Bladder outlet obstruction in women: Scope of the problem and differential diagnosis

Abstract

Introduction: The prevalence, formal definition, and diagnostic criteria of bladder outlet obstruction in owmen have not been clearly defined.

Methods: This is a literature review of the definition of BOO in women, its prevalence, as well as its differential diagnosis.

Results: The main causes of BOO in women are divided into functional and anatomic conditions. Functional etiologies include detrusor external sphincter dyssynergia, dysfunctional voiding, Fowler's syndrome, and primary bladder neck obstruction. Anatomic causes can be further divided into extrinsinc and intrinsic conditions. Intrinsic etiologies include urethral stricture and urethral diverticula, whereas extrinsic causes comprise pelvic organ prolapse, post anti-incontinence surgery, and Skene's gland cyst or abscess.

Conclusions: There are multiple etiologies to BOO in women, and this condition is most probably underdiagnosed, owing to a lack of consensus for a standard definition.

Keywords: Fowler's syndrome; bladder outlet obstruction; detrusor external sphincter dyssynergia; dysfunctional voiding; primary bladder neck obstruction; urethral stricture.