dimensional (2D and 3D) scanning displayed a constriction in the echolucent part of the lower-mid urethra with hyperechogenicity and a lattice-like appearance of the bladder wall. Cystourethroscopy confirmed urethral stenosis and bladder wall trabeculation. The voiding symptoms subsided after the urethral stenosis was relieved by urethral dilatation, but, despite some improvement, the irritative symptoms persisted. Introital ultrasonography with 2D and 3D scanning may help to clarify the cause of female bladder outlet obstruction.
女性膀胱出口梗阻并不常见。我们报告一例因尿道狭窄继发膀胱出口梗阻导致膀胱壁小梁形成的病例。该患者因下尿路症状前来我们诊所就诊，症状包括夜尿、尿急、尿床、排尿犹豫、用力排尿及排尿不完全。尿动力学研究显示最大自由尿流率低、残余尿量高以及充盈期膀胱测压顺应性低。经阴道超声二维和三维扫描显示尿道中下段无回声区有狭窄，回声增强，膀胱壁呈网格状外观。膀胱尿道镜检查证实尿道狭窄和膀胱壁小梁形成。尿道扩张缓解尿道狭窄后，排尿症状消失，但尽管有一定改善，刺激性症状仍持续存在。经阴道二维和三维超声扫描可能有助于明确女性膀胱出口梗阻的原因。
