Contracture of bladder neck was uncommon condition which will occur in men after prostate operation. Different telescopic procedures are commonly performed for benign enlargement of the prostate, known as benign prostate hyperplasia. This condition may be treated with medication or by telescopic surgical removal of a portion of the prostate gland. Following such surgical procedures on the prostate, a bladder neck contracture or scar tissue can form at the junction of the bladder outlet and the prostate. The prostate gland is located between the bladder and the urethra, the tube through which urine leaves the body. Urinary problems occur when abnormalities block the bladder neck and prevent it from opening completely during urination
SYMPTOMS:
Men usually begin to experience symptoms of bladder neck contracture within 3 to 6 months after prostate surgery. At first, a patient may notice a continuous decrease in the urine flow. This symptom can be ignored at first, and can progress to a point where he will be unable to urinate. In other cases, a man may suffer with urine leakage when the bladder becomes too full. This condition is known as overflow incontinence.
Some of the symptoms related along by the contracture of bladder neck includes: Need to push to begin urination, delayed onset of urination, slow or reduce force of urine stream, urine stream that starts and stops, sensation of incomplete emptying. In very rare situations, a bladder neck contracture may lead to more serious problems, such as bladder or kidney damage.
CAUSES:
There is no exact evidence or completely sure that why bladder neck contractures will develop. One probable cause is gaps in the surgical connection or anastomosis of the bladder neck to the urethra. After surgically removing of the prostate, a blood clot called a hematoma may form underneath or between the surgical sutures (stitches), causing them to stretch. The stitches may break or tear. In both the case, gaps can form in the anastomosis, which will be likely to filled with fibrotic or scar tissue. The scarring may cause the opening among the bladder and urethra to will narrower, resulting in the bladder neck contracture.
DIAGNOSIS:
Various tests can be done to detect if a bladder neck contracture was present in men who are experiencing symptoms such as urinary retention or incontinence they are cystoscopy, uroflow test and urodynamic study, ultrasound scan.
The bladder may become permanently damaged if the treatment for bladder neck obstruction is deferred for an extended period of time. A weakened bladder may lead to complications such as urinary tract infections, kidney damage, bladder diverticula, which are bulging pouches that may form in bladder.
