Table of ContentsView AllTable of ContentsSymptomsCausesDiagnosisTreatment
Table of ContentsView All
View All
Table of Contents
Symptoms
Causes
Diagnosis
Treatment
Bladder outlet obstruction (BOO) is a problem in which the flow of urine is partially or completely blocked. This produces symptoms, including diminished urine flow, pelvic pain, and bladder discomfort. Chronic BOO can result in complications such as infections, bladder stones, loss of bladder function, and kidney failure.
Though the condition can affect males and females, bladder outlet obstruction occurs most often in older males. The most common causes of bladder outlet obstruction in males includeprostate problems,tumors of the bladder, and urethral narrowing. Rarely, it’s due to a birth defect.
Often, diagnostic testing is necessary to identify the cause of BOO. Medical or surgical treatments can be used to relieve the obstruction depending on the cause.
This article explains the symptoms and causes of bladder outlet obstruction. It also covers how bladder outlet obstruction is diagnosed and treated, including medications used.
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Bladder Outlet Obstruction Symptoms
Typically, bladder outlet obstruction begins with mild, bothersome symptoms that gradually worsen over time. Depending on the severity, the symptoms may be intermittent; you might only experience them once in a while, rather than every time you urinate.
The symptoms may occur more abruptly if there is an infection within the prostate, large tumor within the bladder, or nerve damage from a recent stroke or back procedures.
Signs of a bladder outlet obstruction include:
As the obstruction becomes more severe, you may have to strain your muscles with increasing effort to push urine past the blockage.
What Causes Frequent Urination?
Complications of Bladder Outlet Obstruction
Over time, you can develop serious health problems due to bladder outlet obstruction. In fact, neglecting early symptoms may lead to irreversible complications.
Issues that can develop as a consequence of BOO include:
If left untreated, prolonged BOO may cause irreversiblekidney failure, as the fluid backflows into the ureter and the kidneys.
Bladder Outlet Obstruction Causes
Thebladderis a muscular cavity that holds urine. It expands as it fills with urine and contracts when it’s time to empty. It is located in the lower abdomen behind the pelvic bone.
Theurethrais a thin muscular tube through which urine travels from the bladder to the outside of the body. In males, the urethra is inside the penis. In females, the urethra is shorter and the opening is near the vagina.
With BOO, the bladder contracts as usual to initiate the stream of urine, but the outlet is partially blocked.
A number of conditions can lead to bladder outlet obstruction. Medical problems that cause pressure, trauma, inflammation, or scarring of the bladder outlet or the urethra can be to blame.
BOO can develop as a result of:
How Is Bladder Outlet Obstruction Diagnosed?
Your healthcare provider will look at your abdomen and place light pressure on it to assess for swelling or discomfort. A physical examination can help your medical team spot any visible signs of an STI, such as redness or discharge.
A male with symptoms of BOO may also need to have adigital rectal examination. The healthcare provider can estimate the size of the prostate and look for any nodules that are concerning for cancer.
Labs and Tests
If you have symptoms such as urinary hesitancy or bladder fullness, your medical team may want you to have a number of tests to identify the problem.
Possibilities include:
Differential Diagnoses
Neurological bladder dysfunctioncan result in a decreased ability to urinate and bladder distension, which may feel similar to the symptoms of BOO.
Diagnostic tests can help distinguish between these causes.
Causes of Urethral Pain and When to Seek Care
Treatment for Bladder Outlet Obstruction
Depending on the cause, you may need interventional treatment for your bladder outlet obstruction. Treatments are generally geared towards what your healthcare provider feels is the main cause of the BOO. Medical procedures and medications can both be used to treat BOO.
Medications for Bladder Outlet Obstruction
There are medications that can be used to help control urine flow. For example,Flomax (tamsulosin)and others may help with symptoms of urinary retention, but they do not relieve the obstruction.
In males, the most common cause is an enlarged prostate. This condition could be treated withmedicationsthat relax or shrink the prostate. These include alpha blockers like Flomax, phosphodiesterase inhibitors, andalpha-reductase inhibitors.
Medical Procedures for Bladder Outlet Obstruction
If the issue is a tumor in the bladder, minimally invasivebladder cancer surgeriesare done to remove the tumor, which can then lead to a better urine stream. Additional procedures or interventions may be needed for the bladder tumors.
If the urethra is scarred from trauma or infections, your healthcare provider may recommend minimally invasive procedures to open up the scarring through the urethra with a small knife or balloon. In severe cases, your healthcare provider may recommend a full reconstruction of the urethra.
