Recovering normal urination after a bladder neck incision

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Hey people 

I had a bladder neck incision to help with my slow and strained flow but I steel feel like I have to pee constantly. Has anyone had and recovered normal urination after a bladder neck incision?

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  • Posted

    Hi Jack, I had the same op about 12 weeks ago - I'm 49 - due to high and narrowing bladder neck. Took about 10 weeks for mild pain during urination to subside but, like you, I still feel I need to pee too often. Saw my uro last week who was impressed I voided 360ml at 26ml/s - but I was hanging on for dear life as he wanted me to have a full bladder! I'm usually averaging about 250ml at 17ml/s (I did some random samples so I could see for myself if things improve over time). Anyway, he told me things should settle down but prescribed Vesicare short term (10mg daily) which is usually given for an over active bladder. Not taken them yet as I'm hoping things will improve gradually on their own. Read about someone who had the same op a while back and he said it took months to gradually get back to normal, although flow improved instantly after the op.

    Strange how I can go out and drink 3 pints in the evening before I need to pee, yet a coffee in the morning and I'm peeing within the hour! I'm currently going about 7-8 times a day and only occasionally once at night now. I suppose cutting that area is bound to upset some nerves which will take time to heal fully.

    Hope things settle down for you soon.

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    • Posted

      Hey Nick, 

      Do you think your symptoms will resolve to normal; ie. before you had any problems? 

      I was quite a young man when I had this op done, 20. It didn't really resolve my issues and more recently I have developed a strong sensation of being on the verge of peeing all the time. 

      I am worried that the operation, for me, might have been a mistake and that I will always have this sensation of being in the verge. I haven't heard from anyone who's symptoms disappeared completely but that would help

      Jack 

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    • Posted

      I reckon things should settle down Jack. My uro recommended the op as he said they find it's successful for most men. We're all different of course, but I think my frequency issues are starting to ease a little now.

      Here's a couple of posts from other forums which I saved about the BNI op:

      'I've had this operation twice, once in 2007 and again in 2014. The first time I had a bad bout of prostatitis beforehand, which was kicked off because I ignored the warning signs for years. After the operation it took me 9 months to start feeling good again, and two years before the discomfort went away completely. The second time was also preceded by a bout of prostatitis, again because I ignored my gradually decreasing stream and increased straining. I felt good about 10 months afterwards, and am still improving to date. My case isn't typical - most cases resolve in three months - but I wouldn't hang about on this. Just make sure you are comfortable with the side effects, which your surgeon should have advised you about.'

      and another...

      'I don't think I would have got better if I hadn't had the BNI, because when the Uro did the op he told me that my bladder neck had become very overgrown. Obviously this process had been going on for a long time and had just reached a critical mass. All I know though is that for the first time in my life I voided like a racehorse, with no split stream or dribbling and felt empty straight away. I felt 50% better straight off and everything else calmed down over 8 or 9 months as the surgical wound healed and the prostatitis fizzled out as there was no longer any perpetuating cause. There were a lot of ups and downs along the way - some pretty bad days - but it settled down to a low grumble, where all felt was a slight tickle or raw feeling in the glans now and then and maybe voided every three hours (which was remarkable for me - I used to think 90 minutes to 2 hours was normal) and once at night sometimes. So I had 12 months of hell pre-op, 8 or 9 months of gradually improving symptoms with many ups and downs, maybe a year of feeling 85% and then 5 years of feeling 90-95%. All of which was freakin' awesome. I'd get a flare every year or so lasting a few days to two weeks, but usually about a week where I would feel like my urethra was swollen, I had suprapubic burning and I'd need to pee every hour to 90 minutes (but always felt empty afterwards). No biggie.'

      I'm not sure if you can add external links on this site so I hope the authors of the above won't mind me posting these. It's always good to hear positive stories from others!

       

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  • Posted

    How are you doing nick? Have symptoms improved for you? I went back to see another urologist who said there was no reason to still feel the need to pee frequently. Which is frustrating when you do! 
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  • Posted

    Hi Jack. Yes, my symptoms have improved a lot during the past couple of months and it seems my BNI op was a good idea after all! No problems now for well over a month and the prostatitis has improved dramatically since the op. I guess my uro knew what he was talking about when he said  most men find things improve significantly. I hope you manage to get some relief soon. We're all different and it is difficult knowing what to do for the best. Best of luck mate.

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  • Posted

    Hi. Jack and Nick.

    Thanks for your reviews on the BIN. I will be having one on Wednesday. After nearly life long voiding issues at the ripe age of 33.

    Wish me luck. The surgeon is very confident that it should be a success.

    Did you guy experience many issues in the first few days/weeks post surgery? Any issues with incontinence?

