Treatment for bladder outlet obstruction (BOO)—a blockage at the base of the bladder that stops or slows the flow of urine—depends upon the underlying cause, of which there are several, including:
- Enlarged prostate (benign prostatic hyperplasia or BPH)
- Bladder cancer or other pelvic cancers
- Bladder stones
- Injury or surgery that caused scarring of the urethra (the tube that carries urine from the bladder).
Immediate Treatment for Bladder Outlet Obstruction
Left untreated, bladder outlet obstruction can harm the bladder or kidneys as the pressure of the urine builds up in the upper urinary tract. In order to minimize this type of damage, the most important first step during treatment is to relieve the pressure caused by the blockage.
In most cases, a tube (catheter) is inserted into the urethra to remove the urine from the bladder. Sometimes, however, a tube is inserted through the stomach and into the bladder (suprapubic catheter). This may be done when the catheter cannot go through the urethra, such as when there is damage to the urethra from a previous surgery.
Long-Term Treatment for Bladder Outlet Obstruction
Treatment of bladder outlet obstruction over the long run depends upon the underlying cause and usually means removing the blockage with surgery or other means, such as:
- Removing tissue from an enlarged prostate (benign prostatic hyperplasia)
- Bladder stone removal, which may involve fragmenting the stone using ultrasound, laser or a mechanical device. The pieces are retrieved from or flushed out of the bladder using a special tube (cystoscope).
- Reconstructive surgery to reduce scarring of the urethra caused by previous injury or surgeries
- Surgery or medication to treat bladder or other pelvic cancers
Recovery after treatment relies on what is causing the bladder obstruction. For example, bladder stone removal can be a relatively simple procedure, while treatments for cancer can be ongoing with longer recovery periods.
Outlook for Bladder Outlet Obstruction
Most cases of bladder outlet obstruction can be treated successfully if caught early. If treatment is delayed, however, the bladder or kidneys can be seriously damaged.
In general, recovery is lower with longer blockage times. If the kidneys were damaged as a result of the obstruction, they will start working properly again within 3 weeks to 5 months. Again, this depends upon the severity of the damage done.
Gerber GS, Brendler CB. (2011). Evaluation of the Urologic Patient: History, Physical Examination, and Urinalysis. Campbell-Walsh Urology, 10th ed.
Zeidel ML. (2011). Obstructive uropathy. In: Goldman L, Schafer AI, eds. Cecil Medicine. 24th ed. Philadelphia, Pa: Saunders Elsevier; chap 125.