My husband had his prostrate remove because of cancer with the robotic surgery.Well we found out why he has not been able to go to the bathroom well.His is self catherizing himself.It has been 11 weeks.By the bladder neck therew was some scar tissue.But the real problems is the tube where the urine is supposed to flow is push down with barely an opening for it to flow.It is collasped from where the pulled the stitches tight.Is it possible to put something there like a stint to keep it open instead of having surgery and trying to loosen where the stitches are?
Thanks for your question. The complication you are referring to is bladder neck contracture, usually the result of scar tissue encircling and narrowing the bladder neck. This is a common short term complications after radical prostatectomy. A diagnosis of this condition could be made by cystoscopy.
Outpatient surgery performed with a cystoscope can relax the contracture easily. The procedure would involve either cutting the scar or resecting the tissue around the scar which is also called TUI (Transurethral incision). Your husband will be using a catheter during the healing process. If the scar is more involved and longer, it may need to be removed in a more complex operation. I think the next step is to perform a cystoscopy and bladder function testing if that is an issue, then your husband and his urologist can discuss the options available. Your husband might also require AUS (Artificial Urinary Sphincter) or a Male sling to prevent excessive leaking after such a procedure.
Most patients getting treatment after bladder neck contracture, become continent within 6 months; therefore, you should not worry and discuss the treatment options with your husband's urologist soon.
My best wishes to you for the new year.
Ashutosh (Ash) K. Tewari, MD
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