Bladder Neck Incision

What is it?

 

A Bladder neck incision (BNI) is an operation where an incision is made in the neck of the bladder to improve the flow of urine and to relieve urinary pressure in the bladder.  The obstruction is removed through a telescope that is inserted up through the urethra to your bladder neck.

 

Why is it done?

 

It is commonly performed to remove obstruction and improve urinary flow and associated symptoms and prevent complications such as complete blockage, urine infections, bladder stones and kidney damage.

 

How is it done?

 

A telescope is passed through the urethra into the bladder. The blockage can be seen and surgically removed with a small knife instrument that has been passed through telescope.  When the obstruction has been removed, a catheter is inserted into the bladder and fluid washed in and out to help settle any minor bleeding and to irrigate the bladder.

(If you have had previous prostate surgery (TURP), resulting in scarring of your bladder neck, the removal of any regrowth in the prostate tissue whilst doing a BNI may be performed to ensure an open channel)

 

Prior to your operation.

 

You will be required to fast for this procedure, normally 6 hrs prior to your procedure.

Please discuss with your Doctor before the procedure if you are taking Aspirin, Warfarin, Plavix or Arthritis medication and any other blood thinning medication. 

 

After the procedure.

 

You will have a catheter in place that will be draining the urine from the bladder.  This will be blood stained initially, but do not be alarmed this will be expected.  Fluid will be washed into the bladder to stop it blocking with blood clots (bladder washout). The catheter may be uncomfortable and you may feel as though you need to pass urine all the time.  You may pass blood clots, but this is to be expected.  Once your urine clears up, the bladder washout will be discontinued. 

 

The catheter will be removed 1-2 days after surgery once the urine clears up (and bladder irrigation stopped.)

 

You may experience burning, urgency and frequency, which should subside and may improve with increasing your fluid intake and taking Panadol or Ural as per instructions on packaging.

 

Your urine may be blood stained and have some small clots for 3-4 weeks. This is to be expected but ensure that the flow of urine is not obstructed or there is any heavy bleeding.  You will need to keep your fluids up – 2-3 litres of fluid per day. Avoid constipation and straining, you may need to increase your dietary fibre. 

 

Please notify us or present to the Emergency Department at John Flynn Hospital if:

• Excessive blood in your urine
• Fevers, shivering, shaking
• Cloudy/Offensive urine
• Difficulty or inability to pass urine

This procedure has a small risk of causing further scar tissue formation where the incision has been made, therefore there is a risk that you may require further bladder neck incisions.