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. 2005;7 Suppl 6(Suppl 6):S3-S13.

Bladder outlet obstruction: etiology and evaluation

Roger R Dmochowski  1
Affiliations

Bladder outlet obstruction: etiology and evaluation

Roger R Dmochowski. Rev Urol. 2005.

Abstract

Numerous gender-specific etiologies are responsible for bladder outlet obstruction (BOO). BOO may be induced by specific functional and anatomic causes. The resulting obstruction frequently produces lower urinary tract symptoms (LUTS). Categorizing and understanding these entities is crucial when proceeding with a LUTS evaluation as specific diagnostic modalities may then be used to fully delineate the degree of BOO and any secondary issues. Although urodynamic evaluation and pressure flow evaluation is the gold standard diagnostic tool, other modalities may also be used, including post void residual analysis, urinary flow rates, cystoscopy, and selected radiologic ones. Patient self-appraisal of symptoms using various inventories such as the American Urologic Association Symptom Index or the International Prostate Symptom Score is relevant to the initial assessment and subsequent longitudinal follow up. Analysis of secondary symptoms of obstruction in women is often performed using a subjective symptom appraisal and is determined urodynamically, assessing the pressure-flow relation during voiding. The complete assessment of LUTS arising from BOO often includes several of these modalities to fully define the obstructive impact on the individual's urinary function and quality of life.

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Figures

Figure 1
Figure 1
Complex urethral diverticulum causing urethral obstruction. Arrow denotes relative area of urethral stenosis.
Figure 2
Figure 2
Urodynamic tracing, including pressure-flow analysis, of woman with BOO after pubovaginal sling surgery. Note voiding pressures greater than 100 cm H2O. BOO, bladder outlet obstruction.
Figure 3
Figure 3
Detrusor storage abnormality associated with high pressure obstruction in male with BOO due to prostatic enlargement. BOO, bladder outlet obstruction.
Figure 4
Figure 4
Fluoroscopic image of non-relaxing bladder neck in young male with presumptive primary bladder neck obstruction.
See this image and copyright information in PMC

References

    1. Gomelsky A, Scarpero HM, Dmochowski RR. Sling surgery for stress urinary incontinence in the female: what surgery, which material? AUA Update Series. 2003;XXII:266–276. (lesson 34)
    1. Leach GE, Dmochowski RR, Appell RA, et al. J Urol. Vol. 158. The American Urological Association; 1997. Female Stress Urinary Incontinence Clinical Guidelines Panel summary report on surgical management of female stress urinary incontinence; pp. 875–880. (3 Pt 1) - PubMed
    1. Kingsnorth AN. Urinary retention due to ovarian cyst. Br J Urol. 1984;56:439–440. - PubMed
    1. Doran J, Roberts M. Acute urinary retention in the female. Br J Urol. 1976;47:793–796. - PubMed
    1. Silva PD, Berberich W. Retroverted impacted gravid uterus with acute urinary retention: report of two cases and a review of the literature. Obstet Gynecol. 1986;68:121–123. - PubMed

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