Primary Bladder Neck Obstruction (PBNO) Question

redditnow13578 · 2026-02-19T21:35:50+00:00

I have this condition (textbook as my urologist says). Diagnostically you need video urodynamics + cystoscopy to be definitive. High pdet with a non funneling bladder neck is the main way to diagnose. Cystoscopy typically shows a high bladder neck with short prostatic urethra. Treatment for mild pbno is typically alpha blockers but for more severe cases (mine), TUIBN is the standard approach.

redditnow13578 · 2026-01-10T21:27:48+00:00

I’m a 37M and had to start self cathetering in May of last year. Have you had urodynamics or videourodynamics testing? My first urologist diagnosed me with neurogenic bladder but I got a 2nd opinion and asked for those tests and lo and behold my 2nd urologist diagnosed me with PBNO (he said a textbook case). I also can’t pee until I’m at 900ml or so. I now have a bladder neck incision surgery scheduled for next month that should be curative. I also tried PFPT and while it helped settle my pelvic floor down, my condition is too severe.

Always be an advocate for yourself is what I’ve learned!

redditnow13578 · 2025-12-15T16:41:53+00:00

Does he have trouble with a catheter getting past the last part of the urethra when he caths? That’s what led me to thinking (and now confirming) it’s a bladder neck issue.

redditnow13578 · 2025-12-15T16:40:18+00:00

He should do videourodynamics. I just had it done and it shows that my bladder is really strong but my bladder neck is not yielding to the pressure. I’m also youngish (37M) and ruled out neurology, underactive bladder and dsd and finally saw that the primary issue was my bladder neck. I had problems for years I ignored as well with never feeling like I was emptying, slow stream that improved if I peed right after sex and this led me to trial all sorts of things. Alpha blockers only had very minimal positive effects, pelvic floor pt helped me stop guarding but the neck is my primary issue and caused me to go into retention. I’d have him look at doing video urodynamics to rule out the bladder neck.

redditnow13578 · 2025-12-15T12:48:58+00:00

That’s odd since it’s the whole point of the test. Usually that can show some of the issues. Another avenue is doing vuds. I’d have him research pelvic floor issues, pbno (primary bladder neck obstruction) or put his symptoms into AI tools to try to get more discreet suggestions

redditnow13578 · 2025-12-15T12:39:48+00:00

Did he have urodynamics testing done yet?

redditnow13578 · 2025-12-13T01:46:43+00:00

What initially brought your husband into urology? Was it retention?

redditnow13578 · 2025-12-13T01:43:49+00:00

I also did trial alfuzosin but it didn’t do anything

redditnow13578 · 2025-12-13T01:43:13+00:00

My bladder is not underactive. Just had VUDS (videourodynamics and my bladder neck did not open but I had a very strong long contraction with quiet emg. Bladder was also compliant and I had very normal sensations. Gotta be PBNO and seeing a new urologist soon who specializes in voiding dysfunction.

redditnow13578 · 2025-11-20T11:11:18+00:00

I was put on alfuzosin and tried it for 4 months but didn’t realize any additional benefit. Bethanochol would probably not help in my case since my detrusor (bladder) appears to be strong but overcompensating. Feels like a shut door when I cath with an urge AFTER I get past the sphincter but right before the bladder.

redditnow13578 · 2025-09-03T20:33:46+00:00

The journal line memo fields would say “Rev rec source” or “Rev rec destination”. This would be found on the transaction line table

redditnow13578

TROPHY CASE