Bladder outlet obstruction

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. 

Clinical presentation

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

Pathology

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.

Radiographic features

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

Treatment and prognosis

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.  

Differential diagnosis

On imaging consider:

• neurogenic bladder
• posterior urethral valves