A bladder outlet obstruction (BOO) is a blockage at the neck of your bladder. This slows or stops pee right before it goes into your urethra. It may cause pain in your abdomen, pain when you pee and/or an inability to empty your bladder. This condition has many possible causes, from scar tissue to prostate cancer. Treatments are available.
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Bladder outlet obstruction (BOO) is a blockage in the neck at the very bottom of your bladder. The neck is where your bladder connects to your urethra, which carries urine (pee) out of your body. A urinary tract blockage stops or slows down the flow of pee.
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BOO is most common in people over age 65 and males. Possible urinary blockages include scar tissue, bladder stones, an enlarged prostate gland or prostate cancer. Women 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.
Rarely, a developing fetus can get bladder outlet obstruction in utero. Other names for this are fetal bladder outlet obstruction or fetal lower urinary tract obstruction (LUTO). When a fetus’s pee is blocked, it increases the size of their bladder and can cause kidney issues and other problems.
Bladder outlet obstruction can cause symptoms of urinary tract obstruction. The name for these is lower urinary tract symptoms (LUTS).
You may have a urinary blockage if you:
An enlarged prostate gland (benign prostatic hyperplasia or BPH) is a common cause of bladder outlet obstruction.
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But many different things can cause a bladder outlet obstruction, like:
Risk factors for bladder obstruction include:
It’s important to treat a urinary tract blockage as soon as possible to prevent complications. Without prompt diagnosis and treatment, you may have complications like:
A healthcare provider will perform a physical exam to diagnose bladder outlet obstruction. They’ll also want to know about your medical history and what you’ve been experiencing. They’ll ask you questions like:
Tests to diagnose bladder outlet obstruction may include:
The type of treatment you get depends on what’s causing the urinary blockage. For example, a healthcare provider will use different treatments for bladder stones than for prostate cancer. For some people, medications like alpha-blockers or finasteride improve bladder outlet obstruction. For others, physical therapy or a pessary (device to support a woman’s pelvic organs) may help with bladder obstruction.
Procedures or surgeries for bladder outlet obstruction may include:
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Many of these urological surgeries are minimally invasive. That means you can expect a shorter hospital stay and a quicker recovery. Recovery time varies by procedure.
While waiting for treatment to fix bladder outlet obstruction, you may be able to unblock urine flow at home. You can learn to use a catheter to empty your bladder (self-catheterization). If you have a penis, you may get a better urine (pee) flow by sitting down to pee. Or you may be able to pass more pee by leaning forward for 30 seconds before trying to pee again.
Go to the emergency department if the pain from a urinary tract blockage is unbearable. This could be a sign of complications. You should also seek immediate help if you can’t pass pee or have a urinary tract infection.
If you’ve had surgery, you’ll need follow-up appointments with your provider. After you’ve recovered, contact your provider if you have problems peeing again.
You may want to ask your healthcare provider:
Unless the pain is unbearable, bladder outlet obstruction shouldn’t keep you from your normal daily activities.
It’s comforting to know that healthcare providers can treat most cases of bladder outlet obstruction. Your BOO-related symptoms should go away with treatment. But bladder outlet obstruction can come back. In some cases, you may need surgery.
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The cause of a bladder outlet obstruction affects your prognosis (outlook). It’s different for each case.
It’s frustrating to have a hard time emptying your bladder. But you don’t have to accept it. Treatments can help many people with this condition. If you have symptoms of bladder outlet obstruction, don’t hesitate to see your healthcare provider. Prompt treatment can help you avoid kidney and bladder complications.
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It can be stressful (and painful) to have bladder disorders, like urinary incontinence or cystitis. But the urology providers at Cleveland Clinic are here for you.
Last reviewed on 06/30/2025.
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