Bladder outlet obstruction

A hollow organ located in your lower abdomen that stores urine is known as the bladder. 

A blockage at the base of the bladder is known as a bladder outlet obstruction (BOO). The flow of urine into the urethra is reduced or stopped. The tube that takes urine out of the body is known as the urethra.

What Causes Bladder Outlet Obstruction?

What Causes Bladder Outlet Obstruction?

  • This is a prevalent ailment in older men. 
  • Prostate enlargement is a common reason.
  • Men are more likely than women to get bladder stones and bladder cancer. As a man gets older, his chances of contracting these diseases rise dramatically.

BOO can also be caused by the following factors:

  • Tumors of the pelvis (cervix, prostate, uterus, rectum)
  • Due to scar tissue or certain congenital disorders, the tube that transports urine out of the body from the bladder (urethra) narrows.

The following are some of the less prevalent causes:

  • Presence of cystocele a kind of cyst (when the bladder falls into the vagina)
  • Objects from another country
  • Spasms of the urethral or pelvic muscles
  • Hernia inguinal (groin)

What is post-void residue?

The amount of urine remaining in the bladder after urinating is measured by the post-void residual (PVR) urine test. The test is used to assess 

  • incontinence (the unintentional leakage of pee) in both men and women.
  • Problems with urination
  • Prostate enlargement (benign prostatic hyperplasia, or BPH).
  • By emptying the bladder with a narrow flexible tube (catheter) or utilizing ultrasonography, the amount of remaining (residual) urine can be determined. 
  • The catheter approach carries a small chance of infecting or injuring the tube that leads from the bladder (urethra). However, if done correctly, the catheter approach is safe.
  • It’s also possible that it’ll be less costly than ultrasonography.

When to say significant post-void?

A doctor might order a post-void residual test for you in cases of :

  • Blockage in your urinary tract.
  • Enlarged prostate.
  • Medication side effects.
  • Narrowed urethra (the tube through which urine flows).
  • Neurogenic bladder.

Failure to empty your bladder can cause a variety of symptoms and consequences, including:

  • Frequent urination.
  • Urine leakage (incontinence).
  • Urinary tract infections (UTI).
  • Kidney damage.
  • Bladder stones.

What is the bladder wall?

  • Your urinary tract includes your bladder which is a hollow organ located in the lower abdomen (pelvis). 
  • The primary function of the bladder is to store urine (a nitrogenous waste that the kidneys produce. 
  • Urine is carried into your bladder via the ureters. 
  • The urine stays in your bladder until you let it out through the urethra, another tube in your body that helps to regulate urine flow, you need ring-shaped sphincter muscles.
  • The bladder is surrounded by a smooth muscular layer called the detrusor muscle. 
  • When your bladder is full, you can tighten the muscles in the bladder wall to force the urine out, the bladder decreases in size when you urinate.

Your bladder wall is made up of many layers these are :

Urothelium or transitional epithelium 

  • One of the several layers that make up the bladder wall.
  • The lining of the kidneys, ureters, bladder, and urethra is made up of this layer of cells. 
  • Urothelial cells or transitional cells are the cells that make up this layer.

Lamina propria

  • The urothelium is surrounded by this layer. It’s a connective tissue type.

Detrusor muscle (muscularis propria).

  • This is the most visible layer. Outside of the lamina propria, it’s the thick smooth muscular tissue.

Fatty connective tissue 

  • This protects the bladder from the elements and keeps it distinct from other organs.
  • The bladder wall comprises a collection of ridges termed rugae, which are huge mucosal folds that enable the bladder to inflate.
  • The detrusor muscle is composed of spiral, longitudinal, and circular bundles of smooth muscle fibres that compensate the muscular layer of the wall.
  • The length of the detrusor muscle can be changed. It can also constrict for an extended time when voiding and remain relaxed as the bladder fills. 
  • The urinary bladder wall is generally 3–5 mm thick. The wall is generally less than 3 mm thick when fully distended.

When to say bladder wall is thickened?

  • When the bladder is almost empty, it has a thickness of 2.76 mm, and when it is inflated, it has a thickness of 1.55 mm. 
  • There is a linear connection between bladder fullness and bladder wall thickness; the maximum limits for a full and empty bladder are 3 and 5 mm, respectively.
  • A thickening of the bladder wall might indicate a variety of medical issues. Other symptoms are generally present as well. 
  • With early detection, many of these illnesses are easily treated.

