Urinary Incontinence

Bladder Neck Contracture

Bladder Neck Contracture

Scar narrowing where the bladder meets the urethra after prostate treatment: symptoms, testing, and treatment.

Written and reviewed by Shervin Badkhshan, MD · Last reviewed

November 2026

Part of:

Urethral strictures

Outpatient

Fellowship-Trained Reconstructive Urology

AT A GLANCE

From symptoms to treatment

1. SYMPTOMS

• Slowing or weak stream • Straining • Not emptying fully

2. TESTING

• Flow test and bladder scan • Cystoscopy, in the office • Retrograde urethrogram

Test result guides →

3. TREATMENT

• Endoscopic incision • Optilume for some recurrent cases • Reconstruction

Surgical options →

A bladder neck contracture is scar narrowing where the bladder meets the urethra. It usually follows prostate cancer surgery or radiation, and less often a TURP or other prostate procedure.

Side-view diagram of the male urethra showing the bladder neck, prostatic, membranous, bulbar, and penile urethra and the fossa

What you might notice

A weak or slowing stream, straining, a feeling of not emptying, or urinary infections, typically within the first year or two after treatment. Some men notice their leakage changed when the narrowing developed.

How I evaluate it

A flow test, a bladder scan, and an in-office cystoscopy to see the scar directly. A retrograde urethrogram helps when the narrowing is longer or harder to see.

Treatment

  • Endoscopic incision: opening the scar from the inside, sometimes with a medication injected into it

  • Drug-coated balloon (Optilume): for some recurrent cases

  • Reconstruction: an open or robotic repair when the scar keeps coming back

Opening the bladder neck can affect continence, so we talk through that before treatment. Some men need an artificial urinary sphincter afterward, and the order of those steps matters.

Related

Urethral strictures · Leakage after prostate treatment · Optilume aftercare

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Your results and questions

Your actual test results, visit notes, and messages with your care team are in your patient portal, the same one you use to book visits. Send questions through the portal or call the office at (516) 535-1900. For anything urgent, call the office or go to the nearest emergency room.