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ReviewIncont Pelvic Floor Dysfunct 2012; 6(2):47-51
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Drug related NeurogenicAnticholinergic BrainAdrenagic agonist Spinal cordAnti-psychotic IatrogenicAnti-histamine Surgical related
Medical co-morbidity Bladder outlet obstructionDiabetes mellitus PsychogenicHypothyroidism
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Inflammatory process Obstetric/gynecologicInflammation of bladder neck Retroverted gravid uterusInflammation of urethra Retroverted uterusStenosis/stricture Uterine tumorDiverticulum Cervical tumorAbscess Vaginal tumorOthers Atrophic vaginitis
Pelvic floor relaxation Iatrogenic obstructionAnterior vaginal wall prolapse Anti-incontinence proceduresApical prolapse Urethral proceduresPelvic vaginal wall prolapse
Neoplasm MiscellaneousBladder Ectopic ureteroceleUrethral tumor Bladder calculiMetastatic tumor Urethral valves
Primary bladder neck obstruction
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Target organ Group of drugs Examples
Stimulation of the bladder Muscarinic agents Carbachol 0.25 µg subcutaneouslyBethanechol CI 25-100 mg qds orally
Anticholinesterase Distigmine bromide 5 mg po/0.5 mg intramuscularlyα-adrenergic blockers PropanololProstaglandins PGE2, PGF2α intravesical
Relaxation of the urethral α-adrenergic blocking agents Phenobenzamine 10 mg bd Prazosin 0.5 mg sphincter mechanism Mixed α1-and α2-adrenergic drugs Isoxsuprine hydrochloride 30 mg qds
α2 stimulants Terbutaline sulphate 5 mg tdsStriated muscle relaxants Dantrolene 25 mg daily, Baclofen 5 mg tds-25 mg qds,
Diazepam 5 mg tds or 10-15 mg nocte
RN
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1. Ng SC, Chen GD: The diverse patterns of voiding dysfunction inwomen attending Urogynecology clinic: Could it be overlooked ?33rd IUGA Annual meeting, 2008 Taipei.
2. Carlson KV, Rome S, Nitti VW: Dysfunctional voiding in women. JUrol 2001; 165:143-148.
3. Chassagne S, Bernier PA, Haab F, Roehrborn CG, Reisch JS,Zimmern PE: Proposed cutoff values to define bladder outlet ob-struction in women. Urology 1998; 51:408-411.
4. Groutz A, Blaivas JG, Chaikin DC: Bladder outlet obstruction inwomen: Definition and characteristics. Neurourol Urodyn 2000; 19:213-220.
5. Nitti VW, Tu LM, Gitlin J: Diagnosing bladder outlet obstruction inwomen. J Urol 1999; 161:1535-1540.
6. Kuo HC: Urodynamic parameters for the diagnosis of bladder outletobstruction in women. Urol Int 2004; 72:46-51.
7. Akikwala TV, Fleischman N, Nitti VW: Comparison of diagnosticcriteria for female bladder outlet obstruction. J Urol 2006; 176:2093-2097.
8. Haylen BT, de Ridder D, Freeman RM, et al: An InternationalUrogynecological Association (IUGA)/International Continence So-ciety (ICS) joint report on the terminology for female pelvic floordysfunction. Int Urogynecol J 2010; 21:5-26.
9. Nitti VW, Fleischman N: Voiding dysfunction and urinary retention,In: Walters MD, Karram MM, eds. Urogynecology and reconstruc-tive pelvic surgery, 3rd ed., Philadelphia: Mosby 2007, pp 390-401.
10. Kuo HC: Spastic urethral sphincter and chronic urinary retention ina girl. Incont Pelvic Floor Dysfunct 2009; 3:57.
11. Carlson KV, Rome S, Nitti VW: Dysfunctional voiding in women. JUrol 2001; 165:143-148.
12. Chancellor MB, Bennett C, Simoneau AR, et al: Sphincteric stentversus external sphincterotomy in spinal cord injured men: Prospec-tive randomized multicenter trial. J Urol 1999; 161:1893-1898.
13. Kuo HC: Videourodynamic characteristics and lower urinary tractsymptoms of female bladder outlet obstruction. Urology 2005; 66:1005-1009.
14. Santucci RA, Payne CK, Anger JT, Saigal CS; Urologic Diseases inAmerica Project: Office dilation of the female urethra: A quality ofcare problem in the field of urology. J Urol 2008; 180:2068-2075.
15. Basu M, Duckett J: The effect of urethral dilatation on PFS andOAB. Int Urogynecol J 2009; 20:1073-1078.
16. Peng CH, Kuo HC: Transurethral incision of bladder neck in treat-ment of bladder neck obstruction in wome. Urology 2005; 65:275-278.
17. Kuo HC: Recovery of detrusor function after urethral botulinum Atoxin injection in patients with idiopathic low detrusor contractilityand voiding dysfunction. Urology 2007; 69:57-62.
18. Olujide LO, O'Sullivan SM: Female voiding dysfunction. Best PractRes Clin Obstet Gynaecol 2005; 19:807-828.
19. Kessler TM, Studer UE, Burkhard FC: The effect of terazosin onfunctional bladder outlet obstruction in women: A pilot study. J Urol2006; 176:1487-1492.
20. Costantini E, Lazzeri M, Bini V, et al: Open-label, longitudinal studyof tamsulosin for functional bladder outlet obstruction in women.Urol Int 2009; 83:311-315.
21. Yamanishi T, Yasuda K, Kamai T, et al: Combination of a cholin-ergic drug and an alpha-blocker is more effective than monotherapyfor the treatment of voiding difficulty in patients with underactivedetrusor. Int J Urol 2004; 11:88-96.
22. Chang SJ, Chiang IN, Yu HJ: The effectiveness of tamsulosin intreating women with voiding difficulty. Int J Urol 2008; 15:981-985.
23. Lee KS, Han DH, Lee YS, et al: Efficacy and safety of tamsulosinfor the treatment of non-neurogenic voiding dysfunction in females:A 8-week prospective study. J Korean Med Sci 2010; 25:117-122.
24. Robinson D, Cardozo L, Terpstra G, Bolodeoku J; Tamsulosin StudyGroup: A randomized double-blind placebo-controlled multicentrestudy to explore the efficacy and safety of tamsulosin and tolterodinein women with overactive bladder syndrome. BJU Int 2007; 100:840-845.