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.