Underactive bladder: Pathophysiology and clinical significance

Underactive bladder (UAB) is a voiding disorder which generates disabling lower urinary tract symptoms (LUTS) due to the inability to produce an effective voiding contraction sufficient to empty the bladder. The underlying abnormality, that is usually appreciated when performing urodynamic studies, has been defined by the International Continence Society (ICS) as detrusor underactivity (DUA). DUA is a common yet under-researched bladder dysfunction. The prevalence of DUA in different patient groups suggests that multiple aetiologies are implicated. Currently there is no effective therapeutic approach to treat this condition. An improved understanding of the underlying mechanisms is needed to facilitate the development of new advances in treatment. The purpose of this review is to discuss the epidemiology, pathophysiology, common causes and risk factors potentially leading to DUA; to aid in the appropriate diagnosis of DUA to potentially improve treatment outcomes.

• Publication year

  2017

• Venue

  Asian Journal of Urology

• Publication date

  2017-04-13

• Fields of study

  Medicine

• Identifiers
  DOI 10.1016/j.ajur.2017.02.003PMID 29379731PMCID 5780287
• External record

  Open on Semantic Scholar

• Source metadata

  Semantic Scholar, PubMed

• No claims are published for this paper.

• No concepts are published for this paper.

• Correlation Between Advanced Glycation End‐Products, Lower Urinary Tract Symptoms and Bladder Dysfunctions in Patients with type 2 Diabetes Mellitus

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• The underactive bladder: detection and diagnosis

  2016cited by this paper
• A hidden cause of neuropathic bladder: Sacral herpes zoster – A case report

  2016cited by this paper
• The underactive bladder: a new clinical concept?

  2015cited by this paper
• Epidemiology and demographics of the underactive bladder: a cross-sectional survey

  2014cited by this paper
• Detrusor underactivity and the underactive bladder: a new clinical entity? A review of current terminology, definitions, epidemiology, aetiology, and diagnosis.

  2014influential reference
• Contemporary concepts in the aetiopathogenesis of detrusor underactivity

  2014influential reference
• Time‐dependent changes and gender differences in urinary dysfunction in patients with multiple system atrophy

  2013cited by this paper
• Detrusor expulsive strength is preserved, but responsiveness to bladder filling and urinary sensitivity is diminished in the aging mouse.

  2012cited by this paper
• Pathophysiology of overactive bladder

  2012cited by this paper
• Prevalence and Clinical Features of Detrusor Underactivity among Elderly with Lower Urinary Tract Symptoms: A Comparison between Men and Women

  2012cited by this paper
• Detrusor underactivity: A plea for new approaches to a common bladder dysfunction

  2011cited by this paper
• Bladder outlet obstruction in women

  2011cited by this paper
• The overlap of storage, voiding and postmicturition symptoms and implications for treatment seeking in the USA, UK and Sweden: EpiLUTS

  2009cited by this paper
• Diabetic bladder dysfunction: current translational knowledge.

  2009cited by this paper
• A new look at detrusor underactivity: Impaired contractility versus afferent dysfunction

  2009cited by this paper
• Development of idiopathic detrusor underactivity in women: from isolated decrease in contraction velocity to obvious impairment of voiding function.

  2008cited by this paper
• Diabetes mellitus and female lower urinary tract symptoms: A review

  2008cited by this paper
• Recovery of detrusor function after urethral botulinum A toxin injection in patients with idiopathic low detrusor contractility and voiding dysfunction.

  2007cited by this paper
• Urodynamic findings suggesting two-stage development of idiopathic detrusor underactivity in adult men.

  2007cited by this paper
• Cerebral control of the bladder in normal and urge-incontinent women

  2007cited by this paper
• Detrusor Underactivity: Clinical Features and Pathogenesis of an Underdiagnosed Geriatric Condition

  2006cited by this paper
• Pathophysiology of overactive bladder.

  2006cited by this paper
• The natural history of lower urinary tract dysfunction in men: minimum 10‐year urodynamic follow‐up of untreated detrusor underactivity

  2005cited by this paper
• Type 2 Diabetes Mellitus and Risk of Developing Urinary Incontinence

  2005cited by this paper
• Innervation and connexin isoform expression during diabetes-related bladder dysfunction: early structural vs. neuronal remodelling

  2005cited by this paper
• Analysis of bladder-outlet function with the linearized passive urethral resistance relation, linPURR, and a disease-specific approach for grading obstruction: from complex to simple

  2004cited by this paper
• Detrusor contractility

  2004cited by this paper
• The standardisation of terminology in lower urinary tract function: report from the standardisation sub-committee of the International Continence Society.

