Bladder neck contracture, prostate cancer, prostatectomy and treatment…

This is a video of a patient who is s/p  a prostatectomy and has developed a bladder neck contracture. He presented with diminution of his urinary stream. If a  patient is voiding well after the prostate is removed and then the stream slowly decreases the likelihood is that he has developed a bladder neck contracture. The most common cause it is felt is that the mucosa of the bladder was not joined to the mucosa of the urethra and this in turn encouraged the formation of scar tissue or stricture. Strictures of the urinary tract are bad actors as they are perpetually are striving to heal in a closing concentric fashion which in turn narrows the urinary passage way and slows the stream at time to a dribble.

In this video  I am  using a cold knife urethrotome to incise the bladder neck contracture at 5 and 7 o’clock. In…