For an enlarged prostate, minimally invasive procedures like prostate lifts or steam vaporization that open up the prostate channel or surgeries where the prostate is resected may be an option.
In acute or emergency cases, you’ll have a catheter placed into your bladder via your urethra to help empty your bladder. A catheter could also be placed after procedures are done to open up your prostate channel or remove scarring from your urethra.
Urinary Catheters Explained
Summary
Bladder outlet obstruction is a serious issue that should not be ignored. The causes of bladder outlet obstruction include infections, cancer, an injury, enlarged prostate in males, and more.
Talk to a healthcare provider if you notice unusual changes in urination or other symptoms of bladder outlet obstruction. Bladder problems can worsen if not treated. Your provider will want to take your medical history and may run diagnostic tests. Treatment will be based on the underlying cause of bladder outlet obstruction.
8 SourcesVerywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.Sussman RD, Drain A, Brucker BM.Primary bladder neck obstruction.Rev Urol.2019;21(2-3):53-62.Katsoufis CP.Clinical predictors of chronic kidney disease in congenital lower urinary tract obstruction.Pediatr Nephrol. 2019, June 13. doi.10.1007/s00467-019-04280-0Nationwide Children’s Hospital.Bladder outlet obstruction.Reddy SVK, Shaik AB.Non-invasive evaluation of bladder outlet obstruction in benign prostatic hyperplasia: a clinical correlation study.Arab J Urol. 2019;17(4):259-264. doi.10.1080/2090598X.2019.1660071Lin YH, Hou CP, Juang HH, et al.Association between bladder outlet obstruction and bladder cancer in patients with aging male.J Clin Med. 2019;8(10). doi.10.3390/jcm8101550Gravas S, Kyriazis I, Klausner AP.Lower urinary tract symptoms including bladder outlet obstruction: What’s new in diagnostics?.Eur Urol Focus. 2018;4(1):14-16. doi.10.1016/j.euf.2018.04.004Vouri SM, Strope SA, Olsen MA, Xian H, Schootman M.Antimuscarinic use in men treated with bladder outlet obstruction medication therapy.Urology.2018;122:76-82.doi.10.1016/j.urology.2018.08.039UpToDate.Patient education: benign prostatic hyperplasia (BPH) (Beyond the Basics).Additional ReadingSharifian H, Zargham M, Khorami MH, Mohamadi M, Mazdak H, Mozafarpour S.Internal urethrotomy in treatment of female with anatomical bladder outlet obstruction.Adv Biomed Res. 2019;8:36. doi:10.4103/abr.abr_200_18Veccia A, Antonelli A, Francavilla S, et al.Minimally invasive radical prostatectomy after previous bladder outlet surgery: A systematic review and pooled analysis of comparative studies.J Urol.2019;202(3):511-517. doi.10.1097/JU.0000000000000312
8 Sources
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.Sussman RD, Drain A, Brucker BM.Primary bladder neck obstruction.Rev Urol.2019;21(2-3):53-62.Katsoufis CP.Clinical predictors of chronic kidney disease in congenital lower urinary tract obstruction.Pediatr Nephrol. 2019, June 13. doi.10.1007/s00467-019-04280-0Nationwide Children’s Hospital.Bladder outlet obstruction.Reddy SVK, Shaik AB.Non-invasive evaluation of bladder outlet obstruction in benign prostatic hyperplasia: a clinical correlation study.Arab J Urol. 2019;17(4):259-264. doi.10.1080/2090598X.2019.1660071Lin YH, Hou CP, Juang HH, et al.Association between bladder outlet obstruction and bladder cancer in patients with aging male.J Clin Med. 2019;8(10). doi.10.3390/jcm8101550Gravas S, Kyriazis I, Klausner AP.Lower urinary tract symptoms including bladder outlet obstruction: What’s new in diagnostics?.Eur Urol Focus. 2018;4(1):14-16. doi.10.1016/j.euf.2018.04.004Vouri SM, Strope SA, Olsen MA, Xian H, Schootman M.Antimuscarinic use in men treated with bladder outlet obstruction medication therapy.Urology.2018;122:76-82.doi.10.1016/j.urology.2018.08.039UpToDate.Patient education: benign prostatic hyperplasia (BPH) (Beyond the Basics).Additional ReadingSharifian H, Zargham M, Khorami MH, Mohamadi M, Mazdak H, Mozafarpour S.Internal urethrotomy in treatment of female with anatomical bladder outlet obstruction.Adv Biomed Res. 2019;8:36. doi:10.4103/abr.abr_200_18Veccia A, Antonelli A, Francavilla S, et al.Minimally invasive radical prostatectomy after previous bladder outlet surgery: A systematic review and pooled analysis of comparative studies.J Urol.2019;202(3):511-517. doi.10.1097/JU.0000000000000312
