[Clinical characteristics and treatment of female stress urinary incontinence combined with bladder neck obstruction]

Objective: To analyze the clinical characteristics and treatment of female stress urinary incontinence (SUI) combined with bladder neck obstruction (BNO). Methods: The clinical data of 17 cases of female SUI patients with BNO, who was admitted to the Urology department, Beijing Chaoyang hospital from November 2011 to April 2018, were retrospectively analyzed. The mean age was (60.3±2.6) years old and the mean body mass index was (23.8±0.5) kg/m(2). All patients had the first stage bladder neck incision with the second stage suprapubic urethral support sling. The clinical characteristics, curative effects and outcomes were analyzed. Results: The maximum flow rate was increased significantly after the bladder neck incision compared with preoperative [(9.3±0.5) vs (25.6±0.8) ml/s, P<0.001]. The postvoid residual urine volume and PdetQmax were decreased significantly than that preoperative [(167.5±4.4) vs (4.1±0.5) ml, P<0.001; (49.4±1.3) vs (24.9±0.7) cmH(2)O, P<0.001]. The incontinence questionnaire-short form score was significantly lower after the second stage suprapubic urethral support sling [(2.4±0.4) vs (14.9±0.3), P<0.001]. The number of subjective and objective case of suprapubic urethral support sling was 13, and the treatment effect of other patients was improved. The hospitalization and operation time of the bladder neck incision and the suprapubic urethral support sling were short. All patients had no intraoperative complications, two cases had dysuria and one case had groin pain after the suprapubic urethral support sling operation. Conclusions: The patients of female SUI combined with BNO are most elderly and obese population. The effectiveness and safety of the first stage bladder neck incision and the second stage suprapubic urethral support sling are high, and the surgeries can effectively relieve the obstruction and improve the quality of patients' life.