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Bladder outlet obstruction (BOO) is a blockage at the base of the bladder that reduces or prevents the flow of urine into the urethra, the tube that carries urine out of the body.
Alternative NamesBOO; Lower urinary tract obstruction; Prostatism
Causes, incidence, and risk factorsBladder outlet obstruction (BOO) can have many different causes, including:
- Benign prostatic hyperplasia (BPH), or enlarged prostate
- Bladder stones
- Bladder tumors (cancer)
- Pelvic tumors (cervix, prostate, uterus, rectum)
- Urethral stricture (scar tissue)
Less common causes include:
- Cystocele
- Foreign objects
- Posterior urethral valves (congenital birth defect)
- Urethral spasms
- Urethral diverticula
This condition is most common in aging men. It is often caused by BPH. Bladder stones and bladder cancer are also more commonly seen in men than women. As a man ages, the chance of developing these diseases increases dramatically.
See also:
SymptomsThe symptoms of bladder outlet obstruction may vary, but can include:
- Abdominal pain
- Continuous feeling of a full bladder
- Delayed onset of urination (urinary hesitancy)
- Frequent urination
- Inability to urinate (acute urinary retention)
- Pain on urination (dysuria)
- Slow urine flow
- Urinary tract infection
- Urine stream starts and stops (urinary intermittency)
- Waking up at night to urinate (nocturia)
If bladder outlet obstruction is suspected, your health care provider will take a thorough history of your problems. During a physical exam, your provider may find one or more of the following possible causes:
- Abdominal mass
- Cystocele (women)
- Distended bladder
- Enlarged prostate (men)
Tests may include:
- Blood chemistries to look for signs of kidney damage
- Cystoscopy and retrograde urethrogram (x-ray) to look for narrowing of the urethra
- Ultrasound to locate the blockage of urineand find out how well the bladder empties
- Urinalysis to look for blood or signs of infection in the urine
- Urine culture to check for an infection
- Uroflowmetry to determine how fast urine flows out of the body
- Urodynamic testing to see how much the urine flow is blocked and how well the bladder contracts
Treatment of bladder outlet obstruction depends on the cause of the problem. For most cases, a tube, called a catheter, inserted through the urethra into the bladder, will relieve the obstruction temporarily.
Occasionally, a suprapubic catheter (a tube placed through the belly area into the bladder) is needed to drain the bladder.
Long-term treatment of bladder outlet obstruction usually involves surgery. However, medical treatment options are available for many of the diseases that cause this problem. Discuss treatment options with your health care provider.
Expectations (prognosis)If diagnosed early, most causes of bladder outlet obstruction can be treated with great success. However, if diagnosis is delayed, permanent damage can result.
ComplicationsLong-term or high-grade bladder outlet obstruction can permanently damage all parts of the urinary system.
Complications include:
- Bladder and kidney stones
- Kidney failure
- Recurrent urinary tract infections
- Urinary incontinence
- Urinary retention
If you have symptoms of bladder outlet obstruction, call your provider. Early diagnosis is important and can often lead to a simple and effective cure.
PreventionThe condition may be prevented by identifying and treating the cause of the blockage.
ReferencesWein AJ, ed. Campbell-Walsh Urology. 9th ed. Philadelphia, Pa: Saunders Elsevier; 2007.
Tseng TY, Stoller ML. Obstructive uropathy. Clin Geriatr Med. 2009 Aug;25(3):437-43.
What else can I help you with?
Is bladder outlet obstruction linked to Marfan's syndrome in newborns?
Bladder outlet obstruction is not a well-documented direct complication of Marfan's syndrome in newborns. Marfan's syndrome is primarily associated with connective tissue abnormalities, which can lead to cardiovascular, skeletal, and ocular issues. However, there may be indirect associations, as some structural abnormalities related to Marfan's could potentially affect urinary function. It's important for affected individuals to be monitored for a range of complications, but bladder outlet obstruction specifically is not a common feature of the syndrome.
Why if the bladder had 16.9 oz of urine can you not pee?
The inability to urinate even if the bladder is full can be due to various reasons, such as urinary retention, bladder outlet obstruction, nerve problems, or medication side effects. It is essential to seek medical attention if you are experiencing difficulty urinating.
Why is indwelling catheterization used?
Palliative care, managing skin ulceration, for those undergoing surgical procedures or with chronic neurological disorders, bladder outlet obstruction, relief from acute urinary retention.
What does thickening of the bladder wall indicate?
Thickening of the bladder wall can indicate a variety of conditions, including inflammation, infection (such as cystitis), bladder stones, or tumors. It may also be associated with chronic conditions like interstitial cystitis or bladder outlet obstruction. Further evaluation through imaging studies or cystoscopy is often necessary to determine the underlying cause and appropriate treatment.
What are Gastric outlet obstruction's etiology and pathophysiology?
Gastric outlet obstruction (GOO). GOO is not a single disease or disorder but a condition in which the stomach cannot empty because the pylorus is blocked.
What is diverticulitis of the bladder?
Diverticulitis of the bladder is a condition characterized by the formation of diverticula, or small pouches, in the bladder wall that become inflamed or infected. This rare condition can lead to symptoms such as abdominal pain, urinary tract infections, and difficulty urinating. It may result from increased pressure in the bladder, often due to conditions like chronic urinary retention or bladder outlet obstruction. Treatment typically involves antibiotics for infection and, in some cases, surgery to remove the affected area.
What is urinary retention?
Urinary retention is a condition where a person is unable to fully empty their bladder, leading to a buildup of urine. This can be caused by various factors such as bladder outlet obstruction, nerve damage, or certain medications. It is important to seek medical attention if experiencing symptoms of urinary retention as it can lead to complications if not treated.
What can cause an enlarged bladder?
An enlarged bladder can be caused by conditions such as bladder outlet obstruction, urinary retention, neurological disorders affecting bladder function, urinary tract infections, bladder stones, or bladder cancer. It is important to seek medical evaluation to determine the underlying cause and appropriate treatment.
What does thickening of the bladder mean?
The wall of the urinary bladder should not be > 3 mm thick when distended and not > 5 mm thick when decompressed. The thickened wall could be due to the edema (swelling) of the wall which can happen due to the inflammation(cystitis) or the thickening could be due to the deposition of urinary sediments on the walls of the bladder. These are the 2 commonest causes. Bladder cancer is another cause. Generally if you are diagnosed with thickening of the bladder you will be sent to a urologist and have a cystoscopy performed.
What is distended urinary bladder?
It means that it is enlarged for some reason. It could mean that you really need to empty it and haven't. Anything that blocks the urethra from allowing the urine to flow, such as an enlarged prostate or kidney stones, can result in a distended bladder.Another symptom of a distended bladder is a delay in urination. A person may need to strain in order to begin the flow of urine.
What is next to the vagina?
Next to the vagina is an outlet that carries urine from the bladder to the outside. This is called the urethra.
What is forniceal rupture?
A Renal Forniceal rupture is due to outlet obstruction. Hydrostatic pressure increases in the renal pelvis and can result in a rupture.
