Laparoscopic cystomyotomy for bladder neck obstruction.

Laparoscopic cystomyotomy was used for the treatment of bladder neck obstruction in 18 male patients with a mean age of 36.4 +/- 10.4 (SD) years (range 22-43 years). Through an extraperitoneal laparoscopic approach, the bladder neck was exposed. A 1-in. linear incision was performed across the bladder neck, dividing the muscle coat but sparing the mucosa, which bulged through the gap. Patients were followed for a mean of 8.3 +/- 2.4 (SD) months (range 3-13 months). Improvement occurred in 16 patients (88.8%) and failure in 2 who had a calcified and contracted bilharzial bladder. No operative or postoperative complications were encountered. There was no retrograde ejaculation or restenosis. In conclusion, laparoscopic cystomyotomy is simple and easy with a short postsurgical recovery period.