Bladder outlet obstruction (BOO), or bladder neck obstruction, is a type of urinary blockage at the base of the bladder neck—a group of muscles connecting the bladder to the urethra. This kind of lower urinary tract obstruction decreases or stops urine flow into the urethra, which is the tube that carries urine from the body.

Bladder Outlet Obstruction can occur in both women and men at any age; however, this bladder blockage is more likely to affect men over age 50 with an enlarged prostate. Without the proper treatment, the bladder can become permanently weakened, which may lead to kidney damage, urinary tract infections, bladder diverticula, and long-term lack of bladder control—also called an overactive bladder.

Causes of Bladder Outlet Obstruction

An enlarged prostate, or benign prostatic hyperplasia (BPH), is one of the main causes associated with bladder neck obstruction.

The prostate is a male reproductive gland that surrounds the urethra. When the prostate becomes swollen, this restricts urine flow. The urinary obstruction can grow so severe that it leads to urinary retention. In other words, no urine is able to empty from the bladder.

Bladder Outlet Obstruction can also result from radiation treatment for prostate cancer or as a side effect of prostate removal surgery. Urethral stricture (scar tissue) from each procedure can lead to bladder neck blockage.

In women, bladder outlet obstruction can develop when the bladder (cystocele) and urethra (urethral diverticula) descend into the vagina, often due to a weakened vaginal wall. This sometimes results from multiple births, a difficult delivery, menopause, or advanced age.

In some cases, a genetic flaw in bladder structure or its surrounding connective tissues and muscles may even cause this urinary obstruction. Other potential causes of bladder outlet obstruction include bladder stones, bladder tumors (cancer), and pelvic tumors (cervix, prostate, uterus, rectum etc).

Symptoms

Women and men with bladder outlet obstruction have similar symptoms. Lower urinary tract symptoms involve the urinary sphincter, urethra, bladder, and prostate in men. The preferred term for lower urinary tract symptoms in men is prostatism.

Some of these symptoms include:

• Incomplete bladder emptying,
• Trouble starting urine stream,
• Irregular urine output,
• Increased urinary urgency,
• Excessive nighttime urination,
• Continuous feeling of a full bladder,
• Inability to control the urge to urinate,
• Pain during urination,
• Abdominal pain,
• Pelvic pain, especially in men.

The patient may even experience urinary tract infections or slow urination.

Complications of Bladder Outlet Obstruction

In addition to lower urinary tract symptoms, those with bladder outlet obstruction may experience other complications, for example:

• Bladder stones,
• Bladder wall damage,
• Kidney dysfunction,
• Urinary tract infections,
• Blood in the urine,
• Involuntary loss of bladder control (urinary incontinence),
• Acute and chronic urinary retention,
• Erectile dysfunction in men,
• Acute and chronic kidney failures.

Diagnosis

First of all, get a full picture of symptoms since signs of bladder outlet obstruction are often similar to several other conditions as explained above.

To help make the correct diagnosis, use video urodynamics—a series of tests that help evaluate bladder function. During this process, an ultrasound or X-rays help detail real-time images of the bladder.

A catheter is then inserted into the bladder to empty urine and later fill the bladder with fluid. When the bladder is full, aske the patient to cough and urinate. Images then allow the doctor to observe bladder outlet obstruction during the bladder filling and emptying.

A cystoscopy is another diagnostic method that uses a cystoscope device to look inside the bladder and determine whether the urethra has narrowed.

Other diagnostic tests that help determine bladder outlet obstruction include uroflowmetry that determines how fast urine flows from the body, urinalysis to check for blood or infections in the urine, urine cultures that check for infections, and blood chemistries that look for kidney damage signs.

Allopathic Treatments for Bladder Outlet Obstruction

The allopathic treatment for bladder outlet obstruction will depend on its cause.

In allopathic treatment most of the time, surgery is needed for long-term bladder outlet obstruction, it involves making an incision in the bladder neck. A resectoscope is then inserted through the urethra to view the bladder neck, and an instrument attached to the device will then make a small incision into the bladder neck wall.

Although surgery doesn’t treat the cause of bladder outlet obstruction, it does relieve pressure from the bladder blockage to help with the symptoms.

If the incision doesn’t improve symptoms or the bladder neck obstruction is severe, open surgery may be needed to reconnect the bladder neck to the urethra.

That being said, many of the conditions that cause bladder outlet obstruction can be treated with medications or natural remedies before surgery is necessary.

