WHAT IS A “BNI”?

Bladder neck incision (BNI) is actually typically 2 incisions into the sides of the bladder neck and prostate. No prostate tissue is removed but these result in the outlet to the bladder being made wider, reducing the resistance to the outflow of urine from the bladder. It is one option available to relieve the symptoms of an obstructive prostate which may be enlarged (Benign Prostatic Hyperplasia or BPH). The prostate is a gland in men which sits between the bladder and the urethra (water pipe). It forms part of the male urinary and reproductive tracts. It is essential for normal fertility and produces some of the fluid that makes up semen. If the inner part of the prostate gland can obstruct the urethra during urination, which may result in:
  • reduced urinary flow or dribbling
  • incomplete bladder emptying
  • urinary frequency
  • urgency and occasional urge incontinence
  • getting up at night to pass urine (nocturia)

A BNI is most often performed for smaller benign prostate glands which cause obstruction, or to treat stenosis (narrowing) of a bladder neck, which may be a complication of previous surgery on the prostate. The procedure is performed under a general or spinal anaesthetic. A fine instrument called a cystoscope is placed into the urethra and a thin band with cautery or a laser fibre is used to make two incisions at along the sides of the bladder neck and prostate. This results in a widening of the outflow channel exiting the bladder through the prostate.

WHAT ARE THE POSSIBLE COMPLICATIONS?

  • Retrograde ejaculation – most men are able to have erections and orgasms after a BNI. However, approximately 50% may not ejaculate when the bladder neck is opened up causing the semen to collect in the bladder and will be expelled when you next pass urine. There are no long-term risk of retrograde ejaculation.
  • Significant bleeding, possibly with clots – this may occur up to 6 weeks after the procedure and usually a result of the scab coming away during the healing process. It is usually possible to flush the blood through by increasing your oral intake
  • Urinary retention (unable to pass urine) – if this happens you must go to the Emergency department
  • Urinary infection
  • Urinary symptoms do not change – sometimes this procedure does not cure your urinary problems. Occasionally things get worse before they get better. Even though the blockage has been cleared, the bladder irritability may continue and you may still have symptoms such as being unable to empty your bladder completely and nocturia (passing urine more than twice during the night). Sometimes slightly more extensive surgery is needed such as TURP or PVP.
  • Urinary incontinence – this is rare with a BNI, and usually temporary if it occurs.
  • Erectile dysfunction (impotence or ED) – this is rare after a BNI
  • Urethral strictures – when scarring occurs in and around the water pipe, it can cause further blockage to the urine flow. Strictures may need to be dilated or need further surgery.

NOTIFY your UROLOGY  if you experience any of the following:

  • Heavy bleeding – urine that looks like pure blood
  • Increased discomfort, severe pain and burning when passing urine
  • Cloudy or offensive urine
  • Fever (temperature over 37.5 degrees), chills, shakes or feeling generally unwell
  • Increasing difficulty or unable to pass urine

Consult a Urologist in India

Cost of BNI (Bladder Neck Incision) in India