Search
underactive bladder; bladder atony
Etiology:
1) drugs
2) fecal impaction
3) neurologic conditions (neurogenic bladder)
a) diabetic neuropathy
b) low spinal cord injury
c) weakening of the detrusor muscle
- vitamin B12 deficiency
- idiopathic causes
4) radical pelvic surgery
Pathology:
- bladder contraction of inadequate magnitude &/or duration effects bladder emptying in a normal timespan
- bladder underactivity may cause overdistension of the bladder, resulting in overflow incontinence
Special laboratory:
- measurement of postvoid residual in men (prior to medication discontinuation) [1]
- postvoid residual <= 450 mL is not suggestive of longstanding urinary retention with bladder atony [1]
- urodynamic studies
Management:
- self intermittent catherization
- intraurethral valve pump [2]
- sacral nerve stimulation may be effective [3]
- also see overflow incontinence
Related
overflow incontinence
Specific
neurogenic bladder
General
sign/symptom
urologic disease
References
- Geriatric Review Syllabus, 8th edition (GRS8)
Durso SC and Sullivan GN (eds)
American Geriatrics Society, 2013
- Geriatric Review Syllabus, 9th edition (GRS9)
Medinal-Walpole A, Pacala JT, Porter JF (eds)
American Geriatrics Society, 2016
- FDA News Release. October 14, 2014
FDA permits marketing of urinary prosthesis device for women
http://www.fda.gov/NewsEvents/Newsroom/PressAnnouncements/ucm418835.htm
- Miyazato M, Yoshimura N, Chancellor MB.
The other bladder syndrome: underactive bladder.
Rev Urol. 2013;15(1):11-22.
PMID: 23671401 Free PMC Article
- Osman NI, Chapple CR, Abrams P et al
Detrusor underactivity and the underactive bladder: a new
clinical entity? A review of current terminology, definitions,
epidemiology, aetiology, and diagnosis.
Eur Urol. 2014 Feb;65(2):389-98. Review.
PMID: 24184024