The Role of Bladder Trabeculation as a Diagnostic Indicator in the Assessment of Bladder Outlet Obstruction

Introduction: Bladder trabeculation is a morphological marker of detrusor hypertrophy, hypothesized to correlate with bladder outlet obstruction (BOO). This study investigates the prevalence, severity, and clinical implications of BOO in patients with and without LUTS.Methods: A prospective observational study included 96 patients divided into Group 1 (Patient presenting for treatment of BOO symptoms) (BOO, n = 44) and Group 2 (Patient presenting for treatment of some other urological conditions) (non-BOO, n = 52). Trabeculation was graded via urethro-cystoscopy (Grade 0–3). Follow-up revealed previously unreported BOO symptoms in Group 2 patients with trabeculation.Results: Trabeculation prevalence was significantly higher in Group 1 (70.5% vs. 25.0%, p < 0.001). BOO patients exhibited 7.2-fold higher odds of trabeculation (95% CI: 2.98–17.32). On follow-up, all patients who were initially in Group 2 (non-BOO) with trabeculation (13/13) reported BOO/LUTS symptoms, suggesting underdiagnosis. Severe trabeculation (Grade 3) remained exclusive to Group 1.Conclusion: By this study, we re-confirm that bladder trabeculation strongly associates with Bladder outlet obstruction. Incidental trabeculation in asymptomatic patients may indicate an undiagnosed Bladder Outlet Obstruction, warranting thorough clinical evaluation.