Bladder Neck Incision

Summary

A bladder neck incision is performed if you have symptoms and signs of obstruction to urine flow, with a tight bladder neck. The bladder neck may be tight for a number of reasons, without an enlarged prostate. If there is a lot of prostate tissue, a TURP, is more likely to help.

If you are planning to undergo brachytherapy for prostate cancer and have trouble with your waterworks, a bladder neck incision may be done before brachytherapy treatment.

What does the procedure involve?

A bladder neck incision is performed under general or spinal anaesthetic. The procedure involves passing a telescope into the bladder via the urethra, and cutting the bladder neck and prostate in one or two areas with electrocautery (electric current).

A catheter (soft plastic tube) is inserted in theatre afterwards, to wash the bladder with fluid for 1-2 days afterwards. Once the urine is a clear colour, the catheter is removed, and if you are passing urine well you can go home.

Potential side effects and complications

All procedures have the potential for side effects. Although these complications are well recognised, the majority of patients do not have problems after a procedure.

Risks of the anaesthetic need be discussed with the anaesthetist who will be looking after you during the operation, and who will visit you beforehand. 

There are specific risks with this surgical procedure, and these will be discussed with you before your procedure. As a guide to complement that one-on-one discussion with your surgeon, these include:

Common risks

• Infection in the urine
• Dry ejaculation
• A small amount of bleeding
• Discomfort after the catheter is removed
• A small number of patients may struggle to get good erections after the procedure
• A small number of patients will not have improved urine symptoms after the procedure

Uncommon

• A scar in the urethra requiring another telescope operation
• Heavy bleeding requiring blood transfusion
• The need to repeat the operation in the future

Very uncommon

• Heavy bleeding requiring open surgery and temporary packing of the prostate
• Incontinence of urine
• Narrowing of the bladder neck requiring a repeat telescope operation

Other options

There are a number of other options that will be discussed with you, if appropriate to your condition. These include:

• Doing nothing, just watching your symptoms
• Treatment with medication rather than surgery
• Other surgical options for treatment

If you would like more information about this or other procedures, Nick would be pleased to talk to you in more detail.

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Disclaimer

This information is intended as an educational guide only, and is here to help you as an additional source of information, along with a consultation from your urologist. The information does not apply to all patients.

Not all potential complications are listed, and you must talk to your urologist about the complications specific to your situation.