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Dr. Y.
Dr. Y., Urologist
Category: Urology
Satisfied Customers: 15027
Experience:  Specializing in general urology and reconstructive urology.
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I am a male aged 36 years. I have been having obstructed

Customer Question

HelloI am a male aged 36 years. I have been having obstructed LUTS with intermittency and terminal dribbling for past few months and have seen a urological consultant recently.I have undergone flexible cystoscopy showing no evidence of urethral stenosis, inflammation or tumour and my prostatic urethra was non occluded. The bladder excluded evidence of tumours, stones or evidence of CIS. However my consultant believed my bladder neck was tight and carried out urodynamic study. The result of this study showed I am obstructed with uroflow rate of 5mls per second with maximum Detrusor pressure of 83cms of water.Although my consultant has confirmed I have tight bladder neck but no cause has been identified for this. My prostate is of normal size.I would like to ask if there are any other known reasons for tight bladder neck (other than enlarged prostate) that should be considered and investigated further. I have been prescribed Alfuzosin 10mg which does not appear to be working so far and we are potentially looking at Bladder neck incision.I am sure you can imagine I am obviously keen to know if there is anything else that can be done or any alternate treatment that should be explored before deciding on surgery.
Submitted: 10 months ago.
Category: Urology
Expert:  Dr. Phil, MD replied 10 months ago.

Hello. I'm Dr. Phil, licensed and practicing internist. Excellent service is my goal.

Expert:  Dr. Phil, MD replied 10 months ago.

still need help?

Customer: replied 10 months ago.
HelloI still need help and I have stated my question in detail. I am looking for an expert opinion from a Urologist. I am not sure if you can help please
Expert:  Dr. Phil, MD replied 10 months ago.

yes, you could be developing a stricture there

Or the muscles could be enlarged from pushing against a tight prostate

it is known as hypertrophy

Customer: replied 10 months ago.
The prostate is of a normal size. Is there still a possibility of bladder neck pushing against "tight" prostate?Also, are you referring to stricture around bladder neck? There were no strictures in cystoscopy
Expert:  Dr. Phil, MD replied 10 months ago.

That is unlikely then

Customer: replied 10 months ago.
What else could be the reason? I have copied my original question again"Although my consultant has confirmed I have tight bladder neck but no cause has been identified for this. My prostate is of normal size.I would like to ask if there are any other known reasons for tight bladder neck (other than enlarged prostate) that should be considered and investigated further. I have been prescribed Alfuzosin 10mg which does not appear to be working so far and we are potentially looking at Bladder neck incision.I am sure you can imagine I am obviously keen to know if there is anything else that can be done or any alternate treatment that should be explored before deciding on surgery. "
Expert:  Dr. Phil, MD replied 10 months ago.

it could be the muscle itself in the neck is the issue

Customer: replied 10 months ago.
It could be but this is something very rare i.e. it is something less than 1% of population gets. The key question I guess I need answering is if there is anything else (other than enlarged prostate or muscle itself) that can cause muscle neck to be tight. Is there anything else that can be pressing externally against muscle neck causing it to be tight?
Expert:  Dr. Phil, MD replied 10 months ago.

No I don't think so.

unless you are constipated all the time?