The first step in treating bladder outlet obstruction is the use of alpha-blockers like phenoxybenzamine or prazosin, which help the bladder muscles relax.

Other times, self-catheterization will be needed alongside alpha-blockers. Self-catheterization is a painless procedure that helps empty urine from the bladder.

From a natural perspective, Homeopathic medicines and/or herbal supplements that help and treat bladder outlet obstruction due to BPH include saw palmetto and stinging nettle root etc.

Research also shows that urinary flow rate gradually improves significantly with pumpkin seed oil in enlarged prostate patients after six months of treatment.

Homeopathic Treatment of Bladder Outlet Obstruction

For the treatment of bladder outlet obstruction, homeopathic medicines are prescribed only on the basis of TOTALITY OF SYMPTOMS with a clear-cut identification of disease and its cause(s).

Here are few homeopathic medicines for bladder outlet obstruction with good and promising results:

Chimaphila Umbellata

Acute prostatitis with dysuria and retention, sensation in perineum as if sitting on a ball. Constant pain in region of kidneys; urine scanty, dark, fetid, thick, with copious sediment. Strangury: constant desire to urinate. Cutting, scalding pain, divided stream; stricture. Urethritis with purulent or profuse mucous discharge. Great quantities of thick, ropy, bloody mucus in urine. Greenish-black urine. Urine scanty; frequently voided, pressing pain before, burning prickling, scalding and smarting during and after, and vesical tenesmus. Albuminuria; hematuria, from long-lasting gonorrhea; clots of coagulated blood pass with urine. Renal dropsy.

Smarting from neck of bladder the whole length of urethra to meatus; excessive itching. Prolapsus and slight uterine leucorrhea. Vaginal prolapsus.

Urtica dioica

diabetes and osteoarthritis. It is also sometimes used for urinary tract infections (UTIs), kidney stones, enlarged prostate, hay fever, and other conditions, but there is no good scientific evidence to support these uses. Arthritis, osteoarthritis, Gout. Seasonal allergies, Asthma. Anemia. Baldness. It increases breast milk and its quality. Skin allergies, acne, rashes. Acts as Analgesic. Brutal nails. Benign prostatic hyperplasia (BPH)

Apis Melifestida

Burning and soreness when urinating. Suppressed, loaded with casts; frequent and involuntary; stinging pain and strangury; scanty, high colored. Incontinence. Last drops burn and smart. Edema of labia.

Berberus Vulgaris

Burning pains. Sensation as if some urine remained after urinating. Urine with thick mucus and bright-red, mealy sediment. Bubbling, sore sensation in kidneys. Pain in bladder region. Pain in the thighs and loins on urinating. Frequent urination: urethra burns when not urinating.

Contraction and tenderness of vagina. Burning and soreness in vagina. Desire diminished, cutting pain during coition.  Leucorrhea, grayish mucus, with painful urinary symptoms.

Pareira Brava

Black, bloody, thick mucus urine. Constant urging; great straining; pain down thighs during efforts to urinate. Can emit urine only when he goes on his knees, pressing head firmly against the floor. Feeling of the bladder being distended and neuralgic pain in the anterior crural region. Dribbling after micturition. Violent pain in glans penis. Itching along urethra; urethritis, with prostatic trouble. Inflammation of urethra; becomes almost cartilaginous.

Selenium Metallicum

Sensation in the tip of urethra as if a biting drop were forcing its way out. Involuntary dribbling. Dribbling of semen during sleep. Dribbling of prostatic fluid. Irritability after coitus. Loss of sexual power, with lascivious fancies. Increases desire, decreases ability. Semen thin, odorless. Sexual neurasthenia. On attempting coition, penis relaxes. Hydrocele.

Clematis Erecta

Tingling in urethra lasting sometime after urinating. Frequent, scanty urination; burning at orifice. Interrupted flow. Urethra feels constricted. Urine emitted drop by drop. Inability to pass all the urine, dribbling after urinating. Pain worse at night, pain along the spermatic cord. Commencing stricture. Straining is needed to pass urine. Flow of urine is also interrupted. Urine frequency is increased with continual desire to pass water. Urine is scanty and is sometimes emitted drop by drop.

Arsenicum Album

Scanty, burning, involuntary. Bladder as if paralyzed. Albuminous. Epithelial cells; cylindrical clots of fibrin and globules of pus and blood. After urinating, feeling of weakness in abdomen. Bright’s disease. Diabetes.  Leucorrhea, acrid burning.

