bladder neck contracture

bandonpaul said:

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

DougP said:

small bladder neck
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.