Two- and three-dimensional ultrasonographic findings in urethral stenosis with bladder wall trabeculation: Case report

Female bladder outlet obstruction is uncommon. We report a case of bladder outlet obstruction secondary to urethral stenosis leading to bladder wall trabeculation. The patient presented at our clinic because of lower urinary tract symptoms including nocturia, urgency, bed wetting, hesitancy, straining to void, and incomplete emptying. Urodynamic study revealed a low maximum free uroflow rate, high residual urine volume, and low compliance on filling phase cystometry. Introital ultrasonography with two- and three-dimensional (2D and 3D) scanning displayed a constriction in the echolucent part of the lower-mid urethra with hyperechogenicity and a lattice-like appearance of the bladder wall. Cystourethroscopy confirmed urethral stenosis and bladder wall trabeculation. The voiding symptoms subsided after the urethral stenosis was relieved by urethral dilatation, but, despite some improvement, the irritative symptoms persisted. Introital ultrasonography with 2D and 3D scanning may help to clarify the cause of female bladder outlet obstruction.