Endoscopy pp 223-228 | Cite as

Endoscopic resection of the bladder neck in the female

  • Roger W. Barnes
  • R. Theodore Bergman
  • Henry L. Hadley
Part of the Handbuch der Urologie / Encyclopedia of Urology / Encyclopédie d’Urologie book series (HDBUROL, volume 6)


Obstruction to urinary outflow due to collar contracture of the vesical orifice is the most definite indication for endoscopic resection of the bladder neck in women and girls (Davis). Symptoms and findings are the same as in small collar type prostatic hypertrophy or marked fibromuscular contracture of the vesical orifice. Residual urine, trabeculation and cellules in the fundus of the bladder and intravesical protrusion of the entire circumference of the rim of the bladder neck are present. Obstructive indications, however, may not be so clear cut. In North America one of the most common syndromes in the female which the urologist is called upon to treat is dysuria, frequency and pain in the region of the urethra. Often thorough urological examination fails to reveal the cause. If there is any lack of force or hesitancy in starting the urinary stream, collar contracture of the bladder neck should be suspected and re-examination performed with this in mind. When elevation of the dorsal lip of the bladder neck is present (p. 275) and no other cause for the symptoms can be found, and when symptoms persist after a course of urethral dilatation, bladder neck resection is indicated.


Bladder Neck Endoscopic Resection Urethral Dilatation Bladder Neck Contracture Female Urethra 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.


Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.


