Clinical study and management of bladder outlet obstruction

Abstract

Background: The incidence of bladder outlet obstruction is different and varied in both age and gender. Hence this study was conducted to assess the incidence, etiology and management of bladder outlet obstruction in patients above 18 years of age in both sexes.Methods: This was a tertiary care hospital based longitudinal study. A total of 100 cases were recruited during the period between 01st June 2014 to 31st May 2016 with objective evidence of bladder outlet obstruction. The subject's demographic data, incidence, etiological factors and clinical presentations of bladder outlet obstruction were recorded on data sheet and analyzed.Results: Male preponderance was observed in the study. Maximum incidence of bladder outlet obstruction was observed in the age group of 60-69 years. The most common cause for bladder outlet obstruction in males was benign prostate hyperplasia (BPH), where as in females the major etiological factor was bladder neck stenosis. Out of 94 cases causing bladder outlet obstruction in males, 37 underwent TURP, 11 cases were treated with alpha blockers like Tamsulosin (medical management), 9 underwent cystolithotripsy, 8 underwent b/l orchidectomy, 7 underwent radical cystectomy and ileal conduit, 7 underwent VIU, 7 underwent urethroplasty, 5 underwent open prostatectomy, 3 underwent cystolithotomy whereas in female’s bladder neck stenosis treated by bladder neck incision.Conclusions: Men were the most affected with BPH, being the leading cause. Among women, bladder neck stenosis was the main cause. Initial and definitive management were varied between causes, gender and age.

Aetiology of Urinary Outflow Obstruction at a tertiary Care Hospital in Bangladesh

“…The etiology of BOO is diverse and definitely gender specific 7 . Often anatomic causes induce functional abnormality that remains somewhat unique for each individual, regardless of sex.…”

Surgical Management and Post-Operative Outcomes of Urinary Outflow Obstruction: Experience of 50 Cases in Bangladesh

“…Therefore, prompt attention to dislodge the stone and relieve the urinary retention was mandatory. In this series, all patients were relieved of urinary retention by suprapubic needle aspiration to allow time for well-planned investigation and definitive treatment of urethral stone under general anesthesia as suggested by Katakwar et al 7 . Seven patients in this series presented with stone impacted in the posterior urethra and treated by retrograde manipulation of the stone into the bladder followed by open cystolithotomy as suggested by Nagarathnam and Latheef 8 .…”

“…So far the treatment of urethral stricture is concerned in Bangladesh; it has been managed mainly by dilatation and in one or two centres by optical external uretbrotomy. Urethral dilatation still has a place in elderly persons who have a short stricture which occurs at frequent intervals 7 . In this series of 50 cases, 11 patients with stricture urethra were treated by intermittent dilatation under general anesthesia.…”

Korelasi Nilai Intravesical Prostatic Protrusion Dan Post Void Residual Urine Menggunakan Pemeriksaan Ultrasonografi Transabdominal Dengan Skor International Prostate Symptom Pada Pasien Pembesaran Prostat Jinak

“…15 Pengukuran volume post void residu (PVR) urine dilakukan dengan mengukur volume kandung kemih pasien setelah miksi. 5,21 Gambar 3. Pengukuran volume post void residu (PVR) urine dengan ultrasonografi transabdominal.…”

“…Pengukuran volume post void residu (PVR) urine dengan ultrasonografi transabdominal. 21 Pada pemeriksaan ultrasonografi, kalsifikasi tampak sebagai fokus hiperechoic yang kadang disertai dengan posterior enhancement. Pada pemeriksaan CT scan, kalsifikasi prostat tampak sebagai fokus hiperdens pada parenkim prostat.…”