Posted , 5 users are following.
Last Cystoscopy my Urologist stated that I have a High Bladder Neck and Large Median Lobe.
I can't find a clear definition of what is defined as a High Bladder Neck.
The closest I've come to a definition is "Bladder Neck Elevation > or = 35 degrees.
35 degree relative to what point of origion?
Does anyone have a clear definition or website reference addressing High Bladder Neck?
0 likes, 6 replies
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kenneth33698 bill24813
Posted
Hello bill24813: I had a diagnosis of a high bladder neck via cystoscopy in 1993. The treatment was surgical; a bladder neck incision. The post surgical recovery was similar to what I experienced with my TUVP in 2019. It was bloody. At one point, it required the emergency insertion of sounds into my urethra to free up the blood clots from the surgery so that I could actually urinate. Until that procedure, I was p*****g blood for a few weeks along with urine. Then I experienced complete urinary retention, requiring that emergency intervention. After that I was ok until my prostate started to grow over time. I was on several medications (the best of which was Cialis) but ultimately needed the TUVP.
bill24813
Edited
My 2nd Uro said I had a high bladder neck with a large median lobe. He did not say I had a narrow bladder neck. I have always been under the impression that the high bladder neck was caused by my prostate enlargement. I assumed the prostate was growing vertically toward the bladder thus stretching the bladder neck. I started questioning my initial impression, so I tried to find a definition, but failed to find anything solid. This is why I posted the question.
My Uro, suggested a TUIP ( basically BNI from what I can tell). The more research I did the less I liked the TUIP. Sent some follow up questions (about a month ago) to the Uro, inquire 2 times, still no response.
I have since had my records sent to MAYO in Jacksonville, fl. I am hoping I meet the qualifications to get a PAE ( Prostate Artery Embolism) or My 2nd choice is a mid-lift (UroLift on the median lobe). I've already had a UroLift(2yrs ago) on the lateral lobes, which didn't help at all. I am on daily coumadin for a mechanical valve, so bleeding is a big concern for me.
Thanks for your reply.
You confirmed one of my biggest concerns regarding TUIP/BNI and prolonged bleeding post op.
TKM bill24813
Posted
I think the high bladder neck is just an enlarged median lobe growing up into the bladder. Sometimes they specify a measurement of how far into the blabber it is growing, usually in millimeters or centimeters. One Urologist did a cystoscopy on me and turned the end of the cystoscope around so the bottom of the bladder could be seen, and he said the bottom of the bladder was rounded up due to the enlarged median lobe pushing up. He let me look at it on the monitor screen.
bill24813
Posted
That makes a little more sense. My Uro expressed it as 2 separate items ( high bladder neck, large median lobe). As an integral affect, lobe creates high bladder neck, I'm still hopeful that I qualify for the PAE. Reduce the median lobe, reduce the high bladder neck.
How did you end up treating your issue?
Milos123 bill24813
Edited
hello, I have diagnosed High sclerotic bladder neck, since I have weak urine flow a lot of years. but my prostate is ok, small 25ml. so high bladder neck do not need to be caused by prostate.
It is abnormality especialy in young men. let say like me 36y old. not very young but let say.
My uro told me that it can be congenital and it is like ,,water dam" not sure if I translate it correctly.
And bladder have to push more and more by years and years and that i am now. my bladder is weak to push. not totaly weak but I need procedure to remove this obstruction which is high neck.
There is maybe another high neck, but it is caused by enlarged prostate. when pull up to the bladder. but neck is not obstruction, but prostate itself.
bill24813
Posted
Thanks for the reply. I believe I have 2 issues, hopefully with a common cause, large median lobe. My symptoms: Always have a delayed stream (1 -15 min). This happens regardless of if I'm on flowmax or not. I am assuming this is a result of the median lobe. The difference is flow. This is hit or miss, nothing consistent. I get rare but random full flow episodes, but for the most part I dribble or have a weak stream. I am assuming this is due to the combination of the median lobe and high bladder neck (possible narrowing). After orgasm, I have notice full flow about 40% of the time. It appears, to me, the back pressure of the orgasm is temporarily widening my high bladder neck, thus allowing better flow thru that section of my urethra. I believe the combination of back pressure exposure and median lobe not blocking the bladder at that time is allowing my occasional full flow.