Conium Maculatum

Much difficulty in voiding. It flows and stops again. Interrupted discharge. Dribbling in old men. Pain of sharp, pressing, stitching nature may be present in the bladder. Pressure is also felt in neck of bladder, and it tends to get worse while walking, and better when sitting. There may be a constant urge to urinate in addition to the above symptoms. Induration of os and cervix. Ovaritis; ovary enlarged, indurated; lancinating pain.

Ledum Palustre

Burning in urethra after urinating. Stream of urine frequently stops during its flow. Frequent want to urinate, with scanty emission. Diminished secretion of urine. Frequent and copious emission of urine. Swelling of urethra. Inflammation of the glans. Inflammatory swelling of penis; the urethra is almost closed.

Arnica Montana

Tenesmus. Spasmodic retention of urine, with pressure in the bladder. Ineffectual attempts to make water. Involuntary emission of urine, at night in bed, and in the day, when running. Frequent micturition of pale urine. Urine of a brownish red, with sediment, of a brick color. Emission of blood.

Cantharis

Retention of urine, with cramp-like pains in the bladder. Urgent and ineffectual efforts to make water, with painful emission, drop by drop. Difficult emission of urine, weak and scattered stream. Urine, pale yellow, or of a deep red color. Flow of sanguineous mucus from the bladder. Emission of blood, drop by drop. Purulent urine. Burning smarting, on making water. Incisive pains in the front part of the urethra, during the emission of urine, and afterwards. Sharp, tearing, and incisive pains, successive Pullings and pulsations in the urinary organs. Burning, stinging and tearing in the kidneys. Pressing pain in the kidneys, extending to the bladder; along the ureters; relieved by pressing upon the glans. Inflammation and ulceration of the kidneys, of the bladder, and of the urethra. Exceedingly painful sensibility of the region of the bladder on its being touched.

Hyoscyamus Niger

Retention of urine, with pressure in the bladder. Retention of urine in childbed. Frequent want to make water, with scanty emission. Urine copious and clear, like water. Involuntary emission of urine, as from paralysis of the bladder.

Male Sexual Organs. Increase of sexual desire, lascivious; exposes his person. Impotence. Lascivious, uncovers sexual parts. Lascivious furor, without modesty. Catamenia more abundant. Suppression of the catamenia. Suppressed lochia. Spasms of pregnant women, especially during parturition. Metrorrhagia, of a bright-colored blood. Metrorrhagia, the blood pale, with convulsions. During the catamenia, delirium, flux of urine, sweat and convulsive trembling. Before the catamenia, hysterical cramps and fits of laughter. During the menses, convulsive trembling of the hands and feet; severe headache; profuse perspiration.

Merc Solubilis

Urine acrid; turbid; too frequent; complaints while passing, and after. Affections of urethra. Polyuria day and night, sometimes with abortive efforts, or with scanty emission. The stream of urine is excessively small. Irresistible, sudden desire to urinate. Frequent and copious emission of urine, as in diabetes, with great emaciation. Involuntary emission of urine. Urgent want to urinate, with incontinence of urine. The quantity of urine emitted is greater than the quantity of fluid drunk.

Wetting the bed at night. Emission of urine drop by drop. Urine of a deep color, or red, or brown, or white, as if mixed with flour or chalk, or of the color of blood. Offensive, turbid urine, which forms a sediment (sanguineous, pungent, or sour-smelling urine). Corrosive and burning urine. White and flock-like clouds in urine (or as if containing pus; scanty, fiery red). Emission of hard mucus, or of flocks, and white threads during or after the emission of urine. Discharge of blood from urethra. Incisive and contractive pains in renal region, at night. Pulsation, incisive pains, burning and shooting in urethra, even when not urinating. Inflammation of orifice of urethra, and discharge of thick, yellowish, or serous, whitish matter. Thick greenish (or yellow) discharge from urethra, more at night, (gonorrhea) with phimosis; chancroids. Increase of sexual desire, and great lasciviousness, with frequent erections and pollutions.

Erections: little boys may have this, lasting all night, causing emaciation; boys often pull and tear at the prepuce all the time, which may cause great emaciation, and result in death; adults often have this pulling, a kind of itching being the cause, and a feeling as if he “must do so”; collection of smegma behind glans. Total loss of sexual power or painful nocturnal erections, and sometimes sanguineous pollutions. Voluptuous itching, tingling, tearing, and shooting in glans and prepuce. Puffing, or inflammatory swelling of prepuce, sometimes with burning pain, fissures, rhagades, and eruptions.

