Primary Bladder Neck Obstruction in Women

Primary bladder neck obstruction (PBNO) is a functional obstruction due to smooth muscle dyssynergia of the bladder neck during voiding without a neurogenic or anatomical cause. This causes poor opening of the bladder neck during voiding. PBNO is an underdiagnosed entity and its prevalence is unknown. The diagnosis of PBNO is primarily by exclusion of other factors causing bladder outlet obstruction and fluoroscopic imaging demonstrating obstruction at the level of the bladder neck. Management is initially conservative and pharmacological in most cases. Bladder neck incision and resection are used rarely for refractory cases.