A bladder neck contracture is scar tissue that narrows the opening where the bladder meets the urethra. Most can be opened from the inside. When the scar keeps coming back, robotic reconstruction rebuilds the opening with healthy tissue instead of cutting the same scar again.

Who it’s for

Men whose bladder neck narrowing has returned after endoscopic incision or Optilume, especially after prostate cancer surgery, radiation, TURP, or simple prostatectomy.

The operation

Through small incisions in the abdomen, the scarred area is opened and the scar is cut through or removed. The opening is then widened with a flap of nearby bladder wall, or with a thin graft from inside the cheek (buccal mucosa) when more tissue is needed.

Before surgery

• Cystoscopy and imaging to map the scar

• A urine culture about 3 weeks before surgery, so any infection can be treated in time

• A plan for continence. Opening the bladder neck can cause leakage, especially after prostate cancer treatment, and some men later need an artificial urinary sphincter.

Recovery

Usually a short hospital stay. You go home with a catheter while the repair heals, and an X-ray (cystogram) is often done before it comes out. If a cheek graft is used, the mouth is sore for several days; see mouth care after a buccal graft.

Risks

Leakage, return of the narrowing, a urine leak from the repair while it heals, bleeding, and infection. These are discussed in detail at your visit.

Related

Bladder neck contracture · Robotic simple prostatectomy · Artificial urinary sphincter