Abstract
PURPOSE OF REVIEW: To evaluate the outcomes of bladder neck incision (BNI) and alternative treatments, such as alpha blockers, in improving voiding dysfunction in posterior urethral valve (PUV) after valve ablation (VA). RECENT FINDINGS: Eleven studies comprising 826 patients with PUV were included. Concomitant BNI and VA significantly improved both VUR resolution (Risk Ratio “RR”= 1.36; 95% CI: 1.04–1.79), and postoperative serum creatinine -0.16 (95% CI: -0.28 to -0.04). Concomitant BNI and VA significantly improved detrusor overactivity (RR = 0.44; 95% CI: 0.22–0.91; p = 0.03), and reduced significantly maximum detrusor pressure at Qmax (Pdetmax) by-23.53 (95% CI: -35.01 to -12.05). It also significantly decreased both the use of alpha blocker/anticholinergic (RR = 0.59; 95% CI: 0.36 to 0.95), and the need for intermittent catheterization (RR = 0.16; 95% CI: 0.03 to 0.83; p = 0.03). However, there were no significant difference either in bladder compliance (RR = 0.75; 95% CI: 0.31 to 1.79), nor children required re-intervention (RR = 0.52; 95% CI: 0.25 to 1.05). Alpha blockers after VA showed a pooled post-void residual urine reduction of -59.44 (95% CI: -129.05 to 10.17). The pooled estimate for peak flow rate with alpha blockers was 14.22 (95% CI: 13.70–14.74). SUMMARY: BNI combined with valve ablation could improves bladder function and reduces the need for additional interventions compared to VA alone. SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1007/s11934-025-01309-w.