Bladder outlet obstruction
Citation, DOI, disclosures and article data
Citation:
Niknejad M, Bickle I, Ranchod A, et al. Bladder outlet obstruction. Reference article, Radiopaedia.org (Accessed on 15 Jan 2025) https://doi.org/10.53347/rID-12403
Permalink:
rID:
12403
Article created:
20 Nov 2010,
Nasir Siddiqui
Disclosures:
At the time the article was created Nasir Siddiqui had no recorded disclosures.
View Nasir Siddiqui's current disclosures
Last revised:
Disclosures:
At the time the article was last revised Mohammad Niknejad had no financial relationships to ineligible companies to disclose.
View Mohammad Niknejad's current disclosures
Revisions:
22 times, by
11 contributors -
see full revision history and disclosures
Systems:
Synonyms:
- Bladder outlet obstruction (BOO)
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.
On this page:
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:
References
- 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
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Articles:
- Voiding cystourethrography
- Uterine artery embolisation
- Pine cone bladder
- Cystography
- Cystitis cystica
- Intravesical prostatic protrusion
- Urinary bladder diverticula (causes)
- Urinary bladder wall thickening
- Patent urachus
- Emphysematous cystitis
- Urinoma
- Prostatomegaly
- Medical abbreviations and acronyms (B)
- Detrusor muscle
- Urinary bladder diverticulum
- Post-void residual
- Brunn's cyst of the urinary bladder
- Bladder calculus
- Adenocarcinoma (urinary bladder)
- Neurogenic bladder
Cases:
- Urinary bladder diverticulum
- Scrotal cystocele - bladder herniation into scrotum
- Prostatomegaly
- Giant urinary bladder diverticulum
- Urethral stricture - high-grade
- Grade IV bilateral hydronephrosis
- Urethral stricture
- Chronic bladder outlet obstruction
- Urinary bladder diverticulum
- Bladder calculus
- Urinary bladder stone
- Gross bladder diverticula secondary to outlet obstruction
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