Burning in urethra during coitus. Purulent secretion between prepuce and glans, sometimes with swelling, heat, and redness of front part of penis. Swelling of the lymphatic vessels along the penis. Vesicles and phagedenic ulcers (chancres) with lard-like, or cheesy, bases, and raised margin, on glans and prepuce. Sensation of coldness in testes. Testes, hard and swollen, with shining redness of scrotum, and dragging pain in testes and spermatic cords. Itching, tingling, and shooting in testes. Profuse perspiration of parts when walking. Excoriation between the parts and thighs. Sloughing of scrotum.

Suppression of catamenia. Catamenia too copious, with uneasiness and colic. Metrorrhagia. Discharge of blood in an old woman. Congestion of blood to uterus. Leucorrhea in general; complaints concomitant to leucorrhea. Hard tubercles on labia majora. Itching pimples, and nodosities in labia. Itching of genitals. Inflammatory swelling in vagina, with a sensation as if it were raw and excoriated.

Swelling of labia, with heat, hardness, shining redness, great sensitiveness to touch, and burning, pulsative, and shooting pains. Prolapsus uteri & vaginae; Sterility with too profuse menstruation. Easy coitus and certain conception.

Belladonna

Polyuria, Retention of urine. Difficult discharge of urine (and then discharge of a few drops of bloody urine only). Continual dribbling of urine. With urination, feces escape. Frequent urination, copious, pale, and watery, sometimes with profuse perspiration, thirst, increased appetite, diarrhea, and obscuration of sight. Incontinence and involuntary emission of urine, even in the night and during sleep. Nocturnal pressure in the bladder. Paralysis of the neck of the bladder. Strictures of the urethra. Urine turbid, of a yellow color, or clear, the color of gold or citron; or scanty and of a brownish red color, or the color of blood, or a bright red color. Red, or whitish and thick sediment in the urine. Sensation of motion in the bladder, as of a worm. Shooting, burning pains in the renal region.

Sharp and drawing pain in the spermatic cords, chiefly while making water. Retraction of the prepuce. Soft and painless nodosity in the glans. Shootings in the testes, which are drawn up. Inflammation of the testicles, great hardness in the drawn-up testicles. Pollutions, with flaccidity of the penis. Nocturnal sweat of the genital parts. Flow of prostatic fluid. Sexual desire diminished, with perfect indifference to all voluptuous excitement.

Violent pressure towards the genital parts, as if all were going to protrude, principally when walking, or when in a crouching posture. Shooting in the internal genital parts. Great dryness of the vagina. Prolapsus and induration of the matrix. Catamenia too copious, and too early, or too tardy. Catamenia too pale. Before the catamenia, fatigue, colic, loss of appetite, and confused sight. During the catamenia, nocturnal sweat on the chest, with yawning and transient shivering, colic, or anguish of heart, burning thirst, sharp and cramp-like pains in the back and in the arms. Flow of blood beyond the period of the catamenia. Flow of blood between the periods.

Menstrual discharge bright red, feeling very hot like hot sealing-wax. Metrorrhagia of clear red blood, with a discharge of fetid clots; with violent pain in the small of the back and bearing down. Menstrual blood of bright color, or of a bad smell. Leucorrhea with colic. Diminished lochia. Spasmodic contraction of the uterus. Labour pains too distressing, spasmodic; too weak, or ceasing. After-pains. Congestion and inflammation of the uterus and labia. Stitches in the organs. Puerperal fever, nymphomania. Flow of milk from the breast. Mammae swelled, inflamed, or indurated.

Sepia Officianalis

Red, adhesive, sand in urine. Involuntary urination, during first sleep. Chronic cystitis, slow micturition, with bearing-down sensation above pubis.

Organs cold. Offensive perspiration. Gleet; discharge from urethra only during night; no pain. Condyloma surround head of penis. Complaints from coition.

Pelvic organs relaxed. Bearing-down sensation as if everything would escape through vulva, must cross limbs to prevent protrusion, or press against vulva. Leucorrhea yellow, greenish; with much itching. Manses Too late and scanty, irregular; early and profuse; sharp clutching pains. Violent stitches upward in the vagina, from uterus to umbilicus. Prolapse of uterus and vagina. Morning sickness. Vagina painful, especially on coition.

