Incision technique shows potential for bladder neck contracture

A US team reports that deep lateral transurethral incisions (TUI) are a promising technique for the treatment of recurrent bladder neck contracture (BNC) in men following prostate surgery.

Allen Morey and colleagues, from the University of Texas Southwestern Medical Center in Dallas, say their 5-year experience of the treatment indicates that it could provide an alternative to other options, such as those requiring patients to self-catheterize, and avoid the need for endoscopic injections.

The team reviewed the outcomes of 50 men consecutively treated at their institution between June 2007 and January 2012, with a median follow-up of 16 months. Most of the men had developed BNC after prostatectomy (70%) or transurethral procedures for benign prostatic hyperplasia (26%), and 78% had undergone unsuccessful treatment elsewhere.

But, following treatment with the novel technique – which involves dilation of the BNC followed by two deep lateral incisions through the muscle fibers – only 28% of the 50 men required further treatment for recurrence after 2 months, half of whom were successfully treated with a repeat procedure.

On univariate analysis, the team found that having a greater than 10 pack–year smoking history was associated with TUIBNC failure, with treatment failing in 71.4% of such patients compared with only 38.9% of patients with lesser smoking histories. Additionally, patients who had two or more prior endoscopic procedures for BNC had a 40.7% failure rate compared with 13.0% in patients with fewer procedures.

The team highlights that concurrent stress urinary incontinence was not uncommon, occurring in 78% of the cohort before surgery and another patient after TUIBNC. Of these 40 patients, 65% underwent subsequent surgery for incontinence, primarily with an artificial urinary sphincter (AUS) placement. Only 21% of these men required AUS revision, which was mostly for cuff downsizing, and at follow-up, none had AUS erosions or infections. BNC recurrence was reported in only two patients following AUS placement.

Writing in Urology, Morey and team note that, owing to the rarity of recurrent BNC, the power of their study is limited.

Nevertheless, they conclude that TUIBNC “constitutes a novel controlled approach for a uniquely challenging group of patients, most of whom had failed previous interventions to relieve obstruction.”

Licensed from medwireNews with permission from Springer Healthcare Ltd. ©Springer Healthcare Ltd. All rights reserved. Neither of these parties endorse or recommend any commercial products, services, or equipment.

Kirsty Oswald

Written by

Kirsty Oswald

Kirsty has a B.Sc. in Human Sciences from University College London. After several years working as medical copywriter, she became a medical journalist and is now freelance. Kirsty also works part-time as an editor for a London-based charity. She is particularly interested in the social and cultural aspects of science.


Please use one of the following formats to cite this article in your essay, paper or report:

  • APA

    Oswald, Kirsty. (2018, August 23). Incision technique shows potential for bladder neck contracture. News-Medical. Retrieved on March 07, 2021 from

  • MLA

    Oswald, Kirsty. "Incision technique shows potential for bladder neck contracture". News-Medical. 07 March 2021. <>.

  • Chicago

    Oswald, Kirsty. "Incision technique shows potential for bladder neck contracture". News-Medical. (accessed March 07, 2021).

  • Harvard

    Oswald, Kirsty. 2018. Incision technique shows potential for bladder neck contracture. News-Medical, viewed 07 March 2021,


The opinions expressed here are the views of the writer and do not necessarily reflect the views and opinions of News Medical.
You might also like... ×
New paper discusses how smoking may affect risk for COVID-19