Abstract
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.
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Barnes, R.W., Bergman, R.T., Hadley, H.L. (1959). Endoscopic resection of the bladder neck in the female. In: Endoscopy. Handbuch der Urologie / Encyclopedia of Urology / Encyclopédie d’Urologie, vol 6. Springer, Berlin, Heidelberg. https://doi.org/10.1007/978-3-642-86571-8_21
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