If you have pain in your abdomen, pain when you pee and/or an inability to empty your bladder, you might have a bladder outlet obstruction (BOO). An obstruction means that something is blocking your pee at the neck of your bladder, right before it goes into your urethra. There are many possible causes, from scar tissue to prostate cancer. Treatments are available.
Bladder outlet obstruction (BOO) is when the neck at the very bottom of your bladder gets blocked. The neck is where your bladder connects to your urethra, which carries urine (pee) out of your body. A blockage stops or slows down the flow of pee. Possible blockages include scar tissue, bladder stones, a large gland, cancer or a tumor.
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Bladder outlet obstruction in utero is also called fetal bladder outlet obstruction or fetal lower urinary tract obstruction (LUTO). This rare condition is where a developing baby’s pee is blocked, which reduces the amount of amniotic fluid, increases the size of their bladder and can cause many other problems.
BOO is most common in those over age 65 and people designated male at birth (DMAB) and is often linked to prostate problems. More men than women get it. Women and people designated female at birth (DFAB) with cystocele (prolapsed bladder) are more likely to have a bladder outlet obstruction than other women. Children and babies, including developing fetuses, can also get BOO.
BOO is considered common. Men ages 50 to 60 have an 80% chance of having some degree of bladder outlet obstruction.
Your bladder is an organ that sits between your hip bones. It’s located above your urethra, below your kidneys. Urine from your kidneys drains down into your bladder, which can stretch to hold about 1.5 to 2 cups of pee.
Pain can be a symptom of BOO. You may feel pain in your lower abdomen, and/or pain when you pee.
There could be many possible reasons for BOO, including prostate cancer.
The causes of bladder outlet obstruction include:
Bladder outlet obstruction sometimes causes lower urinary tract symptoms (LUTS).
You may have BOO if you:
Tests may include:
The type of treatment depends on what’s obstructing your bladder. For example, bladder stones are treated differently than prostate cancer.
Some BOO blockages can be treated by:
It’s important to get treatment as soon as possible. If you don’t, there could be complications.
If the condition that blocks your bladder neck is preventable, then the bladder outlet obstruction might be preventable, too.
Talk to your healthcare provider about medications that could reduce your risk of the different conditions that cause an obstruction.
A urologist, who specializes in the genitourinary tract can help with your kidneys, bladder, adrenal glands, urethra, male fertility and reproductive organs. A gynecologist can help people designated female at birth with issues of pelvic organ prolapse.
Complications can happen if you don’t have your bladder outlet obstruction diagnosed and treated quickly. Complications include:
Your BOO-related symptoms should resolve with treatment. But bladder outlet obstruction can come back. In some cases, you may require surgery.
Unless the pain is unbearable, bladder outlet obstruction shouldn’t keep you from your normal daily activities.
Go to the emergency department if the pain is unbearable. This could be a sign of complications.
A note from Cleveland Clinic
If you have symptoms of a bladder outlet obstruction, don’t hesitate to see your healthcare provider. Pay attention to your pee. Is your urine stream normal? Or does very little pee come out, despite your fluid intake? Are you peeing slower than normal? Or do you have trouble starting to pee, no matter how hard you try? Are you in pain? All of these are reasons to get checked out by your healthcare provider to avoid kidney and bladder complications.
Last reviewed by a Cleveland Clinic medical professional on 02/09/2022.
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