The following are some of the most common reasons for bladder wall thickening: 

Urinary tract infection causes inflammation (UTI) 

  • Bacteria often enter the urethra and ultimately the bladder, causing a UTI. 
  • Females are more likely than males to develop these illnesses.
  • UTIs are frequently linked to sexual activity, but even if a woman isn’t sexually active, she can get a bladder infection. This is due to the high concentration of bacteria in and around the vaginal area. 
  • Inflammation of the bladder wall, known as cystitis, is one of the most common reactions to a UTI. Long-term inflammation might cause the wall to thicken. 
  • Inflammation caused by cancer treatments such as radiation and chemotherapy, as well as chronic catheter use, are some known causes of cystitis.

Tissue growths that aren’t malignant 

  • Tumors form and the bladder wall thickens as a result of abnormal tissue growth in the bladder wall.
  • Papillomas are noncancerous (benign) tumors. Viruses may be the source of these growths in some circumstances. 
  • Leiomyomas are another benign bladder tumor, but they are uncommon. The expansion of smooth muscle cells in the bladder wall causes them. 
  • Fibromas are another type of bladder tumor that is benign which are caused by abnormal fibrous connective tissue growth in the bladder wall.

Cancer 

  • The innermost lining of the bladder wall is where cancerous (malignant) tumors tend to grow earliest. The transitional epithelium is the name for this lining. 
  • Smoking cigarettes or being exposed to toxins may cause aberrant cell development in the bladder wall. Chronic bladder wall inflammation or past radiation exposure could be to blame. 

Cystitis hemorrhagic 

Bladder lining bleeding can occur as a result of irritation and inflammation of the bladder wall. Hemorrhagic cystitis is the medical term for this condition. The following are examples of possible causes: 

  • Radiation treatment 
  • Chemotherapy treatment 
  • a viral infection 
  • contact with chemicals such as pesticides or dyes
  • Amyloidosis 
  • Amyloid is an aberrant protein that is produced in the bone marrow. 
  • The buildup of amyloid in an organ is known as amyloidosis. Although the bladder is one of several organs that might be affected by this disease, it is a rare occurrence. 
  • When dialysis fails to filter out any amyloid that may be present, end-stage renal illness might cause aberrant amyloid development. 
  • Amyloidosis, as well as other illnesses, can be caused by autoimmune inflammatory diseases like rheumatoid arthritis. Familial amyloidosis is an inherited form of the disease. 

What are the signs and symptoms? 

  • Changes in your urine habits are frequently associated with bladder wall thickening symptoms. 
  • You may find that you urinate more frequently or that your urination feels different, changes in the urine may also be seen. 

Some of the following symptoms can be caused by underlying factors such as infections or tumors : 

Fever 

A low-grade fever can be caused by cystitis. Fever is a sign of a variety of illnesses. However, if you develop a fever along with bladder-related symptoms, consult your doctor straight once.

Urinary discomfort 

  • Painful urination can be a sign of a variety of illnesses, from sexually transmitted diseases (STDs) to bladder cancer. 
  • A burning sensation when urinating might also be caused by a bladder or kidney infection. This is one of the clearest indications that you should seek medical help as soon as possible. 

Urgency or inability to urinate 

  • It may be difficult to empty your bladder if you have a bladder problem. This can result in frequent urination, a constant need to urinate, or both. 
  • The bladder may not be able to contain as much pee as it used to as the bladder wall thickens. This can cause you to feel compelled to urinate more frequently.

Urine that is cloudy or has blood in it 

  • You may also see a small amount of blood in your urine. This can happen as a result of something as simple as a tough workout. It could also be a sign of cystitis, bladder cancer, or another disease in the urinary tract.
  • Often, blood in urine can only be seen under a microscope. Even if you don’t have any other symptoms, consult your doctor if you detect blood in your urine or notice your urine becoming murky.
  • It could be a symptom of many dangerous illnesses.

Urine with a foul odor 

Urine that smells foul or has a strong odor could be caused by food or beverages you previously drank. It could, however, be an indication of infection.

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