Problems With the Bladder Neck

The bladder neck is the small area where the urethra and bladder connect. This opening is surrounded by circular muscles called sphincters that relax and contract to allow or prevent urine from exiting the bladder into the urethra. Problems with the bladder neck can be associated with neurological deficits, surgical complications, prostate enlargement or unknown causes. Treatments vary depending on the etiology of the condition.

Neurogenic Bladder

• The term "neurogenic bladder" is an umbrella term for a malfunctioning bladder due to a variety of neurological causes. Brain injuries, such as stroke, tumor and Parkinson's, as well as spinal cord injuries can cause the sphincter muscles in the bladder neck to function improperly, causing incontinence and urgent or frequent urination. Treatment ranges from wearing absorbent materials to catheterizing to surgical treatments. Surgery includes making a sling to provide extra constriction of the bladder neck.

Bladder Outlet Obstruction

• Bladder outlet obstruction, or BOO, is a group of general and gender-specific disorders that cause urinary retention and frequency. In women, the most common cause is stress urinary incontinence, or SUI, surgery. The goal of SUI surgery is to increase contraction of the bladder neck sphincter muscles; however, too much can cause further problems, including BOO. In men, prostate enlargement is the most common cause of BOO. As the prostate, which encircles the bladder neck, enlarges with age or disease, it constricts the bladder neck and urethra.

Primary Bladder Neck Obstruction

• Primary bladder neck obstruction, or PBNO, is characterized by the bladder neck not properly opening while voiding. It is similar to BOO insofar as the symptoms are concerned, but differs in that there is no single known cause. The primary treatment is medication, with alpha-blockers being the most commonly used drug.