Bladder neck incision (BNI) is a simple and effective procedure to treat a narrow bladder neck — a condition that can obstruct urinary flow. Through an endoscope passed along the urethra, the tight bladder neck tissue is incised to widen the outlet and restore normal urinary flow. It is a short procedure with a quick recovery.
TREATMENTS
Bladder Neck Incision
When Is Bladder Neck Incision Recommended?
• Primary bladder neck obstruction — typically younger men with obstructed flow and a small prostate
• Bladder neck narrowing (stenosis) after previous prostate surgery
• Obstruction confirmed on flow studies or urodynamics where the bladder neck is the cause
Procedure Options
• Bladder neck incision: One or two precise incisions are made to widen the outlet.
• Laser bladder neck incision: A holmium or other laser is used to incise the tissue at the bladder neck.
• Balloon dilatation: Occasionally used as an alternative or adjunct, particularly for recurrent narrowing.
Risks and Considerations
All procedures carry risks, which your surgeon will discuss with you in detail. These may include:
• Retrograde ejaculation (~20-30%)
• Recurrence of the narrowing, occasionally needing a repeat procedure
• Temporary burning and blood in the urine
Recovery at a glance: Overnight stay is typical, with the catheter removed the next morning.
1
Diagnostic Assessment
Ultrasound, flow studies and flexible cystoscopy confirm the diagnosis, exclude other causes of obstruction, and plan the procedure.
2
Endoscopic Incision
Performed through the urethra under general or spinal anaesthesia. The tight bladder neck tissue is carefully incised at one or two positions to open the channel.
3
Catheter and Recovery
A urinary catheter usually stays overnight. Most patients go home the following day with a significant improvement in urinary flow.
4
Outcome Monitoring
Flow rates and symptoms are reassessed at follow-up.
Our Approach
