Bladder outlet obstruction is a condition in which the bladder neck becomes obstructed as a result of an abnormality. This prevents the bladder neck from completely opening during urination. Bladder outlet obstruction is common among men over the age of 50. However, the condition can occur among men of any age, as well as women.
There are a number of signs and symptoms that may indicate bladder outlet obstruction. Men and women who suffer from bladder neck obstruction experience similar symptoms. The signs and symptoms of bladder outlet obstruction may include intermittent urine stream, delayed urine stream, incomplete bladder emptying, incontinence, increased urgency and frequency of urination, and pelvic pain (this symptom is more common in men than women).
The possible causes of bladder outlet obstruction might include:
· Benign prostatic hyperplasia (BPH), which is also known as enlarged prostate. This is the most common cause of bladder outlet obstruction in men.
· Bladder stones
· Prostate cancer
· Scarring of the urinary channel (urethra) or bladder neck, as a result of injury or surgery
· Use of certain medications, including antihistamines, decongestants or drugs to treat overactive bladder
A new study suggests that the thickness of the bladder wall may predict the severity of bladder outlet obstruction in men. The study included 236 men with lower urinary tract symptoms secondary to benign prostatic hyperplasia. It was conducted by Özer Güzel, MD, and colleagues at the Ankara Numune Research and Training Hospital in Turkey. They examined the relationship between bladder wall thickness and poor indictors for bladder outlet obstruction: International Prostate Symptom Score above 19, Qmax less than 15 mL/min, and post-void residual greater than 100 mL. The investigators used suprapubic ultrasonography to measure bladder wall thickness.
The results showed that the patients had a mean age of 62.5 years and mean bladder wall thickness of 3.8 mm. The mean IPSS, Qmax, PVR, and duration of LUTS were 17.7, 13.7 mL/min, 89.9 mL, and 46.5 months, respectively. These findings showed that bladder wall thickness increased when the number of bladder outlet obstruction parameters increased. Bladder wall thickness was 2.9 mm in patients without bladder outlet obstruction, whereas bladder wall thickness was 3.5, 4.1, and 4.5 mm in patients with any 1, any 2, and all parameters of bladder outlet obstruction, respectively.