    Thanks in advance

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    • Posted

      Hi Peter,

      I am supposed to go in for a BNI and am kind of scared.  How did yours go?  Any problems afterwords, how lng was your pain and recovery.  What about your flow?  Thanks for taking the time.  I am a bit scared and put this offer for years.  I am 39 and my flow is about a 9.  

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    • Posted

      Hi Joel.

      If I hadn't of had two uti's before the procedure things would have been alot better, the antibiotics have messed up my digestive system and I have C. Diff infection.... But apart from my tummy trouble, now I am currently two months post surgery and my last flow test was 27ml/s and a residual of 40ml. Let's say I can pee freely. I still have retrograde ejaculations although reduced volume and sensations, the Dr said it will take time to adjust. During the day I now focus on filling my bladder up and getting a good strong urge before I void.. Remember to keep drinking.

      The surgery went well and the pain was moderate. Was given endone in hospital and valium at home. The first 6 weeks are the worst, you will still have all your old habits and be worried that something is going wrong. But try to relax and have faith in your doctor.

      Good luck.

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    • Posted

      Joel I wish I had of had mine done years ago. I was on tamsulosin for years and having uti forced the surgon to act. But I really do wish I had it done along time ago. But we can't turn back time.

      Go get it done. You will not regret it.

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  • Posted

    Hi all,

    I had BNI and Plasma button procedure 7 weeks ago. (73 yrs. old) This was 2nd procedure as I had a green light PVP  about 7 years ago. Initially flow volume improved however for the last 8 days it seems I am back to square one with week stream, start & stop and feeling of not emptying bladder, much worse at knight. I went back to Uro doc. Ultrasound revealed 135 ml. of residual  urine. which was about normal for me prior to having procedure. He stated that he thought this was due to weak bladder mussel and to give it more time to heal. Follow up scheduled  in 30 days. I am concerned that scar tissue is already forming restricting flow. He may do another cystoscopy to see what is going on if things don't improve.

    Have any of you gentlemen had similar situation after BNI . Any suggestions or advice is appreciated.

    Thanks. 

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    • Posted

      George.

      Are you drinking enough? I had a lot of trouble because I wasn't drinking but i was always thinking I needed to pee. But in fact I didn't need to pee because I hadn't drunk enough water.

      It takes a lot of time to to recover especially at your age. Take it easy try to relax and do some meditation

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    • Posted

      I had bladder neck contracture surgery yesterday following Holep surgery in May. Doc said it was an obstruction at bladder neck that will only allow me weak stream or trickle. Doc said good results would come right after catheter removal but not yet. Any idea how long fixing this might take or know how to find out?
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    • Posted

      I had bladder neck contracture surgery yesterday following Holep surgery in May. Doc said it was an obstruction at bladder neck that will only allow me weak stream or trickle. Doc said good results would come right after catheter removal but not yet. Any idea how long fixing this might take or know how to find out?
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    • Posted

      I had bladder neck contracture surgery yesterday following Holep surgery in May. Doc said it was an obstruction at bladder neck that will only allow me weak stream or trickle. Doc said good results would come right after catheter removal but not yet. Any idea how long fixing this might take or know how to find out?
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    • Posted

      Hi John

      I'd give it a while. If you don't start to see improvements in two weeks I'd ask your doctor. But it can take up to 8 weeks to heal.

      Make sure you drink plenty of water and urine alkalizer

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    • Posted

      Just my opinion, but 135ml of residual doesn't seem like a lot... I doubt if any guy over 60 fully empties their bladder when urinating... maybe your discomfort is from having more residual than YOUR usual?

      I am at 750ml+ residual, Green Light procedure scheduled for later this month.

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    • Posted

      Yes, I am thinking I need to cath at least 2X/day... maybe 10-12noon and 8-9pm...  I have been dealing with abdominal distension, my primary, uro and gastro Docs all have no clue as to why... IMO, it is my always full bladder not being able to process the amounts of water I drink daily, so the excess stays in my belly and distends it. (sort of like, DUH!)... no pain, no indigestion, no reflux. 

      I will try cathing more and drinking less.

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    • Posted

      George, were you happy with your Green Light procedure?  How long to heal, pain, leakage, etc??  I have one scheduled, but my UroDoc has not discusses any other options, which concerns me...

      IF your Green Light worked well, have you considered a repeat?  Seven years seems like a very good result...

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    • Posted

      The green light procedure I had 7 yrs. ago went well . with slight bleeding for several days after,.along with burning sensation. That Uro Dr. moved away, so when I asked my new Dr. about a 2nd Green light procedure, he told me that he only does the plasma button method which he thinks is more efficient with less bleeding involved. I took him at his word. In reviewing his Doctors notes, it stated he used the plasma button electrode to incise the bladder neck contracture with incisions at 5 and 7 oclock then same plasma button electrode was used for resection of right and left lateral lobes down to the level of the prostatic  capsule .Seemed like a lot more bleeding with this procedure and now, 9 weeks post procedure am just starting to see some positive results. Stream is stronger but not what I had hoped it would be. I get up about twice each night to pee which is a big improvement. I hope things will continue to improve over time. .

