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Case Reports
. 2022 Dec 25;14(12):e32931.
doi: 10.7759/cureus.32931. eCollection 2022 Dec.

Is Sacral Neuromodulation a Treatment Option for Primary Bladder Neck Obstruction?

Ibrahim Alzahrani  1 , Hossam S El-Tholoth  2 , Ali Alsulihem  2
Affiliations
Case Reports

Is Sacral Neuromodulation a Treatment Option for Primary Bladder Neck Obstruction?

Ibrahim Alzahrani et al. Cureus. .

Abstract

Here, we present the first reported case that used sacral neuromodulation as a treatment option for bladder neck obstruction in a 48-year-old man who presented with a long-standing history of lower urinary tract symptoms such as storage and voiding symptoms unresponsive to conservative and medical treatments, including chemodenervation. The patient was diagnosed with primary bladder neck obstruction (PBNO) using a urodynamic study, voiding cystourethrography, and cystoscopy. Sacral neuromodulation was used because the patient refused bladder neck incision because of the risk of retrograde ejaculation. The patient reported significant improvement in symptoms with no obstructive pattern on follow-up uroflowmetry after six months. The use of alpha-blockers, bladder neck incision, and Botox injection into the bladder neck to treat PBNO has been reported. The successful use of sacral neuromodulation to treat PBNO has not been reported before.

Keywords: bladder neck obstraction; lower urinary tract symptoms; sacral neuromodulation; treatment; urodynamic.

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Conflict of interest statement

The authors have declared that no competing interests exist.

Figures

Figure 1
Figure 1. Preoperative uroflowmetry.
Figure 2
Figure 2. Antegrade voiding cystourethrogram with bladder neck obstruction during voiding.
Figure 3
Figure 3. Urodynamic study prior to sacral neuromodulation.
Figure 4
Figure 4. Postoperative uroflowmetry.
See this image and copyright information in PMC

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