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Bladder Outlet Obstruction and Overactive Bladder in Males

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Non-Neurogenic Bladder Dysfunctions

Part of the book series: Urodynamics, Neurourology and Pelvic Floor Dysfunctions ((UNPFD))

Abstract

Bladder outlet obstruction (BOO) is a pathological condition characterized by obstruction during voiding, increased detrusor pressure associated to reduced urine flow rate. OAB is defined as urinary urgency, usually with frequency and nocturia, with or without urgency urinary incontinence. In males, there is often an overlap of these two pathological conditions (up to 50%), clinically represented by the coexistence of urinary symptoms of both storage and voiding phase. The proposed pathophysiological mechanisms underlying the development of OAB in males with BOO include the myogenic, neurogenic and urothelial factors. Diagnosis is based on history, physical examination, validated questionnaires, bladder diary, post-void residual urine, and noninvasive urodynamics such uroflowmetry. Invasive urodynamics is the most accurate investigation for these males, but it is not routinely scheduled. Management comprises conservative approach as a first step in males with mild symptoms. Pharmacological therapy, mono- or combination therapy, is usually administered. Surgical procedures are indicated in males’ refractory to first-line therapy or with severe urinary symptoms and/or clinical condition.

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  1. Department of Urology, A.O.U.I. Verona, Verona, Italy

    Emanuele Rubilotta

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  1. Department of Urology, Azienda Ospedaliera Universitaria Integrata di Verona, Verona, Italy

    Matteo Balzarro

  2. Unit of Minimally Invasive, Robotic Urologic Surgery and Kidney Transplantation, Department of Experimental Medicine, Careggi Hospital, University of Florence, Florence, Italy

    Vincenzo Li Marzi

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Rubilotta, E. (2021). Bladder Outlet Obstruction and Overactive Bladder in Males. In: Balzarro, M., Li Marzi, V. (eds) Non-Neurogenic Bladder Dysfunctions. Urodynamics, Neurourology and Pelvic Floor Dysfunctions. Springer, Cham. https://doi.org/10.1007/978-3-030-57393-5_6

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