What causes contracture of the bladder neck?

What causes contracture of the bladder neck?

No one is completely sure why bladder neck contractures develop. One possible cause is gaps in the anastomosis or surgical connection of the bladder neck to the urethra. After surgical removal of the prostate, a blood clot called a hematoma may form underneath or between the surgical sutures (stitches), causing them to stretch. The stitches may break or tear. In either case, gaps may form in the anastomosis, which tend to be filled by fibrotic or scar tissue. The scarring can cause the opening between the bladder and urethra to become narrower, resulting in the bladder neck contracture.

Poor blood supply to the anastomosis may be another possible cause. Stitches that are too tight can cut off the blood vessels near the anastomosis, reducing blood supply to the site. Some medical conditions, such as diabetes and heart disease, are associated with poor blood flow, so men with these diseases may be more likely to develop bladder neck scarring. Bladder neck contractures tend to occur more often in older men than young men for similar reasons.