A bladder neck obstruction affects the group of muscles that connect from the bladder to the urethra. These muscles are responsible for holding in urine and releasing it when appropriate. When the bladder neck becomes obstructed, urine flow can be disrupted. 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.
If treatment is postponed for a bladder neck obstruction, the muscles can become weak, which results in a slew of complications that will be outlined in greater detail further down. The takeaway message is that if you suspect a bladder neck obstruction, you should contact your doctor right away to be treated.
Bladder neck obstruction symptoms
Symptoms of a bladder neck obstruction can be similar in both men and women. 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 obstruction?
The most common cause of a bladder neck obstruction is an enlarged prostate, which is why this condition is seen more commonly among men. When the prostate becomes enlarged, it begins to press against the urethra, which restricts urine flow. In some cases, the obstruction can be so severe that no urine will be released at all.
A bladder neck obstruction may be a result of surgery or radiation treatment that is used to treat prostate cancer. This occurs as a result of scar tissue from these procedures.
They are not as common in women as in men, but some causes for a bladder neck obstruction in women include older age, menopause, experiencing a difficult child delivery, and multiple births.
In rare cases, a bladder neck obstruction can be the result of a genetic flaw where the structure of the bladder and surrounding muscles lead to an obstruction.
Complications can arise when a bladder neck obstruction is not treated. They include urinary tract infections, kidney damage, bladder diverticula—where bulging patches form in the bladder, and long-term incontinence, meaning the patient deals with constant urine leaks.
Diagnosis of urinary bladder neck obstruction
The first step to properly diagnosis a bladder neck obstruction is for your doctor to review your symptoms. They may ask you questions regarding your urinary habits including frequency and urgency. To confirm their suspicion, your doctor will run a series of tests which include:
Video urodynamics: X-rays and ultrasounds take detailed pictures of the bladder and surrounding muscles. A catheter is inserted into the bladder to fill it up with fluid and then your doctor will ask you to cough to see if any urine comes out.
Cystoscopy: A cystoscope is a long thin tube with a camera on the end which is inserted into the urethra to look at the patient’s bladder and muscles. The doctor may also fill the bladder to see how your bladder stretches and functions.
Bladder neck obstruction treatment
Treatment of bladder neck obstruction is dependent on the cause of the obstruction and the severity. There are a variety of treatments that your doctor can recommend depending on your own situation. Treatments of bladder neck obstructions include:
- Medications including alpha-blockers (prazosin, phenoxybenzamine) to relax the bladder muscles
- Surgery to relieve pressure from the blockage and treat the underlying cause of the obstruction
- Self-cauterization to relieve pressure or to drain the bladder through the abdomen
The key to living well with a bladder neck obstruction is for diagnosis to occur early on and to undergo treatment. The earlier treatment occurs the better the prognosis can be.