Many women, in hopes of reducing their light bladder leaks, have turned to surgical treatment to help with their urinary incontinence. The most common being the vaginal sling surgery to help support the bladder. Although it is widely known that this surgery can lead to some serious complications, such as infection, exposed mesh, and chronic pain, there is another side-effect of the sling surgery - Bladder Outlet Obstruction (BOO). We’ll go over what exactly Bladder Outlet Obstruction is, the causes, how it’s diagnosed, and health complications that may arise if not treated.
What is Bladder Outlet Obstruction?
According to the Cleveland Clinic, BOO is best described as, “a blockage at the base or neck of the bladder. Such a blockage reduces or stops the flow of urine into the urethra, which carries urine from the body.” The bladder neck itself is the group of muscles that connects the bladder to the urethra. While BOO is actually more common in men than women, both genders can develop the problem. How do you know if you’re experiencing Bladder Outlet Obstruction? Symptoms may include:
Pain when passing urine.
Trouble starting your urine stream.
Feel like you have a full bladder but cannot empty completely.
Feel like some urine remains in your bladder after voiding.
Pass urine frequently during sleeping hours.
Have pain in your abdomen.
Have urine flow that starts and stops.
Have a urinary stream that is slow.
Void often with small urine volume.
If you feel that these symptoms are describing what you’re experiencing, talk to your doctor or health care professional about what to do.
These symptoms are fairly common among other urinary complications as well - UTIs, Overflow Incontinence, kidney infections, etc., but there are certain risk factors that could indicate that you have BOO over another kind of urinary problem. Men and women have different sets of risk factors. Men have a prostate, a small gland that produces fluid for semen, which also happens to wrap around the urethra. Some men develop conditions in which the prostate becomes so swollen that the flow of urine is completely restricted. In addition, men may develop BOO as a result of removing the prostate, either developing scar tissue around the urethra or as a side-effect of radiation treatment from prostate cancer. Women may experience BOO as a result of a weakened vaginal wall that allows the bladder to drop into the vagina (yikes!) The weakening of the vaginal wall may be a result of old age, menopause, multiple births, or a particularly difficult delivery. As we mentioned before, women may also develop BOO as a side-effect of pelvic sling or vaginal sling surgery scarring the urethra. Both men and women can develop Bladder Outlet Obstruction if diagnosed with bladder, cervical, uterine and other pelvic cancers. Bladder stones can also occur in both men and women and lead to BOO but are seen more often in men.
As suggested before, if you’re experiencing symptoms of BOO - see your doctor. What may be a bladder obstruction that you’re brushing off as another UTI may actually be indicative of a deeper health issue or can lead to one if left untreated. To properly diagnose your symptoms, doctors have two ways of testing for BOO. The first being video urodynamics. According to Doncaster and Bassetlaw Hospitals this procedure can be described as, “the study of pressure and flow in the lower urinary tract. The test shows doctors what happens to your lower urinary tract when it is filling and emptying.” This is achieved by using an X-Ray or ultrasound of your bladder in real-time and a catheter to empty and fill the bladder with fluid. Another way to diagnose BOO is through a procedure called a Cystoscopy, which uses a long thin tube with a camera on the end called a cystoscope to look in the urethra and bladder. This allows the doctor to see any possible obstructions. Both of these procedures should be done as soon as possible after experiencing symptoms, as untreated Bladder Outlet Obstruction may lead to further urinary health complications.
Other Health Concerns
With BOO, the most common health complication that arises is a weakened bladder, which can, in turn, lead to even more complications. This occurs if symptoms are not diagnosed and properly treated with either medication or a surgical procedure to alleviate them. A weakened bladder may lead to:
Medications like prazosin or phenoxybenzamine may be used to help relax the bladder. Your doctor may recommend surgery for bladder neck obstruction that involves making an incision in your bladder neck.
Revive® is a new bladder support device designed for women suffering from Stress Urinary Incontinence (SUI), the accidental loss of urine when the bladder or urinary tract is put under pressure or stress. The device is inserted like a tampon to reduce leaks comfortably and effectively for up to 12 hours a day, and is easy to remove and clean for up to 30 uses! While Revive was not designed to help women or men that struggle with BOO, the reusable device may be a better alternative for women considering the pelvic mesh surgery, which may ultimately lead to Bladder Outlet Obstruction. Find Revive in a store near you with our store finder!