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Bladder outlet obstruction
BOO; Lower urinary tract obstruction; Prostatism; Urinary retention - BOO
Bladder outlet obstruction (BOO) is a blockage at the base of the bladder. It reduces or stops the flow of urine into the urethra. The urethra is the tube that carries urine out of the body.
Causes
This condition is common in aging men. It is often caused by enlarged prostate . Bladder stones and bladder cancer are also more commonly seen in men than women. As a man ages, his chance of getting these diseases increases greatly.
Enlarged prostate
The prostate is a gland that produces the fluid that carries sperm during ejaculation. The prostate gland surrounds the urethra, the tube through wh...
Bladder stones
Bladder stones are hard buildups of minerals. These form in the urinary bladder.
Bladder cancer
Bladder cancer is a cancer that starts in the bladder. The bladder is the body part that holds and releases urine. It is in the center of the lower...
Other common causes of BOO include:
- Pelvic tumors (cervix, prostate, uterus, rectum)
-
Narrowing of the tube that carries urine
out of the body from the bladder (urethra), due to scar tissue or certain birth defects
Narrowing of the tube that carries urin
Urethral stricture is an abnormal narrowing of the urethra. Urethra is the tube that carries urine out of the body from the bladder.
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Less common causes include:
- Cystocele (when the bladder falls into the vagina)
- Foreign objects
- Urethral spasms
- Inguinal (groin) hernia
Symptoms
The symptoms of BOO may vary, but can include:
- Abdominal pain
- Continuous feeling of a full bladder
- Frequent urination
-
Pain during urination (
dysuria
)
Dysuria
Painful urination is any pain, discomfort, or burning sensation when passing urine.
ImageRead Article Now Book Mark Article - Problems starting urination (urinary hesitancy)
- Slow, uneven urine flow, at times being unable to urinate
-
Urinary tract infection
Urinary tract infection
A urinary tract infection, or UTI, is an infection of the urinary tract. The infection can occur at different points in the urinary tract, including...
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Waking up at night to urinate (
nocturia
)
Nocturia
Normally, the amount of urine your body produces decreases at night. This allows most people to sleep 6 to 8 hours without having to urinate. Some p...
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Exams and Tests
Your health care provider will ask about your symptoms and medical history. You will undergo a physical exam.
One or more of the following problems may be found:
- Abdominal growth
- Cystocele (women)
- Enlarged 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
Cystoscopy
Cystoscopy is a surgical procedure. This is performed to see the inside of the bladder and urethra using a telescope.
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Tests to determine how fast urine flows out of the body (
uroflowmetry
)
Uroflowmetry
Uroflowmetry is a test that measures the volume of urine released from the body, the speed with which it is released, and how long the release takes....
ImageRead Article Now Book Mark Article - Tests to see how much the urine flow is blocked and how well the bladder contracts (urodynamic testing)
- Ultrasound to locate the blockage of urine and find out how well the bladder empties
-
Urinalysis
to look for blood or signs of infection in the urine
Urinalysis
Urinalysis is the physical, chemical, and microscopic examination of urine. It involves a number of tests to detect and measure various compounds th...
ImageRead Article Now Book Mark Article - Urine culture to check for an infection
Treatment
Treatment of BOO depends on its cause. A tube, called a catheter, is inserted into the bladder. The insertion is done through the urethra to relieve the blockage.
Sometimes, a catheter placed through the belly area into the bladder is needed to drain the bladder.
Most often, you will need surgery for long-term cure of BOO. However, many of the diseases that cause this problem can be treated with medicines. Talk to your provider about possible treatments.
Outlook (Prognosis)
Most causes of BOO can be cured if diagnosed early. However, permanent damage to the bladder or kidneys can result if the diagnosis is delayed.
When to Contact a Medical Professional
Call your provider if you have symptoms of BOO. Early diagnosis can often lead to a simple and effective cure.
References
Andersson K, Wein AJ. Pharmacologic management of lower urinary tract storage and emptying failure. In: Wein AJ, Kavoussi LR, Partin AW, Peters CA, eds. Campbell-Walsh Urology . 11th ed. Philadelphia, PA: Elsevier; 2016:chap 79.
Boone TB, Stewart JN. Additional therapies for storage and emptying failure. In: Wein AJ, Kavoussi LR, Partin AW, Peters CA, eds. Campbell-Walsh Urology . 11th ed. Philadelphia, PA: Elsevier; 2016:chap 87.
McNicholas TA, Speakman MJ, Kirby RS. Evaluation and nonsurgical management of benign prostatic hyperplasia. In: Wein AJ, Kavoussi LR, Partin AW, Peters CA, eds. Campbell-Walsh Urology . 11th ed. Philadelphia, PA: Elsevier; 2016:chap 104.
Zeidel ML. Obstructive uropathy. In: Goldman L, Schafer AI, eds. Goldman's Cecil Medicine . 25th ed. Philadelphia, PA: Saunders Elsevier; 2016:chap 123.
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Kidney anatomy - illustration
The kidneys are responsible for removing wastes from the body, regulating electrolyte balance and blood pressure, and stimulating red blood cell production.
Kidney anatomy
illustration
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Female urinary tract - illustration
The female and male urinary tracts are relatively the same except for the length of the urethra.
Female urinary tract
illustration
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Male urinary tract - illustration
The male and female urinary tracts are relatively the same except for the length of the urethra.
Male urinary tract
illustration
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Kidney - blood and urine flow - illustration
This is the typical appearance of the blood vessels (vasculature) and urine flow pattern in the kidney. The blood vessels are shown in red and the urine flow pattern in yellow.
Kidney - blood and urine flow
illustration
-
Kidney anatomy - illustration
The kidneys are responsible for removing wastes from the body, regulating electrolyte balance and blood pressure, and stimulating red blood cell production.
Kidney anatomy
illustration
-
Female urinary tract - illustration
The female and male urinary tracts are relatively the same except for the length of the urethra.
Female urinary tract
illustration
-
Male urinary tract - illustration
The male and female urinary tracts are relatively the same except for the length of the urethra.
Male urinary tract
illustration
-
Kidney - blood and urine flow - illustration
This is the typical appearance of the blood vessels (vasculature) and urine flow pattern in the kidney. The blood vessels are shown in red and the urine flow pattern in yellow.
Kidney - blood and urine flow
illustration
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Urinary incontinence
(In-Depth)
Review Date: 5/23/2016
Reviewed By: Jennifer Sobol, DO, urologist with the Michigan Institute of Urology, West Bloomfield, MI. Review provided by VeriMed Healthcare Network. Also reviewed by David Zieve, MD, MHA, Isla Ogilvie, PhD, and the A.D.A.M. Editorial team.