  2003cited by this paper
• A prospective controlled quantitative study of ultrastructural changes in the underactive detrusor.

  2003cited by this paper
• Editorial: bladder failure--a condition to reckon with.

  2003cited by this paper
• Diabetic cystopathy correlates with a long-term decrease in nerve growth factor levels in the bladder and lumbosacral dorsal root Ganglia.

  2002cited by this paper
• The urethrodetrusor facilitative reflex in women: results of urethral perfusion studies.

  2000cited by this paper
• Voiding dysfunction and Parkinson's disease: urodynamic abnormalities and urinary symptoms.

  2000cited by this paper
• Multiple sclerosis and the urologist.

  1999cited by this paper
• Brain activation during micturition in women.

  1998cited by this paper
• The maximum watts factor as a measure of detrusor contractility independent of outlet resistance

  1998cited by this paper
• Effects of partial outflow obstruction on bladder contractility and blood flow to the detrusor: comparison between mild and severe obstruction.

  1997cited by this paper
• Structural basis of geriatric voiding dysfunction. VII. Prospective ultrastructural/urodynamic evaluation of its natural evolution.

  1997cited by this paper
• Urodynamic and neurophysiological evaluation in Parkinson's disease and multiple system atrophy.

  1997cited by this paper
• Acute cerebrovascular accident and lower urinary tract dysfunction: a prospective correlation of the site of brain injury with urodynamic findings.

  1996cited by this paper
• Urinary bladder blood flow changes during the micturition cycle in a conscious pig model.

  1996cited by this paper
• Bladder outlet obstruction in women.

  1996cited by this paper
• Bladder outlet obstruction versus impaired detrusor contractility: the role of outflow.

  1991cited by this paper
• Urinary bladder function and its control in healthy females.

  1986cited by this paper
• The assessment of prostatic obstruction from urodynamic measurements and from residual urine.

  1979cited by this paper

• An Unusual Presentation of Massive Asymptomatic Urinary Retention in a 63-Year-Old Male With Iron Deficiency Anaemia

  2025cites this paper
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  2024cites this paper
• Efficacy in Using Urodynamic Parameters of Intravesical Electrical Stimulation for Detrusor Underactivity

  2024cites this paper
• Underactive Bladder and Detrusor Underactivity: New Advances and Prospectives

  2023cites this paper
• Coexisting overactive–underactive bladder and detrusor overactivity–underactivity in pelvic organ prolapse

  2022cites this paper
• Bladder Monitoring Systems: State of the Art and Future Perspectives

  2022cites this paper
• Coexistent Detrusor Overactivity-Underactivity in Patients with Pelvic Floor Disorders

  2022cites this paper
• Effects of losartan on bladder dysfunction due to aging-related severe hypertension in rats.

  2022cites this paper
• Correlations between bladder wall thickness and clinical manifestations in female patients with detrusor underactivity and detrusor overactivity–with–detrusor underactivity

  2021cites this paper
• Detrusor underactivity influences the efficacy of TURP in patients with BPO

  2021cites this paper
• Physiopathology of Underactive Bladder

  2021cites this paper
• Underactive Bladder Syndrome: An Often Overlooked Condition

  2021cites this paper
• Aging-related severe hypertension induces detrusor underactivity in rats.

  2021cites this paper
• [Therapeutic effects of sacral neuromodulation on detrusor underactivity].

  2021cites this paper
• Efficacy of holmium laser enucleation of the prostate in patients with detrusor underactivity: systematic review and meta-analysis

  2021cites this paper
• Dysregulated Purine Metabolism Contributes to Age-Associated Lower Urinary Tract Dysfunctions

  2021cites this paper
• Overactive Bladder Symptoms Within Nervous System: A Focus on Etiology

  2021cites this paper
• Understanding underactive bladder: a review of the contemporary literature

  2020influential citation
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  2020cites this paper
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  2020cites this paper
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  2020cites this paper
• Purine nucleoside phosphorylase inhibition ameliorates age-associated lower urinary tract dysfunctions

  2020cites this paper
• Detrusor underactivity in women: A current understanding

  2019influential citation
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  2019cites this paper
• Treatment of Voiding LUTS

  2019cites this paper
• Shared Pathophysiology of Detrusor Overactivity and Detrusor Underactivity

  2018cites this paper
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