How long is a Transurethral Bladder Neck Resection (TUBNR) effective?

Effectiveness Duration of Transurethral Bladder Neck Resection (TUBNR)

Transurethral Bladder Neck Resection (TUBNR) is effective long-term with success rates of 85-91% after a single procedure, with effectiveness typically lasting several years, though some patients may require repeat procedures due to recurrence.

Understanding TUBNR Effectiveness

TUBNR (also called Transurethral Incision of Bladder Neck or TUIBN) is a surgical procedure used to treat bladder neck obstruction. The effectiveness duration varies based on several factors:

Initial Success Rates

• 72-85.7% of patients experience successful outcomes after a single TUBNR procedure 1, 2
• After a second procedure in those who fail initially, the overall success rate increases to approximately 86% 1

Long-term Effectiveness

• Studies show durable results with follow-up periods ranging from:
  • 6-12 months with sustained improvement 3
  • Median 42 months (range 4-108 months) with maintained symptom relief 2

Objective Improvements

Following TUBNR, patients experience significant improvements in:

• Maximum urinary flow rate (increases from 7.0-7.2 ml/s to 16.8-19.8 ml/s) 3, 2
• Decreased post-void residual urine volume 2
• Decreased voiding pressure 4

Subjective Improvements

• Overall patient satisfaction rates of 71-91% 4, 3
• Significant improvement in quality of life scores 2
• Resolution of symptoms including difficult micturition and urinary retention 4

Factors Affecting TUBNR Durability

Risk Factors for Recurrence

• Smoking history >10 pack-years (significantly associated with treatment failure) 1
• History of ≥2 previous endoscopic bladder neck procedures 1

Complications Affecting Longevity

The following complications may reduce the effectiveness duration:

• Bladder neck reobstruction (7.1% of cases) 2
• Urethral stricture formation (10% of cases) 2
• Stress urinary incontinence (10% of cases) 2

Comparison to Other Procedures

When comparing TUBNR to other procedures for bladder outlet obstruction:

• Transurethral incision of the prostate (TUIP) shows similar efficacy to TURP but has a higher reoperation rate (18.4% vs 7.2%) 5
• TUBNR appears to have better durability than some other minimally invasive procedures for bladder neck obstruction 5

Monitoring and Follow-up

To ensure continued effectiveness of TUBNR:

• Regular follow-up with urodynamic testing is recommended to assess for recurrence
• Patients should be monitored for symptoms of recurrent obstruction (decreased flow, straining, incomplete emptying)
• Early intervention for recurrence may improve long-term outcomes

Special Considerations

• In female patients with bladder neck obstruction, TUBNR shows excellent long-term results with 85.7% success rate 2
• In cases of recurrent bladder neck contracture, deep lateral transurethral incisions show promising results with high success rates 1

The effectiveness of TUBNR is generally maintained for several years in most patients, though some may require repeat procedures for recurrent obstruction.