Bladder Neck Contracture: Symptoms, Causes, Treatment

What are the symptoms of bladder neck contracture?

Bladder neck contracture is a condition where the bladder neck becomes narrowed or blocked, leading to difficulty urinating. The symptoms can vary but may include:

1. Difficulty starting urination: You may have trouble initiating urination or feel like you have to strain to start urinating.
2. Weak urine stream: The flow of urine may be weak or intermittent.
3. Incomplete emptying: You may feel like your bladder is not emptying completely after urination.
4. Frequent urination: You may need to urinate more often than usual.
5. Urinary urgency: You may have a sudden, urgent need to urinate that is difficult to delay.
6. Urinary retention: In severe cases, bladder neck contracture can lead to urinary retention, where you are unable to urinate at all.
7. Urinary tract infections (UTIs): Recurrent UTIs may occur due to incomplete bladder emptying.
8. Pelvic pain: Some individuals with bladder neck contracture may experience pelvic discomfort or pain.

It’s important to see a healthcare provider for an accurate diagnosis if you experience symptoms of bladder neck contracture, as this condition can have serious implications for urinary function. Treatment options may include medications, dilation procedures, or surgery, depending on the severity of the condition.

What are the causes of bladder neck contracture?

Bladder neck contracture can have several causes, including:

1. Surgery: One of the most common causes is previous pelvic surgery, particularly prostate surgery in men. Procedures such as transurethral resection of the prostate (TURP) or radical prostatectomy can lead to scarring and narrowing of the bladder neck.
2. Radiation therapy: Radiation treatment for prostate cancer or other pelvic cancers can cause inflammation and scarring of the bladder neck, leading to contracture.
3. Injury: Trauma to the pelvic area, such as a pelvic fracture or blunt trauma, can lead to scarring and narrowing of the bladder neck.
4. Infection: Chronic or recurrent urinary tract infections (UTIs) can cause inflammation and scarring of the bladder neck over time.
5. Idiopathic: In some cases, the cause of bladder neck contracture is unknown, and it occurs spontaneously without a clear underlying cause.
6. Congenital: Rarely, bladder neck contracture can be present from birth due to abnormalities in the development of the urinary tract.

The exact cause of bladder neck contracture can vary from person to person, and in many cases, it may be a combination of factors. Treatment for bladder neck contracture often depends on the underlying cause and the severity of the condition.

What is the treatment for bladder neck contracture?

Bladder neck contracture (BNC) is a condition in which the muscles at the junction of the bladder and urethra become scarred and contracted, leading to urinary retention and other symptoms. The treatment for BNC depends on the severity of the condition and the individual patient’s needs. Here are some common treatments:

1. Watchful waiting: Mild cases of BNC may not require treatment, and patients may be monitored with regular follow-ups to assess the progression of the condition.
2. Medications: Medications such as alpha-blockers, anticholinergics, and phosphodiesterase type 5 inhibitors (PDE5Is) may be used to relax the muscles in the bladder neck and improve urine flow.
3. Endoscopic procedures: Endoscopic procedures, such as transurethral resection of the bladder neck (TUR-BN) or laser ablation, can be used to dilate the bladder neck and restore normal urine flow.
4. Open surgery: In more severe cases, open surgery may be necessary to release the scar tissue and improve urine flow. This may involve a transperineal or transvesical approach.
5. Laser therapy: Laser therapy can be used to break up scar tissue and promote healing in the bladder neck.
6. Balloon dilation: Balloon dilation is a minimally invasive procedure that involves inserting a balloon through the urethra and inflating it to stretch the bladder neck and restore normal urine flow.
7. Stent placement: In some cases, a stent may be placed in the bladder neck to keep it open and allow for normal urine flow.
8. Urethral dilation: Urethral dilation is a procedure that involves inserting a dilator into the urethra to stretch the muscle fibers and improve urine flow.
9. Botulinum toxin injections: Botulinum toxin injections have been used to relax the muscles in the bladder neck and improve urine flow.

It’s essential to work with a healthcare provider to determine the best course of treatment for an individual case of BNC. The goal of treatment is to relieve symptoms, improve urine flow, and prevent complications such as urinary retention, kidney damage, and infection.