Bladder neck incision

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Hi guys , 

I’ve read on the forum about multiple procedures for enlarged prostates . I was diagnosed with a bladder obstruction earlier this year which has been helped by Alpha Blockers . It would appear that the pills are becoming less effective. 

Does anyone know if the new procedures for BPH will work for bladder neck incision ? As the main side effect of BNI is retro ejaculation.  which I would like to avoid .  I would like to be armed with some alternatives prior to seeing my URO again . 

Thanks in advance 

Darren 

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  • Posted

    Good Afternoon.  If you are worried about retro ejaculation then you have to stay away from the bladder neck incision procedure any time they do that your bladder neck will not close right.  Try a different pill.  Clalis is good and so is Myrbetriq.  They would both help relax the bladder Or you can try the Urolift procedure.  That would open you up and it would relax the bladder No side effects And there is Rezum that would make the prostate smaller with steam.  There is a 5 to 10 % chance of retro.  Good luck.  When you see the doctor you can tell him no to the BNI and tell him your concerns You don't have to have anything you don't want.  And if he give you a attitude get another doctor.  Good luck  Ken

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  • Posted

    yepo BNI...or T U I P, same thing, will lead to retro.......mine did and i was told it would by 75%...occasionally i still ejaculate, but not often.  so avoid if possible, Ken1955 is right in his piece, every other avenue first!! all the best Syd
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    • Posted

      Yes he is going to have to either change medicine or go with a less evasive procedure.  I would go see a different doctor.  PS  ON Me..  I had a infection a few weeks ago and was on Bactrim DS for 10 days.  Took a urine sample in the other day.  Still have the infection.  Going to be on Bactrim DS 800-160 for 21 days before I go see him.  Take care all  Ken
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    • Posted

      Surfman.  Did you every ask your doctor why that happens It like a hit and miss.  I just read a article on TUIP and it said that it is a given that you will have retro after this procedure   Take care  Ken 
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    • Posted

      Kenneth,  I hope you will take probiotics while on the antibiotics. Take them at least two hours or more from the antibiotics.  Some of it will get through. At least you will have some coverage.  Would also take Saccharomyces boulardii, a probiotic yeast that is not killed by the antibiotic.  Otherwise, you may end up with a GI problem which you don't need.  

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    • Posted

      Yes I am and thank you.  My urologist sent me a e-mail and told me that I needed to take that also for the 21 days.  It's a bacterial infection and he said they are hard to get rid of Thanks again  Ken  

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    • Posted

      Hey Phil  I hope your doing good.  No Bactrim DS is not on that list of Quinolone.  I have to take this for 21 days with a probiotic.  This is going on over a month.  Last month I took the same for 10 days I thought it was gone.  Blood work in 2 weeks, the cystoscopy, DRE and what every else he wants to do.  I need to find out why I am getting the infection again.  Time will tell.  I do trust him to do what is right my me he told he will do what he can and we will find out why.  .Good health all  Ken    
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    • Posted

      I guess the type of infection I have Cipro will not work for it.  That is why the Bactrim.  Will see I have to get some Benadryl today.  It is making me itch this time.  Ken   
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  • Posted

    Darren, I had a bladder neck incision last year for prostatitis and I too was concerned about retro. However, the uro said the cut can be adjusted and obviously the deeper the cut, the greater chance of retro. I was one of the lucky ones - I'm still firing! I guess he didn't cut too deeply. Takes a few weeks to fully recover, although I was back to work within a week. Good luck!

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    • Posted

      Nick,

      I am 39 and have a uroflow test of 9.  Very low.  I am scheduled for the BNI and am very scared.  How long was your recovery, your pain?   Can you tell me about the difference pre op vs post op?  Is it a big difference, would you do again?

      thank you

      Joel

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    • Posted

      Hey Joe.  Sorry you are having a problem.  I hope your doctor has told you all the side effects with this procedure.  For a older man it is bad but at 39 I hope you have voice you concerns to your doctor.  Infections, Dry orgasm, bleeding, discomfort after the catheter come out, problems with erections and you may not get any improvement in urine symptoms.  It also can cause scar tissue.  Just for your own good talk with your doctor like Nick not to cut to deep because if it is the bladder will not close right and you will end up with retro ejaculation.  And believe be they suck.  Had them from Flomax and Rapaflo.  Good luck and I hope all goes well  Ken     ,   
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    • Posted

