Bladder neck incision in India
Bladder neck incision is a surgery to improve the urinary output in those suffering from urinary bladder neck obstruction.
The bladder neck is a muscular structure that is located at the point where the urinary bladder opens into the urethra. When closed tightly, the bladder neck holds the urine inside the bladder. When relaxed it allows the urine to flow into the urethra, as happens during urination.
Any obstruction near the bladder neck can prevent the proper flow of urine into the urethra. This leads to the retention of urine inside the bladder and a weakening of the urinary bladder. This creates complications like urinary tract infections, damage to kidneys, bladder diverticulum (formation of bulging pouches) and incontinence or the inability to control urine.
Bladder neck incision aims to relieve the flow of urine through incisions on the bladder neck. The surgery is a minimally invasive one and is done with the help of a laparoscope called the resectoscope.
Symptoms of bladder neck obstruction:
Obstruction to the bladder neck can create difficulty in urination and gives rise to a lot of symptoms. They are:
• an irregular output of urine
• incomplete emptying of the bladder
• increased frequency of urination
• increased urgency of urination
• an inability to control urination
• pain in the pelvic region
Men over the age of fifty are more likely to develop bladder neck obstruction than any other group. However, the condition can occur in both men and women at any age. The most important reason for bladder neck obstruction is the pressure exerted by the prostate. Other reasons may also contribute to bladder neck obstructions but are comparatively rare.
Causes of bladder neck obstruction:
In men the most common cause of bladder neck obstruction is an enlarged prostate gland. The prostate gland squeezes the urethra and the bladder neck located just above it. This causes a block in the proper flow of urine. Bladder neck obstruction can also occur as a result of the formation of scar tissue around it. The scar tissue may be a side effect of a previous surgery in the area.
In women bladder neck obstructions are rarely found. The most common cause is the dropping of the bladder neck into the vagina. This occurs when the vaginal wall gets weakened due to a variety of reasons. The most common reasons are advanced age, menopause, multiple child births and so on.
Bladder neck incision surgery procedure:
The goal of the surgery is to relieve the obstruction in the bladder neck and ease the flow of urine. The surgery is done as an inpatient procedure and hence requires hospitalisation for a few days. The average duration of hospital stay is about three days.
The surgery is a minimally invasive one. The procedure is usually done under spinal anaesthesia. General anaesthesia may be chosen if the patient have any problems with the intervertebral discs.
The procedure begins with the introduction of a catheter through the opening of the penis. The catheter is then guided up to the urethra. Once it reaches the bladder neck it is secured in place. A laparoscopic instrument called a resectoscope is introduced through the catheter. It contains a camera as well as a surgical tip. The resection tip is used to make an incision in the neck of the urinary bladder. This helps to improve the outflow of urine.
Bladder neck Incision Surgery cost in India:
The cost of bladder neck incision in India ranges between 4000 -5500 USD. The price includes the procedure cost, doctor’s and hospital charges(3-5days) and food for the patient and bystander.
Bladder neck incision success rates:
Bladder neck incision surgery helps to relieve the symptoms in a majority of the cases. Being a minimally invasive surgery, the complications are also on the lower side. The major drawback is that the surgery may not be effective in all patients. Such patients may need other laparoscopic or open surgeries to relieve the obstruction due to the enlarged prostate.
Bladder neck surgery recovery:
Once the surgery is complete the patient will be shifted to a recovery room for monitoring. A catheter will be introduced into the bladder to drain urine. Once the effect of the anaesthesia wears off the patient may experience any or all of the below mentioned symptoms.
• A burning sensation in the urinary tract
• A desire to urinate, in spite of the presence of the catheter.
• A burning sensation on the tip of the penis
• Feeling spasms in the urinary bladder
All these symptoms are normal and disappear within a couple of days. The catheter will be removed in a day or two after surgery. The patient will be discharged after two days.
One will have to drink about one and a half to two litres of water every day. This helps to remove blood clots and other debris by passing it through urine. An increased output of urine also helps to prevent the incidence of urinary tract infections.
Dos and don’ts after bladder neck incision surgery:
• Take the medicines prescribed on time
• Drink plenty of fluids
• Avoid strenuous activity for a few days
• Avoid lifting of heavy objects for few days
• Do the pelvic floor exercises regularly if suggested to do so
• Take adequate precautions to prevent the occurrence of deep vein thrombosis
Bladder neck incision complications and side effects:
• Problems due to anaesthesia
• Increased frequency of urination
• Burning sensation during urination
• Urinary tract infections
• Retrograde ejaculation , where the semen passes into the bladder
• Failure to achieve the intended result after surgery
• Possibility of deep vein thrombosis