What is bladder neck incision?

Bladder neck incision is a cut made in the neck of the bladder and extended into the prostate.  It is also called a transurethral incision of prostate. 

Why is a bladder neck incision carried out?

It is carried out to improve the flow of urine and to relieve your
urinary symptoms.

What happens during the operation?

The operation is carried out under general anaesthesia or spinal anaesthesia, depending on which is the best method for you. The decision will be made by the anaesthetic who will discuss this with you prior to your operation.
A telescope is passed up the urethra, which allows the surgeon to be able to see your bladder neck. A cut is made into your bladder neck so that your urine will be able to flow freely.  The operation itself usually takes 30-60 minutes.

What happens after the operation?

You will be taken from the theatre to the recovery room, where you will be closely monitored until you are awake enough to return to the ward.
You will usually have a catheter (tube) inserted into your bladder to drain your urine and also any blood or debris from the operation. This allows the prostate to start healing. As the bladder neck is very vascular (full of blood), it needs help to remove the debris and blood, so you may have irrigation fluid running into the bladder via the catheter to help flush it out.
The irrigation will usually stay in place for 24-48 hours,
depending on how quickly it takes the bladder neck to recover and the urine to become clearer. Once your catheter is removed, you can usually go home that day if you are able to pass urine independently.

How will I feel when I go home?

It may be uncomfortable to pass urine for two to three days after you have been discharged from hospital. It is important to drink plenty of fluids to help improve these symptoms. If your symptoms last longer than a week or you are worried about any thing else, then you should seek advise from your GP. If at any time you cannot pass urine at all or start passing heavy blood clots you should call out your GP or go to your local A&E department.

Will I have full control of my urine?

After your operation and following the removal of the catheter, it is usual to need to pass urine more often than usual. This will settle down with time, once you cut starts to heal. It takes at least six weeks for the wound inside to heal and you may still experience symptoms until the wound has fully healed.

Will I still see blood in my urine?

It is usual to still see blood in your urine for a couple of weeks following the operation.  This is where the wound is healing. After about two week you may notice that the  bleeding becomes heavier and there are "bits" in your urine. This is due to the  scabs falling off from the raw wound. It is important to drink plenty of fluids to flush your bladder through in order for the wound to heal itself. If the bleeding becomes heavy and there are thick blood clots that block the flow of urine, you should contact your GP.

How much should I drink?

You should drink up to two litres per day for the first week, as it helps to wash away the blood and helps prevent infection. After this, you should try to drink more fluid (water or juice preferably) than you would usually do. You may drink alcohol when you return home (in moderation!).

What should I eat?

It is important to avoid constipation by eating plenty of high fibre foods, fresh fruit and vegetables. Try to avoid straining when opening your bowls, as this can cause the wound inside to re-bleed.

What about excersize?

You should try to take things easy for the first ten days after leaving hospital, keeping all physical activity to a minimum. You should avoid any activities that involve heavy lifting for about six weeks after leaving hospital.

Will I be able to drive?

You should not drive for the first two weeks after the operation. Even though you may have no visible scars, you have still had an operation. In addition you may not be covered by your car insurance.

When can I go back to work?

You should be able to go back to work three to four weeks following the operation. But you may need a little more time if you have a manual job that require heavy lifting or physical work. If you require a sick certificate, you can collect one from the ward to cover the time you spent in hospital. If you need one when you return home, you will be able to collect one from your GP.

Will it affect my sex life?

You should not have intercourse for three weeks after your operation. This is because it may cause the wound inside to bleed. The operation causes the semen to be directed back into your bladder instead of coming out through the penis, so you will find you will have a "dry orgasm". This is not harmful and the semen will be flushed away with your urine, therefore it is very
likely that you will be sterile.

What if I get an infection?

While you have an open wound on the inside of your bladder, you are at
risk of getting an infection. If you find that your urine become cloudy or
smelly, and you have a burning sensation on passing urine, then you should
contact your GP as you may need a course of antibiotics.

What about follow up by the hospital?

You will be sent an outpatient appointment to see your consultant approximately six weeks after you have left hospital.

 All operations carry the risk of complications. However, general anaesthetics are very safe these days and you will have the opportunity to discuss these risks and complications with the anaesthetist prior to your operation. Any for of surgery carries the risk of you developing a chest infection, a clot in your lung or leg, bleeding during or after surgery, or developing cardiac problems. Your doctor will discuss all risks or complications with you when you attend the pre admission clinic.