Summary:
Introduction and objective: Female subvesical obstruction is frequently underestimated and its clinical
importance is relativized. At the present time it is not defined precisely and most authors use the urodynamic
method for diagnosis. The aim of the work was to evaluate the results of examination of subvesical
obstruction by several diagnostic methods and to compare it with the results of therapy in symptomatic
female patients with subvesical obstruction determined by calibration of urethra.
Material and Methods: In the group of 31 patients with symptoms of lower urinary tract (urgent symptomatology,
obstruction symptomatology, relapsing infection of lower urinary pathways), where the calibration
determined the urethra lumen less than 22Ch, the analysis of voiding urethrocystography. The
same examinations were also made three months after endoscopic operation therapy (urethrotomy, endoresection
of the bladder neck) and the comparison is described. One year after the surgery the subjective
satisfaction of the patients was evaluated and semi-objective parameters obtained by analysis of the
micturion diaries as well.
Results: Only three (9.68%) of patients of the cohort fulfilled all urodynamic criteria of obstruction
according to Blaivas, only in four (12.9%) patients the pathological finding during voiding
urethrocystography. In spite of that the deobstruction therapy reached a complete disappearance
of the symptomatology in nine (29.0%) and a substantial improvement of the condition in 15
(28.4%) patients.
Conclusion: In our opinion the clinical importance of subvesical obstruction in women is greater than
generally presented. None of the urodynamic or imaging methods is able to reveal the obstruction safely
and the calibration of urethra should be therefore a routine part of examination in women with symptoms
of disorders in lower urinary tract. Uretrotomy is a simple and effective method in the therapy of
subvesical obstruction in women with very good outcomes.
Key words:
calibration of urethra, urodynamic examination, voiding urethrocystography, dysfunction of
lower urinary tract, urethrotomy
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