Obstruction that interferes with voiding may be caused by lesions of the bladder outlet or urethra, by enlargement of the prostate in men, by ureteral stricture disease, or by contraction of the bladder neck.
Symptoms. Symptoms include hesitancy, intermittency, straining to void, post-void dribbling, poor force and volume of stream, and sensation of incomplete emptying. Urinary retention may be due to outflow obstruction or to weakness of the detrusor muscle. Neurologic dysfunction due to spinal cord injury, neurologic diseases, and diabetes mellitus with resultant neuropathy is a common cause of inadequate bladder emptying.
Diagnosis. While these symptoms most commonly reflect the presence of some obstruction, other abnormalities such as weakness of the detrusor muscle can produce similar voiding patterns. Incomplete emptying of the bladder judged subjectively by the patient can be established objectively by urodynamic testing.
Treatment. Treatment is directed to relieving the cause of the blockage and may include the use of medications and/or surgical intervention.