Kreosotum

Offensive. Violent itching of vulva and vagina, worse when urinating. Can urinate only when lying; cannot get out of bed quick enough during first sleep. Dreams of urinating. Enuresis in the first part of night. Must hurry when desire comes to urinate.

Corrosive itching within vulva, burning and swelling of labia; violent itching between labia and thighs. During menses, difficult hearing; buzzing and roaring; eruption after. Burning and soreness in external and internal parts. Leucorrhea, yellow, acrid; odor of green corn; worse between periods. Hemorrhage after coition. Menses too early, prolonged. Vomiting of pregnancy, with ptyalism. Menstrual flow intermits; ceases on sitting or walking; reappears on lying down. Pain worse after menses. Lochia offensive; intermits.

Lycopodium Clavatum

Pain in back before urinating; ceases after flow; slow in coming, must strain. Retention. Polyuria during the night. Heavy red sediment. Child cries before urinating.

Impotence. Premature emission. Enlarged prostate. Condylomas.

Menses too late; last too long, too profuse. Vagina dry. Coition painful. Right ovarian pain. Varicose veins of pudenda. Leucorrhea, acrid, with burning in vagina. Discharge of blood from genitals during stool.

Borax

Hot, smarting pain in orifice. Pungent smell. Child afraid to urinate, screams before urinating. Small red particles on diaper.

Labor pains with frequent eructation. Galactorrhea. In nursing, pain in opposite breast. Leucorrhea like white of eggs, with sensation as if warm water was flowing. Manses too soon, profuse, with griping, nausea and pain in stomach extending into small of back. Membranous dysmenorrhea. Sterility. Favors easy conception. Sensation of distention in clitoris with sticking. Pruritus of vulva and eczema.

Baryta Carbonica

Baryta Carb is indicated for managing dribbling at end of urination in cases of bladder neck obstruction. Urinary frequency is increased with inability to retain urine. Much urine is passed at nighttime. Burning may be present while urinating.

Copaiva Officinalis

Mostly indicated for retention with pain in the bladder, anus and rectum. There is burning pressure with painful urination by drops. Given when there is constant desire to urinate.

Causticum

Involuntary when coughing, sneezing. Expelled very slowly, and sometimes retained. Involuntary during first sleep at night; also, from slightest excitement. Retention after surgical operations. Loss of sensibility on passing urine.

Important Tips to Help Keep Your Bladder Healthy

To help prevent bladder outlet obstruction, there are a number of things you can do to help keep your bladder healthy.

Below are some natural tips to prevent this and other related bladder problems.

Double-void urination: To help with urinary symptoms, double-void at night. This means you urinate twice before bed. Go to the bathroom, brush your teeth and finish your bedtime routine, and urinate once more before going to bed.

Schedule bathroom trips: To help retrain the bladder, keep a daily diary of trips to the bathroom and urinary urges. When you figure out how many times you go to the bathroom daily, you can schedule your trips to help improve bladder control.

Watch water intake: Although it is important to drink enough water, too many liquids before bed will increase the need to urinate at night. Try not to drink liquids after 5:00 p.m. or 6:00 p.m. if you suffer from bladder problems.

Avoid dietary triggers: Foods that contribute to bladder problems include caffeinated beverages, alcohol, artificial sweeteners, milk and dairy products, spicy foods, soda and other carbonated beverages, citrus juices and fruits, and white sugar and high-sugar foods.

Quit smoking: Smoking irritates the bladder and increases bladder cancer risk.

Try Kegel exercises: Kegel exercises involve tightening the pelvic muscles as when you hold in your urine. They can be done anywhere, and when performed regularly, they can help an overactive bladder. If you feel an urge to urinate, doing a Kegel will help settle the bladder until you get to the bathroom.

P. S: This article is only for doctors having good knowledge about Homeopathy and allopathy, for learning purpose(s).

For proper consultation and treatment, please visit our clinic.

None of above-mentioned medicine(s) is/are the full/complete treatment, but just hints for treatment; every patient has his/her own constitutional medicine.

To order medicine by courier, please send your details at WhatsApp– +923119884588

Dr. Sayyad Qaisar Ahmed (MD {Ukraine}, DHMS), Abdominal Surgeries, Oncological surgeries, Gastroenterologist, Specialist Homeopathic Medicines.

  Senior research officer at Dnepropetrovsk state medical academy Ukraine.

Location:  Al-Haytham clinic, Umer Farooq Chowk Risalpur Sadder (0923631023, 03119884588), K.P.K, Pakistan.

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