A bladder neck contracture is a form of scarring that occurs at the narrow outlet where the bladder connects to the urethra. This condition is typically an acquired complication following previous surgical interventions on the prostate, such as a radical prostatectomy for prostate cancer or surgeries for benign prostatic hyperplasia (BPH) like TURP. The development of dense scar tissue progressively restricts the opening, creating a high-pressure bottleneck for urine attempting to leave the body.

Primary Symptoms

• Severe Flow Reduction: A progressively weakening, narrow, or trickling urinary stream.

• Straining to Urinate: The physical necessity to push down or strain using abdominal muscles to force urine past the scar barrier.

• Urinary Retrying: Struggling to initiate the stream, or experiencing a split, spraying flow.

• Incomplete Emptying & Frequency: Sensation of trapped urine, leading to frequent trips to the bathroom day and night.

Diagnostic Approach

1. Flexible Cystoscopy: The gold-standard evaluation where an ultra-thin, flexible camera is passed into the urethra to directly visualize the ring of dense scar tissue narrowing the bladder outlet.

2. Uroflowmetry: A computerized test that graphs the speed and force of your urine stream to quantify the level of mechanical obstruction.

3. Post-Void Residual Ultrasound: A quick scan to measure exactly how much urine remains trapped in your bladder immediately after voiding.

Recommended Surgical & Treatment Pathways

Dedicated Subspecialty Center: Urethral Strictures & Stricture Disease Hub →

Surgical Reconstruction: Urethroplasty & Complex Bladder Neck Reconstruction — Robotic or perineal revision for recurrent post-prostatectomy stenosis.