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bladder neck contracture

Posts: 19
Joined: Apr 2005

I just found out that I have scar tissue at the neck of my bladder. This is the apparent cause of my continued minor incontinence. Has anyone else had this problem and what kind of treatment was recommended. My uro says that to surgically treat could cause my problem to become worse. Of course if the stricture gets larger I could have trouble urinating. I am one year out of LRP and cancer free so far so I do have a lot to be thankful for. Russ

03serk's picture
Posts: 16
Joined: Dec 2005

Congrats on your recovery, Edmund. I'm about 2 months post surgery now and have very little incontinence problems. I do have a rather diminished flow stream most of the time unless I strain when urinating. My uro said it could be fixed but may cause leaking problem. I'm 53. My first PSA last week was .02 so I'm looking forward to being proclaimed 'cancer free' as you are.
I just met a 70 year old this morning in chat who had a flow problem 'fixed' and now he leaks like a seive. Unless my flow stream becomes a real problem, I think i'll just stay like I am. I had a real problem with the discomfort of wearing the pads and I wouldn't want to go back to that.
I hope this helps and best of luck in your continued recovery. Stay strong.
Keep the Shiny Side Up!

bandonpaul's picture
Posts: 8
Joined: Feb 2005

I too had bladder neck contracture following RP in December '03. Subsequently, because of slow stream and frequent urge I made two trips in 4 months to the hospital for balloon catheter stretching of the area. That worked for a while, but the problem persisted. During this time I had very little leakage. After the operating doc retired I found a much younger and up-to-date doc who assessed the problem and offered info about 'revision' of the bladder neck. He warned that the procedure might make incontinence a significant problem, and it did. However, I did not want the pain associated with recurring contracture, and determined to accept the challenge of incontinence. Not a favorable choice, but doable.

After the revision area healed, as evidenced by cystoscopy, my doc offered info about an artificial urinary sphincter (AUS), the potential for significant control over incontinence, and some detail about surgery for implanting the 'AMS 800 Sphincter.' Detailed info is available at 'www.ams.com.' Because I was having real problems handling free flow incontinence, I agreed to surgery.

The surgery was done in short stay under spinal anesthesia. Since I have a strong interest is surgeries of all kinds, especially this one, and would be 'awake', a monitor in the OR was set up for me to watch the entire procedure. Very interesting! No pain. No fright. Comforting to actually see it done. I was to be discharged later that day, but due to some distance from my home to the hospital the doc had me to stay overnight. A Foley cath stayed in for a week. The pain that followed for almost a week was well controlled with meds, then no pain ...but I had to deal with incontinence while the surgical area healed.

One month after the implant my doc activated the sphincter, allowing me to urinate at will or urge. It is simple for me to activate it whenever... Since then no pain, no incontinence. I feel very fortunate to have that problem under control, and my life has returned to normal.

I still have a major problem resulting from the RP - impotence. That's another story, another time.

I hope my story sheds light on 'one way out,' and I sincerely hope you find your way. If you wish to talk with me further about my experience, email me via CSN and we can arrange a phone conversation. Or, we can email directly after exchanging personal addresses.

Good luck! Paul

Posts: 2
Joined: Jul 2009

Hi Pau
Real fine of you to share oue experience. Seems most men are in dinial.
Like it never happened to them!

My name is Dennis. I am 64 YOM. RP 1999.
Eight years of dryness. EDF.
Feb. 2008#1 urologist dialated and this started the leaking. Not bad though. Stress inc.
I complained about the leaking. He sugested colligen injection to elimate.
Proceeded with injection. Leaking much worse post.
Changed Urologist
New #2 Uroligist found 12 cm scare tissue at blatter (First Urologist was aware of the 12 cc scare tissue but chose to dialate. I read online that this scare tissue in area of bladder rarely blocks off completely. I was not informed of this information. If I had neen may have not had surgery done to correct?
#2 said he had to clean it up before he could procced woth treatment.
Bladder neck contracture surgery (cold knife) 4 weeks ago. Leaking like a seive!
Had a rough time post surgery with pain in crouch and burning in ureatha
Two days now POST FOUR WEEKS with no burning and advil controlled pain in crouch.
Was getting a little depressed but ordered and read my medical records from both Urologist and think I am feeling better with more understanding of my condition.
How was the pain post bladder construture surgery?
Leaking post?
How long after did you have the 800 installed.
How is it permorming?
Any more information appreciated.

Posts: 2
Joined: Jul 2009

If you would like to reply via email.
Mine is denniscarpenter@verizon.net
Again thank for your post.
Dennis Carpenter

Posts: 7
Joined: Jul 2009

I have recently had surgery for pc (July 14). The procedure went well with the exception of issues with my bladder. The day after surgery, my surgeon told me that I have a very small bladder neck and that I may have difficulty urinating if my catheter was removed to early. I was released from the hospital two days after surgery and had the catheter removed 5 days later. When I got home from having the catheter removed, I was able to pass urine in one small, slow stream. That evening, I decided to take a Tylenol PM before bed and wear a pad in case of overnight leakage. When I awoke, I was surprised to see NO leakage, yet I had the urge to urinate. When I tried to urinate, I could only manage a couple of drops. As the day proceeded, my inability to empty my bladder continued. As my bladder discomfort continued, I called my doctor and he told me to come to the hospital where they would administer an ultra sound to see how much urine was in my bladder. By the time my wife and I arrived, I was in the most unbelievable pain that I had ever experienced. My stomach was extended and couldn't bear to have anyne touch my abdomen. I was RE-catheterized and will return in 6 days to have my catheter removed for a second time. I have since found out that the Tylenol PM may have caused my bladder neck to constrict. Has anyone heard of this before? I'm worried that when they remove the catheter for the second time, I will still have problems. Having been catheterized a second time was the worst, so I can't imagine being catheterized for a third time if I still have problems urinating.

ismetals's picture
Posts: 70
Joined: Feb 2009

I'm no doctor but it seems to me that having the catheter out in 7 days seems pretty quick. Most of us here seem to have gone just a little longer. Mine was out in nine days and i have had no trouble that i haven't brought on myself.
Good luck and keep us posted

Posts: 1
Joined: Mar 2010

Hey DougP I have just had surgery three weeks ago.First cath removal did not work for me.Went to Er same night for recath.Second removal a week later voided for about 7 hrs then shut down, back to Er.Waiting for third try and hope for better results.Your mention of Tylenol caught my attention.I have been taken tylenol daily for fever,have you learned any possible effects causing the bladder neck to constrict? I see your post is from 2009 hope you are doing well.

Posts: 931
Joined: Jan 2010

I found ibuprofen works well for me in controlling swelling.

Overall, this thread has put a new level of fer in me- I have wondered, but now I am very afraid to let anyone start messing with the bladder opening. I have enough problems as it is. Like I told my family doc when he suggested a new med, "doc, I have all the side effects I can handle right now- I don't want any more." That was the end of that discussion.

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