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Bladder Neck Obstruction

Obstruction Urinary Bladder


Presentation

  • Six of 7 patients presented with symptoms of obstruction, including a weak or intermittent stream and urinary hesitancy.[ncbi.nlm.nih.gov]
Recurrent Urinary Tract Infection
  • RESULTS: Of the 11 patients, 5 had chronic urinary retention and 6 had difficult micturition; 3 also had recurrent urinary tract infection or upper urinary tract deterioration.[ncbi.nlm.nih.gov]
  • urinary tract infections following hypospadias repair at the age of 3 years.[indianjurol.com]
Noncompliance
  • BNI was performed in patients with a poor response, noncompliance, or side effects from the alpha-blockers. Postoperatively, patients were assessed by symptom score, uroflowmetry, and postvoid residual urine volume.[ncbi.nlm.nih.gov]
Asymptomatic
  • Asymptomatic non-prostatic hypertrophy, no matter how large the adenoma, is considered to be a pre-clinical phase of the disease as long as bladder trabeculation, impairment of the flow rate and residual urine are absent.[ncbi.nlm.nih.gov]
Abdominal Pain
  • If patients aren’t diagnosed with dilation of their urinary tract via ultrasound in utero, they can present after birth with vague symptoms such as abdominal pain, blood in their urine or a urinary tract infection.[en.wikipedia.org]
  • Pain Osteoporosis Otitis Media, Child Paracentesis Parkinsonism Penicillin Allergy Peripheral Arterial Disease Pertussis, Adult or Adolescent Pleural Effusion Pleural Effusion, Thoracentesis Pneumonia, Adult, Community-Acquired Pneumonia, Infant and[jamaevidence.mhmedical.com]
  • pain Continuous feeling of a full bladder Frequent urination Pain during urination ( dysuria ) Problems starting urination (urinary hesitancy) Slow, uneven urine flow, at times being unable to urinate Straining to urinate Urinary tract infection Waking[medlineplus.gov]
  • Most patients present with nonspecific symptoms, including dull abdominal pain, of less than 12 months' duration but patients can present with the complications of the fibrosis.[patient.info]
Suprapubic Pain
  • Usually severe suprapubic pain (but not if superimposed on chronic retention or underlying neuropathy). Look for evidence of a distended bladder - eg, abdominal distention, suprapubic dullness on percussion.[patient.info]
Impulsivity
  • Virtual Touch tissue quantification on acoustic radiation force impulse imaging can quantitatively reflect the bladder neck stiffness and change in texture.[ncbi.nlm.nih.gov]
  • […] obstruction: Description of a novel surgical procedure. ( 27037830 ) Shen W....Zhou Z. 2016 6 Primary bladder neck obstruction may be determined by postural imbalances. ( 27876119 ) Camerota T.C....Sforza C. 2016 7 Application of Acoustic Radiation Force Impulse[malacards.org]
Neck Stiffness
  • Virtual Touch tissue quantification on acoustic radiation force impulse imaging can quantitatively reflect the bladder neck stiffness and change in texture.[ncbi.nlm.nih.gov]
Bladder Neck Obstruction
  • Primary bladder neck obstruction is one of the functional causes of bladder outlet obstruction. We evaluated surgical treatment in our patients with primary bladder neck obstruction.[ncbi.nlm.nih.gov]
Urinary Retention
  • RESULTS: Of the 11 patients, 5 had chronic urinary retention and 6 had difficult micturition; 3 also had recurrent urinary tract infection or upper urinary tract deterioration.[ncbi.nlm.nih.gov]
  • Retention - NIH (National Institute of Diabetes and Digestive and Kidney Diseases) [ Read More ][icdlist.com]
Urinary Incontinence
  • CONCLUSION: The modified transurethral bladder neck incision is effective in the long term in relieving voiding difficulties owing to primary bladder neck obstruction in women without urinary incontinence. Copyright 2012 Elsevier Inc.[ncbi.nlm.nih.gov]
  • International Consultation on Incontinence Modular Questionnaire—Urinary Incontinence The median ICIQ-UI score was 1 (IQR 0–2.5) with an ICIQ-UI bother score of 0 (IQR 0–1).[journal.frontiersin.org]
  • Some common ones are Cystitis - inflammation of the bladder, often from an infection Urinary incontinence - loss of bladder control Overactive bladder - a condition in which the bladder squeezes urine out at the wrong time Interstitial cystitis - a chronic[icdlist.com]
  • incontinence. ( 22310746 ) Jin X.B....Zhang Y.D. 2012 16 Giant Urinary Bladder and Bilateral Giant Hydronephrosis due to Bladder Neck Obstruction: One Case Report and Literature Review. ( 22606637 ) Tazi M.F....Farih M.H. 2012 17 Urodynamic differences[malacards.org]
  • Modified transurethral incision for primary bladder neck obstruction in women: a method to improve voiding function without urinary incontinence. Urology. 2012;79(2):310–13. PubMed CrossRef 14. Diokno AC, Hollander JB, Bennett CJ.[springermedizin.at]
Pelvic Pain
  • High Prevalence of Bladder Neck Obstruction Suggested in Patients with Chronic Pelvic Pain and Small Fiber Polyneuropathy Video coming soon! 1. Albany Medical College, 2.[ics.org]
  • These symptoms include: Irregular output of urine Incomplete emptying of the bladder Increased urinary frequency Increase in urinary urgency Inability to control one’s need to urinate Pelvic pain—seen more often in men than women What causes bladder neck[belmarrahealth.com]
  • pain, which is more common in men than in women An enlarged prostate is often responsible for causing bladder neck obstruction.[healthline.com]
  • Common symptoms can be irregular urination, incomplete bladder emptying, inability to control urination and pelvic pain. The success rate of bladder neck incision is about 60 percent.[tourmyindia.com]
  • 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[samadimd.com]
Dysuria
  • We present the cases of two women complaining dysuria, abdominal straining and sensation of incomplete bladder emptying. Videourodynamic evaluation was fundamental for a correct diagnosis.[ncbi.nlm.nih.gov]
  • The symptoms usually present are hematospermia or dysuria.[omicsonline.org]
  • Similarly, infection of the genitalia, bladder ( cystitis ) or of the prostate (prostatitis) may cause the symptoms mentioned above, along with pain on passing urine (dysuria) and a dull ache either in the scrotum, above the pubic bone (pubic symphysis[netdoctor.co.uk]
  • […] the bladder falls into the vagina) Foreign objects Urethral or pelvic muscle spasms Inguinal (groin) hernia The symptoms of BOO may vary, but can include: Abdominal pain Continuous feeling of a full bladder Frequent urination Pain during urination ( dysuria[medlineplus.gov]

