Bladder outlet obstruction
Citation, DOI & article data
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.
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.
On imaging consider:
- 1. Abrams. Bladder Outlet Obstruction Index, Bladder Contractility Index and Bladder Voiding Efficiency: Three Simple Indices to Define Bladder Voiding Function. BJU Int. 1999;84(1):14-5. doi:10.1046/j.1464-410x.1999.00121.x
- 2. Blaivas J & Groutz A. Bladder Outlet Obstruction Nomogram for Women with Lower Urinary Tract Symptomatology. Neurourol Urodyn. 2000;19(5):553-64. doi:10.1002/1520-6777(2000)19:5<553::aid-nau2>3.0.co;2-b
- 3. Dmochowski R. Bladder Outlet Obstruction: Etiology and Evaluation. Rev Urol. 2005;7 Suppl 6:S3-S13. PMC1477620
- 4. Malde S, Solomon E, Spilotros M et al. Female Bladder Outlet Obstruction: Common Symptoms Masking an Uncommon Cause. Low Urin Tract Symptoms. 2019;11(1):72-7. doi:10.1111/luts.12196 - Pubmed
- 5. Malde S, Nambiar A, Umbach R et al. Systematic Review of the Performance of Noninvasive Tests in Diagnosing Bladder Outlet Obstruction in Men with Lower Urinary Tract Symptoms. Eur Urol. 2017;71(3):391-402. doi:10.1016/j.eururo.2016.09.026 - Pubmed