      Hey Buddy.  I do not know if this is a concern of your and if your planning anymore kids but I did more checking and I never know that retro ejaculation was so high.  I read a article that it is at 90 %.  Is there not something else you can do. I hate to see this happen to any one but at 39  It is going to chance your life.   Take care Ken  
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    • Posted

      Hi Joe

      I’ve also been recommended for BNI but Ken is spot on . My uRO actually said retro ejaculation is almost certain and insisted that my wife was with me when he described the procedure as fathering children will be out of the question . He did also say though that any other side effects are very rare and that success rate is extremely high . Nick was lucky as he escaped the RE . Maybe it’s down to the surgeon but most things I’ve read also say 90 % chance of RE. Have you been put on meds at all ? 

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    • Posted

      Hi DCooper,

      Thanks for the reply.  I tried flomax for a while and worked a bit at first but then stopped.

      Being 39 my Dr said an output of 9 is very low.  Had a cysto and determined tight and high BN.  I am scheduled for the surgery but think I may cancel or reschedule.   I understand the retro part as being high.  I think it is all the other stuff scaring me.  Ie. loss of erections, incontinence, long recovery time.

      I was told recovery would be outpatient, 4-5 days with Cathitor and then take it easy for two weeks.  Then I see people saying months and tons of pain.  So I am happy to listen to everyones experiences in this.

      Thanks again,

      JP

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    • Posted

      Hey Joe.  I think that would be a good idea to cancel for now.  There are med's out there that will help relax your bladder and bladder neck.  One is Vesicare 10 mg.  or Myrbetriq 50 mg.  I would check into a pill before I would have anything cut.  Take care and good luck

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    • Posted

      D Cooper.  Did you go on some med's or were you talked into the surgery.  It will not only chance your life but also your partners.  God Bless  Ken 

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    • Posted

      If you are scared then that is not for you.        That surgery may help you but it also may cause more problems.  I was on Flomax .  Did not like the side effects.  I was on that before I had my Urolift.  Have a great day  Ken
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    • Posted

      Hi Ken

      My URO was very clear and said BNI should be a definite last resort .when he first suggested the BNI  I waS in in a lot of discomfort  due to prostatitis and a blockage,  ( which is the possible cause of the prostatitis)so it was me that was pushing for a solution.  The meds took a long time to work . I’ve been on alphazusin and then Tamusin . Doing ok as prostatitis has receded . Flow is still low and sometimes a messy spray but not a major issue . Darren 

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    • Posted

      Thank Darren.  I am deal with prostatitis now and it's doing a job on me.  I see my doctor Wednesday have bladder stones to.  But I would never do anything procedure that will give me retro.  I will deal with not peeing or a slow steam.  I am on med's to relax my bladder.  I also have a tight external sphincter.  But I still keep going.  I sit and pee a lot and take hot bath That helps be pee.  Take it easy and good luck  Ken   

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    • Posted

      Joel, I opted for a BNI as my bladder wasn't emptying, it was thickening up - and I was peeing for England - every 90 mins or so! So, after trying various meds, I had little choice but to go for it. Pain wise, very little straight after the op due to plenty of anesthetic, but certainly bearable for the first few days (with the help of some off the shelf painkillers!) It was actually worse when the scab came off the scar (takes about 10-14 days), but my uro told me to expect this and to be patient as it would take a few months to really settle down. I was back to work within a week. I still get bouts of prostatitis - something my uro felt might be caused by urine getting forced into the prostate - but I'm far better now than I was. Also I don't need to pee urgently any more which is a great relief. Regarding retro, lots of views on this tread, but you might like to get some facts from the horse's mouth, so to speak. It you do a search for baus (British Association of Urological Surgeons) and add bladder neck incision, you should find a pdf which gives you some really useful information. Part of that information states that approximately 4 out of 10 men end up with retro, so roughly 60% don't. Those odds did concern me, but I was lucky - no retro and I'm still in good working order! Nothing changed in that respect. Because uros know it's a big deal to us men, I think they often exaggerate the odds to cover themselves and prepare you for the worse, but the stats show it's actually no so bad - though still not good! Would I do it again? Well, it I had to a second time, yes (and I've ready some men do have to have it done again some years later) - but I think you meant would I do the first op again and the answer is definitely yes. We're all different though Joel. I hung on as long as I could, and the decision was easy for me as I had no other choice on the table. I read extensively on the Internet and some had retro, some didn't. Good luck with whatever you decide.