      Best of luck with your condition and choice of procedures. It seems each Uro Dr. has their favorite method. 

      George.

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    • Posted

      Thanks for the feedback, George... all the different procedures... very confusing...  did your Green Light procedure address the bladder neck when you had it done?  I think I have a BN problem, and for a LONG time (since my mid-late 20's, I am 62 now)...  Not sure if meaningful, but I feel a lot of resistance at the bladder neck when I cath... a fair amount at the prostate too, but nor nearly as much...

      I'll do some homework on the plasma button (button TURP same thing?)... thanks again... I see my new UroDoc next week.

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    • Posted

      No, the green light procedure did not address bladder neck problem however that doctor did say I had symptoms of BN contracture at that time. I guess it got worse over the years. Please let me know what your new Uro doc recommends. I am guessing he would probably have to do a cystoscopy to see what is going on up there.

      Good luck with your new guy. Hope all works well for you.

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    • Posted

      Thanks, George,  Odd, I would have thought that since your Doc was already "up there"... why not do a BN incision or two?  Yes, unfortunately, my new UroDoc will probably want to do a Cysto... I've had several and even though cathing does not cause me much discomfort at all, Cystos DO... I know, man up.  ;-) 

      I think my BN got worse over the years too, but I am a little bummed that I always used to be able to pee normally, but weakly... then it got very slow, pretty suddenly... now, once I began cathing, I can't really pee at all... is this normal?  I hope my dang prostate didn't suddenly get a major growth spurt!

      BTW:  I hope he will ask for an MRI and that insurance will approve it... I think that is the best way to really see what's what... I have been having some very unusual abdominal distension too... same time I slowed way down in peeing... probably related... maybe not... sure like to get both fixed!

      I am now cathing 3X/day... getting some good volumes, though still don't have a measuring vehicle... maybe a bit too much... hate to have to go to 4X/day!  Thx again!

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    • Posted

      Thanks, Peter……your advice is very much on target. I had bladder neck contracture after HOLEP 3 weeks ago and peeing like I did at 18 (66 now). Pain is still there and frequency a little better each day. 3 weeks is probably too soon to see profound results but so far so good. I take it you agree that time is critical? Does anyone know if scar tissue can come back necessitating the BNI again? God, I hope not. Always worry when I pee if things are going to go south again.
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    • Posted

      Time and plenty of water are the key.

      Scar tissue may come back but I guess it depends on what was the cause in the first place. Once I hit the 8 weeks all pain and issues had resolved. I'm still getting used to using my bladder correctly but at least I'm emptying fully.

      Best of luck with your recovery.

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    • Posted

      hi Peter,

      I had BNI procedure along with plasma button turp  10 weeks ago. Went home with catheter that was removed next day. First few weeks was passing some blood and small clots. Peeing flow rate improved and felt like I was emptying bladder pretty good. Only getting up twice per night. However things went downhill from there with some good days and bad days. bleeding has stopped. Now I am back to week stream , Getting up 4 or 5 times at night, No sleep. always feel like bladder is full.. I have been back to Uro Dr. 3 times, Bladder scans show residual urine ranging from 135 ml. to 200 ml. He thinks it is a week bladder muscle not pumping urine out. and that healing from procedure could take up to 6 months? I am frustrated to say the least. Starting to think procedure was not a success.

      Maybe new scarring or a stricture is blocking flow. Have another Dr. visit tomorrow

      Thanks for listening or should I say reading.

       

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    • Posted

      Hi George…..Hope you don’t mind my checking in. The recurrence of scar tissue is what haunts me too. I had bladder neck contracture about a month ago after HOLEP and every time I have to pee I’m afraid the really good stream will revert back to trickle mode. My URO doc is very non-communicative and can be harsh even sometimes. I think he’s torqued off that the HOLEP needed this extra follow up. I had total blockage 3 times which was holy hell and wound up in the ER in excruciating pain so I am very anxious to know if scar tissue can grow back and what’s the likelihood of that happening. Anyone weigh in?
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    • Posted

      Hi, George,  another question, if you don't mind... I had a couple of failures in using the 16 caths... I finally realize, I am too tight in urethra and prostate areas to use the 16's... even had a little blood last try... even the 14's I use successfully seem a little tight... should I try a 12?I assume the smallest diameter cath is the best... IF it does not leak... and with my tight bladder neck... I doubt if it would.  thanks for your help!

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