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detrusor hyperactivity with impaired bladder contractility (DHIC)

Pathology: - involuntary detrusor contractions - weakness of the detrusor muscle - incomplete bladder emptying Clinical manifestations: - may mimic urinary stress incontinence - urinary frequency, urgency, urge incontinence - leakage of urine when bending over & walking up or down stairs - urinary retention - sensation of incomplete bladder emptying - patients either are unable to empty their bladder completely or can empty their bladder completely only with straining due to poor contractility of the detrusor Special laboratory: - elevated post-void residual Differential diagnosis: - cholinesterase inhibitors increase bladder contractility - severe pelvic prolapse due to cystocele can cause urethral obstruction - not so much with moderate pelvic prolapse - stress incontinence not associated with urinary retention

Related

detrusor muscle (musculi detrusor vesicae) detrusor sphincter dyssynergia (DSD) neurogenic bladder

General

detrusor instability (unstable bladder, hyperactive bladder, irritable bladder)

References

  1. Geriatric Review Syllabus, 7th edition Parada JT et al (eds) American Geriatrics Society, 2010 - Geriatric Review Syllabus, 11th edition (GRS11) Harper GM, Lyons WL, Potter JF (eds) American Geriatrics Society, 2022
  2. Resnick NM, Yalla SV. Detrusor hyperactivity with impaired contractile function. An unrecognized but common cause of incontinence in elderly patients. JAMA. 1987;257(22):3076-3081 https://jamanetwork.com/journals/jama/article-abstract/366489