Evaluation and treatment of dyssynergic bladder neck obstruction. Is synchronous pressure-flow cystourethrography necessary?

Eighteen male patients underwent unilateral bladder neck incision for relief of bladder neck obstruction. The presence of obstruction was determined by clinical symptoms, residual urine, and uroflowmetry only. The decision to perform bladder neck incision was based on the typical endoscopic appearance of the prostatic urethra and bladder neck. Sixteen of 18 patients (89 per cent) had normal postoperative uroflowmetry. Subjectively, all patients judged themselves improved by the procedure. In those patients who are judged to be obstructed by clinical symptoms and uroflowmetry, dyssynergic bladder neck obstruction may be diagnosed by classic endoscopic findings rather than the routine use of synchronous pressure-flow cystourethrography.