Urogenital ImagingBladder neck dysfunction
an uncommon disorder of unknown aetiology characterized by clinical symptoms and urodynamic evidence of outlet
obstruction (
Fig.1), but with no evidence of a structural cause of outlet
obstruction. The condition occurs predominantly in young and middle-aged men. Some believe it is due to poor coordination of voiding, such that the bladder contracts against a closed sphincter - hence, the synonym of bladder sphincter dysynergia. This poor coordination may be secondary to sympathetic hyperactivity, since the condition appears disproportionately common in anxious and highly-strung individuals, but this is speculative. Treatment options include adrenergic blocking agents and bladder neck incision. The childhood equivalent of bladder neck dysfunction is
non neurogenic neurogenic bladder (Hinman's syndrome).
HH
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Voiding cystourethrogram demonstrates constriction of the bladder neck during voiding, due to bladder neck dysfunction. The prosthetic urethra has a typical triangular or "spinning top" appearance.
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Bladder neck dysfunction, Fig.1 | |