Scarring in the bladder neck: What can be done?

Dear Dr. Motola:

I have scaring in my bladder neck after prostate removal. I have had this scarring removed 2 times in the last 2 years. I have been inserting a catheter daily for the past 11 months to help prevention. I am scheduled for scar tissue removal for a third time next month. What, if anything, can be done to prevent scar tissue from returning?

Bladder neck scarring after radical prostatectomy can be extremely frustrating to treat for both the patient and the urologist. Injections of steroids have been tried to help prevent this, however the results are not very successful. Utilizing a different energy source such as a laser may provide some advantage.

I am not sure if you have had a TURP or a radical prostatectomy. If it were a TURP, a more complete resection of the prostate can be helpful. If you had treatment with a radical prostatectomy, this becomes an extremely challenging problem because if the removal of the scarring is too aggressive, permanent incontinence can occur. Various prostatic stents are available that may also be helpful.