Navigating the Diagnostic Maze: Unraveling the Non-invasive Evaluation of Bladder Outlet Obstruction in Men—a Comprehensive Systematic Review

Purpose of Review: Bladder outlet obstruction (BOO) encompasses the diagnosis of obstructive urinary flow accompanied by increased detrusor pressure. It can contribute to renal function deterioration, recurrent urinary tract infections, and potentially acute urine retention. While the diagnosis of BOO plays a critical role in clinical management and decision-making, a consensus on the precise evaluation remains elusive. This study aimed to comprehensively review non-invasive methods for diagnosing BOO, primarily in cases related to benign prostatic hyperplasia. Recent Findings: A systematic literature review was conducted on PubMed from January 2016 to November 2022, focusing on non-invasive tests and lower urinary tract symptoms (LUTS) or bladder outlet obstruction (BOO) in men. A total of 2520 results were included, resulting in 1620 unique findings after removing duplicates. From these, 263 abstracts were thoroughly evaluated, leading to a detailed review of 80 full-text articles and their references. The review identified numerous cutting-edge technologies, primarily ultrasound-based, such as intravesical prostatic protrusion (IPP), bladder wall thickness (BWT), and detrusor wall thickness (DWT), among others. These advancements demonstrate promising sensitivity and specificity, positioning them as valuable tools for evaluating patients with BOO. Summary: Achieving an accurate diagnosis and implementing effective management strategies for BOO patients can lead to improved patient care, optimized resource allocation for those in need, and significant reductions in unnecessary expenditures. In the near future, a plethora of additional tools will become available, poised to enhance our diagnostic and prognostic approaches for patients with BOO.