Bladder Neck Incision (BNI) is a minimally invasive surgical procedure used to relieve urinary obstruction caused by a tight or narrowed bladder neck, often resulting from benign prostatic hyperplasia (BPH), bladder neck contracture, or previous prostate surgery. It involves making one or two small incisions in the bladder neck (where the bladder connects to the urethra) to widen the passage and allow better urine flow. The procedure is typically performed under spinal or general anesthesia and usually takes 30–60 minutes.
BNI does not involve removal of tissue but rather a strategic incision to relieve obstruction. It is ideal for patients with bladder neck dysfunction or tightness not responding to medications. Since no tissue is removed, bleeding is minimal, and recovery is usually quick. A catheter is often placed temporarily post-procedure to allow proper bladder drainage during the initial healing phase.
Most patients undergoing BNI can go home the same day or may require a short hospital stay, depending on overall health and recovery speed.
Your urologist will insert a thin instrument called a resectoscope through the urethra into the bladder under anesthesia. Using specialized tools, one or two small incisions are made in the tight bladder neck area to relieve obstruction and improve urine flow.
No tissue is removed, so the risk of bleeding is low. A urinary catheter is placed at the end of the procedure to help with bladder drainage and healing. The catheter is usually removed after 1–3 days.
Let your doctor know:
Patients may experience the following temporary symptoms:
Pain is generally mild and controlled with oral medications. If you notice heavy bleeding, fever, or inability to urinate after catheter removal, contact your doctor immediately.
Most patients recover quickly after a BNI. You can resume light activities within a few days, but avoid heavy lifting and strenuous exercise for about 1–2 weeks. Sexual activity should also be postponed until your doctor gives clearance.
Your doctor may recommend a follow-up visit within 1–2 weeks to check healing and urinary flow. A uroflowmetry test might be repeated to assess improvement.
BNI is a simple, effective, and minimally invasive treatment for bladder outlet obstruction due to bladder neck narrowing or tightness. It’s particularly useful in patients with small prostates or post-surgical scarring.
✔ Minimally Invasive – No external cuts; procedure performed through natural urinary passage.
✔ Quick Relief – Patients usually notice improved urinary flow almost immediately after the catheter is removed.
✔ Low Bleeding Risk – No tissue removal reduces bleeding and shortens recovery.
✔ Same-Day Discharge – Most patients can go home within hours after the procedure.
✔ Short Recovery Time – Light activity can resume within days, and full recovery usually takes 1–2 weeks.
✔ Preserves Sexual Function – Lower risk of retrograde ejaculation compared to more invasive prostate surgeries.
✔ Ideal for Small Prostate/Scarring – Best suited for men with minimal prostate enlargement but significant obstruction.
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The procedure is done under anesthesia, so you won’t feel pain. Post-surgery, mild burning or discomfort while urinating may occur but usually fades within a few days.
Most people recover within 5–7 days. While light work can resume in a few days, heavy lifting and sexual activity should be avoided for 1–2 weeks.
Yes, a catheter is typically placed for 1–3 days after BNI to allow bladder healing and urine drainage.
Although uncommon, possible risks include:
BNI has a lower risk of causing retrograde ejaculation compared to other prostate surgeries, but there's still a small chance. Erections are typically unaffected.
Yes, medications like aspirin, Plavix, or blood thinners should be stopped in advance under your doctor’s guidance.
Most people can return to non-strenuous jobs within 2–3 days. Jobs involving physical labor may require up to 1–2 weeks off.
In some cases, the bladder neck can tighten again, especially if there's underlying scarring. However, most patients experience long-term relief with one procedure.
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