Bladder neck obstruction in women is also known as bladder neck sclerosis or bladder neck contracture. It is more frequent in older women and can lead to serious consequences of upper urinary tract dilatation, hydronephrosis, and renal impairment in advanced stages. The etiology of bladder neck obstruction in women is not well understood. It may be inflammatory, non-inflammatory or aging phenomena causing bladder neck fibrous tissue hyperplasia, bladder neck muscle hypertrophy, sclerosis due to chronic inflammation and periurethral glandular hyperplasia due to hormonal imbalance in elderly women. It can be caused by poor bladder neck nerve and muscle structure; early nerve damage; secondary formation of bladder neck sclerosis after vaginal, urethral, and bladder neck surgery. Some patients may be caused by tumors of the uterus, vagina, or urethra, so imaging of the periurethral tissues needs to be completed to exclude these diseases. Severe obstructive lesions of the bladder neck can cause difficulty in urination or even urinary retention, which can lead to hydronephrosis in the long term, producing the same symptoms and results as prostatic hyperplasia in men, resulting in irreversible kidney damage. The disease can occur at any age, mostly in older people, and in female patients at the age of 40-60. The main problem is difficulty in urination, manifested as delayed urination, thin urine stream, straining to urinate, urine dripping, incomplete urination, nocturnal urination, and can appear as urinary retention and overflow incontinence. Routine examination of this disease includes: 1.Urological ultrasound: It can observe the condition of kidney, ureter and bladder, determine whether there is hydronephrosis and other conditions, and also determine the residual urine in the bladder. 2.Urethral ultrasound: except for similar symptoms caused by periurethral diseases such as tumor, urethral diverticulum, etc. 3, cystoscopy: is an important method to confirm the diagnosis of bladder neck obstruction. It can directly understand the obstruction of bladder neck and also observe the lesions in the bladder, such as trabeculae and small columns in the bladder; the bladder neck is obviously elevated, the mucosa is stiff and edematous and loses elasticity. Also cystoscopy can exclude bladder stones, tumors and other causes of dyspareunia. 4.Urodynamic examination of urine flow rate is the most useful index for objective evaluation of urination status. In patients with bladder neck obstruction, a significant increase in pressure in the bladder, a decrease in urine flow and a change in the urine flow curve can be seen. 5. Experienced physicians can also get a general idea of the condition around the urethra by transvaginal palpation. Treatment Conservative treatment is indicated for those with mild symptoms and insignificant difficulty in urination; those without residual urine; and those without vesicoureteral reflux and renal impairment. The main treatments are selective alpha-blockers such as Harle, Cordovan, and Gautrin; transurethral bladder neck dilatation; and supplemental estrogen supplementation therapy for those with low estrogen levels. Surgical treatment 1. Transurethral bladder neck electrosurgery has obvious bladder neck obstruction as well as conservative treatment is ineffective. It is currently the most commonly used treatment and is favored for its minimally invasive and effective results. The treatment effect can be achieved by making the posterior urethra and bladder triangle close to the same plane after electrodesection. It is characterized by fast recovery, few complications and significant results.2. Cystoplasty of the bladder neck is currently used less frequently and is not used as the first choice of treatment, but only in isolated cases.