  1. Baird, S.S., and H. M. Spence: Transurethral resection of female bladder neck; a rebuttal. Urol. cutan. Rev. 52, 658–661 (1948).PubMedGoogle Scholar
  2. Barnes, R. W.: Endoscopic prostatic surgery. St. Louis: C. V. Mosby Co., 1943, p. 75.Google Scholar
  3. Caulk, J. R. : Contracture of the vesical neck in female. J. Urol. (Baltimore) 6, 341–343 (1921).Google Scholar
  4. Caulk, J. R. : Obstruction at bladder neck in men, women and children. Int. Clin. 4, 136–148 (1937).Google Scholar
  5. Caulk, J. R., and J. F. Patton: Cautery punch operation for removal of obstructive lesions at vesical orifice in women and children. J. Urol. (Baltimore) 33, 504–520 (1935).Google Scholar
  6. Coutts, W. E., and R. Vargas-Zalazar: Contribution to etiology of acquired fibrosis of bladder neck. Brit. J. Urol. 17, 136–141 (1945).PubMedCrossRefGoogle Scholar
  7. Davis, D. M. : Vesical orifice obstruction in women and its treatment by transurethral resection. J. Urol. (Baltimore) 73,112–116 (1955).Google Scholar
  8. Emmett, J. L., S. P. R. Htjtchins and J. R. McDonald: Treatment of urinary retention in women by transurethral resection. J. Urol. (Baltimore) 63, 1031–1041 (1950).Google Scholar
  9. Engles, C. F.: Bladder neck resection in women and children. Trans, west. Sect. Amer. urol. Ass. 12, 94–95 (1944).Google Scholar
  10. Evatt, E. J. : Contribution to development of prostate gland in human female and a study of homologies of urethra and vagina of the sexes. J. Anat. Physiol. (Lond.) 45, 122–130 (1910).Google Scholar
  11. Everett, H. S.: Condemnation of resectoscopic procedures upon female vesical neck. Urol. cutan. Rev. 52, 121–124 (1948).Google Scholar
  12. Fite, E. H. : Vesical neck obstruction in female treated by resection with McCarthy resectoscope. Urol. cutan. Rev. 38, 163–164 (1934).Google Scholar
  13. Foley, F. E. B.: Diagnosis and classification of various forms of bladder neck obstruction. Minn. Med., 12, 137–145 (1929).Google Scholar
  14. Folsom, A. L: Female urethra; A clinical and pathological study. J. Amer. med. Ass. 97, 1345–1351 (1931).CrossRefGoogle Scholar
  15. Folsom, A. I., and J. C. Alexander: Referred pain from female urethra. J. Urol. (Baltimore) 31, 731–739 (1934).Google Scholar
  16. Folsom, A. I., and H. A. O’Brien: Female obstructing prostate. J. Amer. med. Ass. 121, 573–580 (1943).CrossRefGoogle Scholar
  17. Folsom, A. I., and H. A. O’Brien: Female urethra. J. Amer. med. Ass. 128, 408–414 (1945).CrossRefGoogle Scholar
  18. Hicks, J. B.: Bladder neck contracture in women. Surg. Clin. N. Amer. 14, 1219–1223 (1934).Google Scholar
  19. Hoover, S. R.: Prostatism in women. Urol. cutan. Rev. 50, 326–328 (1946).PubMedGoogle Scholar
  20. Houtum, G. van : Six cases of chronic retention of urine in women caused by dysectasia of bladder neck. Proc. roy. Soc. Med. 28, 1511–1514 (1935).PubMedGoogle Scholar
  21. Howard, T. L., and H. A. Buchtel: Resection of vesical neck in children; Indications and results. Amer. J. med. Ass. 146, 1202–1206 (1951).CrossRefGoogle Scholar
  22. Hutchins, S. P. R. : Vesical neck obstruction in women. J. Urol. (Baltimore) 69,102–108 (1953).Google Scholar
  23. Hyams, J.A., and S. R. Weinberg: Hyperplastic change at vesical neck in female. J. Urol. (Baltimore) 51, 149–161 (1944).Google Scholar
  24. Jacobson Jr., C. E.: Unrecognized vesical neck obstruction in women. New Engl. J. Med. 235, 645–648 (1946).PubMedCrossRefGoogle Scholar
  25. Johnson, F. P. : The homologue of prostate in female. J. Urol. (Baltimore) 8, 13–27 (1922).Google Scholar
  26. Keyes, E. L. : The clinical course of bladder neck abstruction attributed to sclerosis or bar (discussion). Amer. J. Surg. 19, 215–229 (1933).CrossRefGoogle Scholar
  27. Loeb, M. J.: Bladder neck obstruction congenital in young males : inflammatory in females. Urol. cutan. Rev. 44, 455–460 (1940).Google Scholar
  28. MacKenzie, D.W., and S. Beck: A histopathologic study of female bladder neck and, urethra. Trans Amer. Ass. gen.-urin. Surg. 29, 227–253 (1936).Google Scholar
  29. Mathé, C. P.: Vesical neck obstruction in female. J. int. Coll. Surg. 21, 146–159 (1954).PubMedGoogle Scholar
  30. McDonald, H. P., W. E. Upchtjrch and C. E. Stttrdevant : Vesical neck obstruction in children. J. Urol. (Baltimore) 70, 94 (1935).Google Scholar
  31. Melville, B. : Resection of bladder neck in female report with of a case. Aust. N. Z. J. Surg. 15, 299–303 (1946).PubMedCrossRefGoogle Scholar
  32. Mills, W. G. Q. : Treatment of chronic urinary retention in women by transurethral resection of bladder neck. Brit. J. Urol. 24, 236–237 (1952).PubMedCrossRefGoogle Scholar
  33. Mtrabile, C. : Resection of bladder neck for obstruction in women. New Engl. J. Med. 228, 751–753 (1943).CrossRefGoogle Scholar
  34. Neff, J. H. : Resection of prolapsed mucosa at vesical neck for retention of urine in female. Trans. Amer. Ass. gen.-urin. Surg. 31, 263–270 (1938).Google Scholar
  35. Negley, J. C., and E. M. Berkery: Bladder neck obstruction: Relief by surgical methods. Urol. cutan. Rev. 55, 327–331 (1950).Google Scholar
  36. Nelson, N. M., R W. Barnes, H. L. Hadley and R. T. Bergman : Transurethral resection of bladder neck in female. J. Urol. (Baltimore) 77, 198–213 (1957).Google Scholar
  37. Nesbit, R. M. : Vesical neck contracture in female with urinary obstruction. Urol. cutan. Rev. 87, 291–293 (1933).Google Scholar
  38. O’Brian, J. H., and B. D. Pmck: Vesical neck obstruction in female. J. med. Soc. N.J. 46, 400–403 (1949).Google Scholar
  39. Patton, J. F. : Bladder neck obstruction in women and children. Rocky Mtn. med. J. 46, 540–544 (1949).Google Scholar
  40. Powell, N. B., and E. B. Powell: Female urethra; a clinico-pathological study. J. Ürol. (Baltimore) 61, 557–570 (1949).Google Scholar
  41. Randall, A. : Prostatisme sans prostate. N. Y. med. J. 102, 1123–1132, 1177–1186 (1915).Google Scholar
  42. Renner, M. J.: So called female prostate and concretion formation in female urethra. Surg. Gynec. Obstet. 52, 1087–1092 (1931).Google Scholar
  43. Ritter, J. S., and L. A. Shterin: Vesical neck obstruction in female. Urol. cutan. Rev. 52, 147–149 (1948).PubMedGoogle Scholar
  44. Shumaker, L. B., and F. C. Hendrickson: Contracture of vesical neck in females. Urol. cutan. Rev. 52, 205–206 (1948).Google Scholar
  45. Thompson, G. J.: Transurethral operations for relief of dysfunction of vesical neck in female. Proc. Mayo Clin. 10, 598–600 (1935).Google Scholar
  46. Thompson, G. J.: Urinary obstruction of vesical neck and posterior urethra of congenital origin. J. Urol. (Baltimore) 47, 591–601 (1942).Google Scholar
  47. Winsbury-White, H. P.: Two cases of retention of urine in women. Lancet 1936, 1008.Google Scholar
  48. Young, H. H. : Pathology and treatment of obstructions at vesical neck in women. J. Amer. med. Ass. 115, 2133–2136 (1940).CrossRefGoogle Scholar

Copyright information

© Springer-Verlag OHG. Berlin · Göttingen · Heidelberg 1959

Authors and Affiliations

  • Roger W. Barnes
    • 1
  • R. Theodore Bergman
    • 1
  • Henry L. Hadley
    • 1
  1. 1.Los AngelesUSA

Personalised recommendations