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
Sussman RD, Drain A, Brucker BM.Primary bladder neck obstruction.Rev Urol.2019;21(2-3):53-62.Katsoufis CP.Clinical predictors of chronic kidney disease in congenital lower urinary tract obstruction.Pediatr Nephrol. 2019, June 13. doi.10.1007/s00467-019-04280-0Nationwide Children’s Hospital.Bladder outlet obstruction.Reddy SVK, Shaik AB.Non-invasive evaluation of bladder outlet obstruction in benign prostatic hyperplasia: a clinical correlation study.Arab J Urol. 2019;17(4):259-264. doi.10.1080/2090598X.2019.1660071Lin YH, Hou CP, Juang HH, et al.Association between bladder outlet obstruction and bladder cancer in patients with aging male.J Clin Med. 2019;8(10). doi.10.3390/jcm8101550Gravas S, Kyriazis I, Klausner AP.Lower urinary tract symptoms including bladder outlet obstruction: What’s new in diagnostics?.Eur Urol Focus. 2018;4(1):14-16. doi.10.1016/j.euf.2018.04.004Vouri SM, Strope SA, Olsen MA, Xian H, Schootman M.Antimuscarinic use in men treated with bladder outlet obstruction medication therapy.Urology.2018;122:76-82.doi.10.1016/j.urology.2018.08.039UpToDate.Patient education: benign prostatic hyperplasia (BPH) (Beyond the Basics).
Sussman RD, Drain A, Brucker BM.Primary bladder neck obstruction.Rev Urol.2019;21(2-3):53-62.
Katsoufis CP.Clinical predictors of chronic kidney disease in congenital lower urinary tract obstruction.Pediatr Nephrol. 2019, June 13. doi.10.1007/s00467-019-04280-0
Nationwide Children’s Hospital.Bladder outlet obstruction.
Reddy SVK, Shaik AB.Non-invasive evaluation of bladder outlet obstruction in benign prostatic hyperplasia: a clinical correlation study.Arab J Urol. 2019;17(4):259-264. doi.10.1080/2090598X.2019.1660071
Lin YH, Hou CP, Juang HH, et al.Association between bladder outlet obstruction and bladder cancer in patients with aging male.J Clin Med. 2019;8(10). doi.10.3390/jcm8101550
Gravas S, Kyriazis I, Klausner AP.Lower urinary tract symptoms including bladder outlet obstruction: What’s new in diagnostics?.Eur Urol Focus. 2018;4(1):14-16. doi.10.1016/j.euf.2018.04.004
Vouri SM, Strope SA, Olsen MA, Xian H, Schootman M.Antimuscarinic use in men treated with bladder outlet obstruction medication therapy.Urology.2018;122:76-82.doi.10.1016/j.urology.2018.08.039
UpToDate.Patient education: benign prostatic hyperplasia (BPH) (Beyond the Basics).
Sharifian H, Zargham M, Khorami MH, Mohamadi M, Mazdak H, Mozafarpour S.Internal urethrotomy in treatment of female with anatomical bladder outlet obstruction.Adv Biomed Res. 2019;8:36. doi:10.4103/abr.abr_200_18Veccia A, Antonelli A, Francavilla S, et al.Minimally invasive radical prostatectomy after previous bladder outlet surgery: A systematic review and pooled analysis of comparative studies.J Urol.2019;202(3):511-517. doi.10.1097/JU.0000000000000312
Sharifian H, Zargham M, Khorami MH, Mohamadi M, Mazdak H, Mozafarpour S.Internal urethrotomy in treatment of female with anatomical bladder outlet obstruction.Adv Biomed Res. 2019;8:36. doi:10.4103/abr.abr_200_18
Veccia A, Antonelli A, Francavilla S, et al.Minimally invasive radical prostatectomy after previous bladder outlet surgery: A systematic review and pooled analysis of comparative studies.J Urol.2019;202(3):511-517. doi.10.1097/JU.0000000000000312
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