Overflow incontinence residual volume11/5/2023 TREATMENT FOR BLADDER OUTLET OBSTRUCTION (BOO)Īdvice should be sought from the doctor or Bladder & Bowel Service for those with symptoms identified as a result of possible bladder outlet obstruction or underactive detrusor. Haylen BT, de Ridder D, Freeman RM, Swift SE, Berghmans B, Lee J, Monga A, Petri E, Rizk D, Sand PK, Schaer GK An International Urogynecological Association (IUGA) / International Continence Society (ICS) joint report on the terminology for female pelvic floor dysfunction. The side-effects of various medication one example being overactive bladder medication This may occur in patients with spinal cord injury or multiple sclerosis for example.įollowing childbirth, first few hours or days post-deliveryįollowing the removal of an indwelling catheter Examples are diabetes and spina bifida.ĭetrusor sphincter dyssynergia describes ‘incoordination between detrusor and sphincter during voiding due to a neurological abnormality’. Underlying conditions affecting the nerve supply to the bladder may result in a reduced or absent detrusor contraction for bladder emptying. Other causes include scar tissue in the urethra causing stricture or stenosis, bladder stones, and tumours in the rectum, uterus or cervix.ĭamage to the urethra can occur during catheterisation.Ī full rectum can cause direct pressure on the urethra.ĬONTRIBUTING FACTORS IN UNDERACTIVE DETRUSOR In females this may be due to prolapse causing anatomical changes which obstruct the bladder neck, or less commonly following some surgical procedures to alleviate urine leakage. In male patients obstruction may be caused by an enlarged prostate gland. ‘The treatment of female bladder outlet obstruction’, BJUI International, Vol 98, Issue s1, pages 17-23ĬONTRIBUTING FACTORS IN BLADDER OUTLET OBSTRUCTION (BOO) Patients may be referred for further investigations such as Uroflowmetry or Urodynamics.Goldman HB and Zimmern PE, 2006. Urinalysis or MSU to be considered if suspicious of urinary tract infection (UTI). This should be completed for at least three days. This involves patients recording the time and volume of each void and the volume, type and time of fluid intake. Patients with LUTS should have abdominal palpation examination, a digital rectal examination to assess the prostate and assessment for post void residual urine which could include a palpable or percussible bladder or alternatively use of a bladder scanner.Ī bladder diary is very useful. Symptoms: Weak urinary flow, hesitancy, straining, reduced bladder sensation, abdominal distension with/without discomfort, nocturnal enuresis, recurrent UTI’s. This can lead to residual urine remaining inside the bladder. Underactive bladder is where the bladder muscle (detrusor) is unable to contract effectively and fully empty. Incomplete emptying / residual urine and dribbling are examples of post micturition symptoms. This group includes symptoms of voiding difficulty such as weak urinary flow, hesitancy and straining. Nocturia means increased voiding at night. In this group we find bladder problems like increased frequency, urgency, urgency incontinence and nocturia. LUTS can also affect women mainly by chronic constipation, obstruction from a pelvic organ prolapse or stricture. It is also often used to describe prostatism (a disorder resulting from obstruction of the bladder neck by an enlarged prostate gland) and therefore more commonly used for men who have lower urinary tract symptoms. LUTS are broadly grouped into obstructive symptoms or irritative symptoms. LUTS is a term used to describe a range of symptoms related to the Lower Urinary Tract (bladder, prostate and urethra). These symptoms are often described as lower urinary tract symptoms (LUTS). Overflow incontinence is the involuntary loss of urine when the bladder is unable to empty properly due to a bladder outflow obstruction (BOO) or an underactive detrusor muscle (UAB).
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