Product Summary: AMA rates Bladder neck incision BNI, Mini-TURP
Item number: 36854, 105
For those guys with normal sized prostates, but with a prominent bladder neck causing all the irritating symptoms of an enlarged prostate (LUTS).
Why is it done?
- This procedure is performed when the bladder neck has become stenotic (narrow) and tight, usually after a TURP, can also be found in the young man, with an overactive bladder neck.
- Usually seen in the younger Type-A personality-type businessman who keeps his finger on the pulse of everything.
- Symptoms include: a weak stream, nightly urination, frequent urination, inability to urinate, kidney failure due to the weak urination (obstruction), bladder stones, recurrent bladder infections.
- Medication such as Flomaxtra, Minipress etc. should always be given as a trial first.
- Prostate cancer first needs to be ruled out by doing a PSA and when indicated a 3T MRI scan is required prior to targeted prostate biopsies to exclude a malignancy.
How is it done?
- Patients will receive a general Anastesia unless otherwise indicated.
- A cystoscopy is performed by placing a camera in the urethra with the help of a lubricant jelly and an irrigant (fluid).
- The inside of the bladder is viewed for pathology. If any suspicious lesions are seen, a biopsy will be taken.
- And incision of the bladder neck is made until a largely patent bladder neck is present. Using bipolar current.
- Laser can also be utilized and is probably preferred due to lack of bleeding.
- Prophylactic antibiotics will be given to prevent any infections.
What can go wrong?
- Any anaesthesia has its risks and the anaethiatist will explain this to you.
- You may in extreme cases experience blood loss, which may require a blood transfusion.
- Please inform the practice and the hospital if you are a Jehovas witness, and cannot use blood products.
- You will wake up with a catheter in your urethra and bladder. This will remain in the bladder for 1-3 days depending on the technique used and incidence of post-operatve bleeding.
- You may have a continuous bladder irrigant running in and out of your bladder to prevent clot formation.
- Lower abdominal discomfort for a few days.
- NB! Each person is unique and for this reason symptoms vary!
What next?
- You will spend 1-3 days in hospital.
- You will a trial without catheter as soon as your urine is clear.
- You will be discharged as soon as you can completely empty your bladder.
- You may initially suffer from urge incontinence and will improve within the next 6 weeks.
- Allow for 6 weeks for stabilization of symptoms.
- There may be some blood in your urine. You can remedy this by drinking plenty of fluids until it clears.
- A ward prescription will be issued on your discharge, for your own collection at any pharmacy.
- A follow-up appointment will be scheduled for 6 weeks. Should your pathology be worrisome, you will be contacted for an earlier appointment.
- Don’t hesitate to ask me if you have any queries.
- DON’T SUFFER IN SILENCE, OR YOU WILL SUFFER ALONE!
Side-effects
- Retrograde ejaculation in more than 90% of patients. Therefore if you have not completed your family, this procedure is not for you unless absolutely necessary.
- Infertility as a result of the retrograde ejaculation.
- Stress incontinence especially in the elderly and the diabetic patients.
- Patients with Multiple Sclerosis, Strokes and Parkinsons have a higher risk of incontinence and risks should be discussed and accepted prior to surgery.
- Urethral structuring in 2-3% of patients, requiring intermittent self dilatation.
- Regrowth of prostate lobes within 3-5 years requiring a second procedure.
- NB! Each person is unique and for this reason symptoms vary!
Download Information Sheet