Trabeculation in BOO
Trabeculation refers to the muscular thickening and irregularity of the walls of the bladder, typically seen in patients with bladder outlet obstruction (BOO).
BOO is a condition where there is a blockage or obstruction that prevents the normal flow of urine out of the bladder. This obstruction can be caused by various factors, including an enlarged prostate in men, bladder stones, urethral strictures, or bladder neck contracture.
When the bladder outlet is obstructed, the bladder muscles have to work harder to push urine through the obstruction. Over time, this increased effort causes the bladder muscles to thicken and develop trabeculations. These trabeculations are ridges or folds in the bladder wall and are formed by hypertrophy (thickening) of the detrusor muscle fibers.
Trabeculation is a compensatory response of the bladder to increase its contractility and overcome the obstruction. However, it also leads to reduced bladder capacity and increased bladder instability. The irregularities in the bladder wall can also create spaces where urine can pool and form bladder diverticula or pockets.
Trabeculation in BOO is typically identified through various diagnostic tests such as cystoscopy, urodynamic studies, and imaging tests like ultrasound or MRI. Treatment of BOO usually involves addressing the underlying cause of the obstruction, such as medications for an enlarged prostate or surgery for urethral strictures. In severe cases, where the bladder muscles are severely trabeculated, surgical intervention may be required to remove the obstructing tissue and improve bladder function.