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    • Posted

      I have read many articles on this and all of them say 90 % but still 40 % is not good odds.  He is only 39 he may what to have another child.  Some men don't have kids till there in there 40  My father was 41 when I was born.  Why should you have to give up anything to just pee better.  That is one thing I would not do.  To many thinks are taking away form us as we get older.  4 out of 10 Is still 4 to many.  I wonder what they are doing in the UK that our doctors are doing over here.  Life is hard enough and we have to live with many things when we get older I am 63 and I can live with different thing then what Joe can live with.  That is why we have to stand up for our body's.  He has only tried a few pill he needs to try a few more.  I am deal with a lot right now and I will not do anything that would get rid of my ejaculation.  It's mine and no doctor is going to tell me I don't kind it.  I have prostatitis, bladder stones. and a tight external sphincter.  I see my doctor Wednesday he will be doing scope on me and then we will go from there.  Take care and good luck to all  Ken    

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    • Posted

      First let me thank you all for being so kind as to take the time to help me.  I genuinely mean that.    

      I do have two children and not wanting an more.  The retro is a small concern but I think I could live with that.  My biggest concerns are impotence and incontinence.  Being so young I would not be able to handle having either of those be my new norm.  I also fear the recovery time.  I do not do well with pain for some reason.  Especially long term.  I was told I would be working again after a few days and pain free in about two weeks, but when reading the experiences of others it seems like it could be months of pain and bleeding.  Then I fear it not working and I did it all for nothing. (or relapsing)

      On the other hand I do not want to damage my kidneys or bladder. 

      My only real symptoms are that I have a

      -slow flow (a 9 when doing uroflow. Done 4 of them)

      Is a 9 on the flow chart horrible.  Maybe not if I am passing my urine.  These are all the things running in my head.

      -dribblng at the end

      -very small residual

      -get the sensation to need to go even when bladder doesn't seem its fullest

      -wake up 1, maybe 2 times at night.

      -multiple streams at times

      I do get some pains in my pelvic area and abdominal area. However those might be from straining to pass stools or related to my testical.  

      I put this surgery off for a few years and tried flow max on and off.   I went to the dr yesterday for testicle pain and he suggested this was my reason. Maybe straining is pushing urine to your testicle or straining  it somehow.  However, I also have a very noticeable vericocele.  He wants to do both surgeries  same day.

      My worry is maybe my current pain is not from my slow flow or tight and high bladder neck. My be it is something unrelated like injury, infection, and so on.  

      I know my left testicle has the vericocele and a small hydrocele.   

      I am just so confused.  

      You all are great for speaking with me.  Thank you.

       

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    • Posted

      Thanks so much Nick.  Yes I was wondering about if you would do again given the recovery, pain and outcome. Thank you again.  Retro I think I could live with, its the incontinence and impotence that scare me.  At 39 I would be devastated.

      I am very happy I found this group and thanks for your time.  smile

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    • Posted

      Joe I am so sorry for what you are going through and it is a lot to digest If you want to have the Bladder neck surgery they you do it for you but you have to talk to your wife because the side effects will affect her to.  The pelvic pain can also be prostatitis.  All men have to deal with that at one time or another.  With cutting the bladder neck it will not close right that will cause the leaking and you may need to ware pads for a while.  That will cause retro to.  Getting up at night 1 time is not bad you may have to watch what you drink.That may help.  As with the vericocele you don't need that done unless it hurts you.  I read a article that the only reason men have that taking care of is if they have a low sperm court.  And being you have 2 kids you don't.  If you go for the one surgery that will be enough for you to handle.  I would try different pill to relax your bladder to see if that helps.  Life is short and I know your wife will love you what ever you decide.  God help you  Ken  PS  I also read that article from the UK  it dose said 4 out of 10 but it also said that 1 to 10 % will have erection problems.  They do there with laser how is the doctor hear going to do it.  Also if you do go for the BNI procedure make sure that is the only thing that you agree to.  Because when he get in there something they decide to take out some of the prostate and that will be a hole new problem.  God help you make the right choice  Ken  

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