Bladder-Neck Incision

A bladder-neck incision, also known as a bladder neck incision (BNI), is a surgical procedure used to treat urinary obstruction caused by an enlarged prostate or other conditions that affect the bladder neck.

Indications

• Benign prostatic hyperplasia (BPH)
• Prostate cancer
• Bladder neck contracture
• Urinary retention
• Weak urine flow

Procedure

The procedure is typically performed under general anesthesia or spinal anesthesia. A cystoscope, a thin tube with a camera and light on the end, is inserted through the urethra and into the bladder. The surgeon then uses a special instrument to make one or more incisions in the bladder neck, which helps to widen the opening and improve urine flow.

Types of Bladder-Neck Incision

• Transurethral bladder-neck incision (TUBNI): This is the most common type of BNI, where the incision is made through the urethra using a cystoscope.
• Suprapubic bladder-neck incision: This type of BNI involves making an incision in the abdomen to access the bladder neck.
• Laparoscopic bladder-neck incision: This is a minimally invasive procedure where several small incisions are made in the abdomen and a laparoscope (a thin tube with a camera) is used to visualize the bladder neck.

Benefits

• Improved urine flow
• Relief from urinary retention
• Reduced risk of urinary tract infections
• Minimally invasive procedure with faster recovery time

Risks and Complications

• Bleeding or hemorrhage
• Infection
• Urinary incontinence
• Erectile dysfunction
• Bladder neck contracture or stricture

Recovery

After the procedure, patients typically spend a few hours in the recovery room and may need to stay overnight in the hospital. A catheter may be inserted to help drain urine from the bladder for a few days. Patients can usually return to normal activities within 1-2 weeks.

Follow-up Care

Follow-up appointments with the surgeon are necessary to monitor healing and ensure that the procedure was successful. Additional treatments or procedures may be needed if complications arise or if symptoms persist.