Bladder neck incision (BNI)

ABOUT BLADDER NECK INCISION

What is a bladder neck incision?

A bladder neck incision (BNI) is an operation to open a narrowing at the junction between your bladder and prostate (bladder neck stenosis).

The bladder neck is the area where the bladder and prostate connect. Sometimes this opening can be abnormally narrow, which is known as a bladder neck stenosis.

A bladder neck stenosis can be something you are born with, or it can occur due to benign enlargement of the prostate, previous surgery, or scarring.

Why is a bladder neck incision required?

Bladder neck stenosis causes urinary symptoms due to restricting the flow of urine out of the bladder.

These symptoms may include:

Waking through the night to void.
Needing to pass urine frequently.
Having to pass urine urgently.
Reduced urine flow.
Difficulty starting urination.
Stop-start flow.
Dribbling after passing urine.
A feeling of incomplete bladder emptying.

A BNI can:

Improve these urinary symptoms in 80-90% of men with bladder neck stenosis.
Reduce the frequency of recurrent urinary tract infections.
Stop stones from forming in the bladder.
Prevent long-term damage to the bladder and kidneys due to urinary retention.

PATIENT JOURNEY

What does a bladder neck incision involve?

A BNI is performed in hospital under general anaesthetic (completely asleep) or spinal anaesthetic (numb from the waist down).

What does a bladder neck incision involve?

A telescope is passed into your bladder through the urethra (waterpipe).

A cauterizing knife is then passed through the telescope and used to incise (cut open) the neck of the bladder.

A catheter (a soft flexible tube which drains urine from the bladder via the urethra into a bag) is inserted at the end of the procedure. The catheter is continuously flushed with fluid after the operation to remove blood and debris.

The catheter is usually removed one day after the operation but occasionally needs to stay in longer.

What is the recovery after a bladder neck incision?

You will usually be in hospital for one night after the operation.

It is common to have urinary frequency, urgency, waking at night to pass urine, stinging when passing urine, and blood in the urine for a few weeks after the operation.

You can usually return to sedentary work one to two weeks after the operation. If your job involves physical work, please discuss this with your doctor.

You can start doing gentle exercise such as walking approximately one week after the operation. You will need to avoid strenuous exercise and heavy lifting for at least four weeks after the operation.

You can usually return to driving one to two weeks after the operation.