Workup

Bladder Trabeculation
  • Asymptomatic non-prostatic hypertrophy, no matter how large the adenoma, is considered to be a pre-clinical phase of the disease as long as bladder trabeculation, impairment of the flow rate and residual urine are absent.[ncbi.nlm.nih.gov]
Bladder Trabeculation
  • Asymptomatic non-prostatic hypertrophy, no matter how large the adenoma, is considered to be a pre-clinical phase of the disease as long as bladder trabeculation, impairment of the flow rate and residual urine are absent.[ncbi.nlm.nih.gov]

Treatment

  • The efficacy of doxazosin was maintained over the 12-month treatment period.[ncbi.nlm.nih.gov]

Prognosis

  • The earlier treatment occurs the better the prognosis can be.[belmarrahealth.com]
  • Ultrasound evaluation of prognosis in fetuses with posterior urethral valves . J. Pediatr. Surg. 46 , 1412–1418 (2011). 17. Johnson, M. P. et al .[nature.com]
  • Treatment and prognosis The goal of treatment is to relieve the obstruction and prevent urinary tract infections and renal compromise.[radiopaedia.org]
  • The Fetal Center offers extensive counseling to patients about the diagnostic findings and treatment options, as well as a birth plan and the baby’s long-term prognosis.[cincinnatichildrens.org]
  • While you are still pregnant, we will help you arrange consultations with a neonatologist, pediatric urologist and pediatric nephrologist who will discuss the treatment needs and prognosis of your baby after he/she is born.[fetaltonewborn.org]

Etiology

  • There are multiple theories as to the etiology of PBNO, including muscular and neurologic dysfunction and fibrosis.[ncbi.nlm.nih.gov]

Epidemiology

  • Congenital lower urinary tract obstruction: a population-based epidemiological study . BJOG 119 , 1455–1464 (2012). 7. Knox, W. F. & Barson, A. J. Pulmonary hypoplasia in a regional perinatal unit . Early Hum. Dev. 14 , 33–42 (1986). 8. Liao, A.[nature.com]
  • We provide invaluable learning opportunities for attending medical students and research opportunities in biomedical, clinical and epidemiological research across all disciplines.[sydney.edu.au]
  • Ejaculatory disorders: epidemiology and current approaches to definition, classification and subtyping. World J Urol (2005) 23(2):68–75. doi:10.1007/s00345-004-0486-9 PubMed Abstract CrossRef Full Text Google Scholar 17. Kaplan SA, Te AE, Jacobs BZ.[journal.frontiersin.org]
  • Epidemiology Age Urinary tract obstruction occurs most commonly in the young and the old: In older men, this is a relatively common condition due to prostatic enlargement: Incidence of lower urinary tract symptoms (LUTs)/BPH averages 15 per 1,000 man-years[patient.info]
  • Etiology, epidemiology, and natural history of benign prostatic hyperplasia. Urol Clin North Am. 2009;36: 403–415, v. pmid:19942041 View Article PubMed/NCBI Google Scholar 4. Ezz el Din K, Kiemeney LA, de Wildt MJ, Debruyne FM, de la Rosette JJ.[journals.plos.org]
Sex distribution
Age distribution

Pathophysiology

  • While the pathophysiology of dysfunctional bladder neck obstruction is uncertain possible mechanisms are discussed.[ncbi.nlm.nih.gov]
  • A thorough evaluation to determine the exact anatomy and pathophysiology allows the surgeon to individualize the treatment appropriately. Financial support and sponsorship Nil. Conflicts of interest There are no conflicts of interest. 1.[indianjurol.com]
  • Recently, the pathophysiology of male LUTS has been regarded as being highly complex and multifactorial [ 2 ].[journals.plos.org]

Prevention

  • However, in a few patients the bladder neck may be completely obstructed preventing retrograde access into the bladder.[ncbi.nlm.nih.gov]
  • During ejaculation the bladder neck closes tightly to prevent semen from flowing back and to assist in the throw of semen. How do you evaluate patient with Bladder neck symptoms.[urologyrbh.blogspot.com]
  • Prompt treatment will relieve your symptoms and prevent complications from developing.[healthline.com]
  • This means urine may be prevented from being expelled or it may leak out unintendedly. Bladder neck obstruction is most commonly seen in men over the age of 50, but it can affect both men and women.[belmarrahealth.com]
  • Lower Urinary Tract Obstruction (formerly referred to as Bladder Outlet Obstruction) is a blockage in a baby’s bladder that restricts or prevents most or all of the flow of urine out of the body.[cardinalglennon.com]

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