A bladder neck contracture is a rare condition that may occur after surgery or treatment on your prostate. Scar tissue forms in the bottom of your bladder, making it difficult to pee. Treatment may include using tubes to widen your urethra or surgery.
Your urinary bladder is a round, hollow organ in the lower part of your abdomen (belly) that holds your urine (pee). It expands like a balloon as it fills with pee. When you go to the bathroom, it shrinks back down. Your bladder neck is a narrow outlet at the bottom of your bladder. It’s where pee enters the tube that carries it out of your body (urethra).
Scar tissue can form after prostate treatments. The scar tissue causes your bladder neck to narrow (contract). This bladder neck contracture makes it more difficult to pee and can lead to conditions that affect your bladder and kidneys.
The following treatments may cause bladder neck contracture:
Yes, bladder neck contracture is curable. Talk to your healthcare provider if you have symptoms of bladder neck contracture after prostate treatment.
Bladder neck contracture is rare. Experts estimate that bladder neck contracture affects around 1 in 10 people after prostate surgery.
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Bladder neck contracture symptoms may include:
Most people usually start to have bladder neck contracture symptoms three to six months after prostate surgery. You may notice that your pee stream gets gradually weaker. It’s easy to overlook at first, but it can progress to the point where you may not be able to pee at all.
Healthcare providers and medical researchers aren’t entirely sure why bladder neck contractures develop.
One possible cause is a complication after prostate removal. Your bladder neck connects to your prostate gland. During the procedure, your urologist reconnects your bladder neck to your urethra (anastomosis). A blood clot (hematoma) may form underneath or between your stitches (sutures) as you heal. The blood clot causes your sutures to stretch or even break, which causes gaps in the anastomosis. The gaps fill with scar tissue, which can cause the opening between your bladder and urethra to shrink.
Another possible cause is poor blood supply to the anastomosis. If your sutures are too tight, they can cut off the blood vessels near the anastomosis, which reduces blood supply and causes scarring.
A bladder neck contracture can affect anyone who has surgery on their prostate.
However, if you have surgery on your prostate and have another condition that may cause poor blood flow — such as diabetes or heart disease — you may be more likely to develop a contracture in your bladder neck.
If you have symptoms of bladder neck contracture, a urologist can make an official diagnosis. Urologists are healthcare providers who specialize in conditions that affect your urinary tract or reproductive system. They’ll conduct a physical examination and order tests.
Your urologist may order the following tests to diagnose bladder neck contracture:
Treatment options for a bladder neck contracture may include:
No, bladder neck contracture doesn’t go away on its own. But if your contracture is mild, your urologist may recommend a “wait and see” approach. This means that you and your urologist will watch for any changes in your symptoms.
Your contracture is mild if it doesn’t harm your kidneys and you can completely empty your bladder without any problems.
Most people recover two to three weeks after bladder neck contracture surgery. However, your recovery may be different. Your urologist will give you a better estimation of your recovery timeline.
You can’t do anything to prevent a bladder neck contracture. It’s a rare type of scarring that may form after prostate treatments.
The outlook for bladder neck contractures is good. However, scar tissue can come back and cause another contracture. Scar tissue may return if you have:
If you develop another contracture, you may need another procedure.
Talk to your healthcare provider if you have any symptoms of a bladder neck contracture after prostate treatment. You should also talk to your provider if you receive treatment for a contracture and develop new or worsening symptoms.
Go to the emergency room immediately if you:
A note from Cleveland Clinic
A bladder neck contracture is a rare condition that makes it difficult to pee. Symptoms go away for most people after treatment. However, a contracture can come back and require additional treatment. Talk to your healthcare provider if you have signs of bladder neck contracture after prostate treatment. They can make an official diagnosis and work with you to determine the best treatment option.
Last reviewed by a Cleveland Clinic medical professional on 07/18/2023.
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