Bladder outlet obstruction

Last revised by Ian Bickle on 4 Aug 2023

Bladder outlet obstruction can arise from a number of conditions affecting the urethra and/or bladder outlet but is most commonly encountered in elderly men due to prostate enlargement. 

Patients often present with difficulty in urination, retention, and urinary discomfort 2.

Obstruction can be caused by multiple etiologies but is most often seen from urethral strictures, mass lesions within the periurethral region, prostate enlargement, and congenital urethral valves 1.

On radiographic evaluation, the bladder wall appears thickened and trabeculated. Urinary retention is noted with increased post-void residual on sonographic or voiding studies.

The goal of treatment is to relieve the obstruction and prevent urinary tract infections and renal compromise. This can be done by either catheterization or surgical intervention depending on the etiology of the obstruction 2.  

On imaging consider:

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