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.

Frequently Asked Questions (FAQs)

What is a bladder-neck incision?
A surgical procedure to treat bladder neck obstruction or urinary retention.

Who typically performs a bladder-neck incision?
A urologist or surgeon specialized in urinary tract procedures.

What are the indications for a bladder-neck incision?
Bladder neck obstruction, benign prostatic hyperplasia, or urinary retention.

How is a bladder-neck incision typically performed?
Using endoscopic or open surgical techniques, often under general anesthesia.

What are the potential benefits of a bladder-neck incision?
Relief from urinary symptoms, improved urine flow, and reduced risk of complications.

What are the possible risks and complications of a bladder-neck incision?
Bleeding, infection, incontinence, or recurrent obstruction, among others.

Is a bladder-neck incision usually an outpatient procedure?
It may be performed on an outpatient basis, but sometimes requires a short hospital stay.

How long does it typically take to recover from a bladder-neck incision?
Recovery time varies, but often takes several days to weeks for full recovery.

Are there alternative treatments to a bladder-neck incision?
Yes, alternatives may include medication, catheterization, or other surgical procedures.

Is a bladder-neck incision typically covered by insurance?
Coverage depends on the specific insurance plan and medical necessity of the procedure.