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Detrusor underactive

Alan J Wein
No abstract text is available yet for this article.
November 2016: Journal of Urology
Sachin Malde, Arjun K Nambiar, Roland Umbach, Thomas B Lam, Thorsten Bach, Alexander Bachmann, Marcus J Drake, Mauro Gacci, Christian Gratzke, Stephan Madersbacher, Charalampos Mamoulakis, Kari A O Tikkinen, Stavros Gravas
CONTEXT: Several noninvasive tests have been developed for diagnosing bladder outlet obstruction (BOO) in men to avoid the burden and morbidity associated with invasive urodynamics. The diagnostic accuracy of these tests, however, remains uncertain. OBJECTIVE: To systematically review available evidence regarding the diagnostic accuracy of noninvasive tests in diagnosing BOO in men with lower urinary tract symptoms (LUTS) using a pressure-flow study as the reference standard...
September 26, 2016: European Urology
Ahmed Ahmed, Bilal Farhan, Simone Vernez, Gamal M Ghoniem
OBJECTIVE: To review the current definitions, terminology, epidemiology and aetiology of detrusor underactivity (DU), with specific attention to the diagnostic criteria in use. In addition, we address the relation and the overlap between DU and bladder outlet obstruction (BOO). In this mini-review, we hope to help identify DU patients and facilitate structured clinical evaluation and research. METHODS: We searched the English literature using ScienceDirect and PubMed for relevant articles...
September 2016: Arab Journal of Urology
Alan J Wein
No abstract text is available yet for this article.
August 2016: Journal of Urology
Elizabeth T Brown, Joshua A Cohn, Melissa R Kaufman, Roger R Dmochowski, William S Reynolds
AIMS: Underactive bladder (UAB) is a symptom complex with poorly characterized causation. The aim of this study was to determine if clinical and UDS parameters differed between categories of presumed detrusor underactivity (DU) etiologies. METHODS: A retrospective review was performed at a single institution from 2011 to 2015 to identify patients with symptoms of UAB. Patients were excluded if they were male, had anti-incontinence, or pelvic organ prolapse (POP) surgery within 1 year, or the UDS did not demonstrate DU as defined within...
July 26, 2016: Neurourology and Urodynamics
Derek J Lomas, Amy E Krambeck
OBJECTIVE: To evaluate long-term outcomes for men with benign prostatic obstruction (BPO) and concurrent detrusor underactivity (DUA) or acontractility following holmium laser enucleation of the prostate (HoLEP). METHODS: A retrospective chart review was performed on all patients with BPO and urodynamic evidence of DUA or acontractility secondary to a nonneurogenic etiology that underwent HoLEP at our institution over a 4-year period. Patients were included if they had at least 24 months of follow-up...
July 19, 2016: Urology
Kevin L J Rademakers, Gommert A van Koeveringe, Matthias Oelke
PURPOSE: Detrusor underactivity (DU) has lately gained increasing interest because this bladder condition is an important cause of post-void residual urine and lower urinary tract symptoms (LUTS) in adult men. Until now, DU can only be diagnosed by pressure-flow measurement. Therefore, the aim of this study was to search for noninvasive tests which can safely predict DU in adult men. METHODS: Unselected, treatment-naïve male patients aged ≥40 years with uncomplicated, non-neurogenic LUTS were prospectively evaluated...
July 22, 2016: World Journal of Urology
Marcus J Drake, Anthony Kanai, Dominika A Bijos, Youko Ikeda, Irina Zabbarova, Bahareh Vahabi, Christopher H Fry
The isolated bladder shows autonomous micromotions, which increase with bladder distension, generate sensory nerve activity, and are altered in models of urinary dysfunction. Intravesical pressure resulting from autonomous activity putatively reflects three key variables; the extent of micromotion initiation, distances over which micromotions propagate, and overall bladder tone. In vivo, these variables are subordinate to the efferent drive of the central nervous system. In the micturition cycle storage phase, efferent inhibition keeps autonomous activity generally at a low level, where it may signal 'state of fullness', whilst maintaining compliance...
July 22, 2016: BJU International
Zuohui Zhao, Roya Azad, Jing-Hua Yang, Mike B Siroky, Kazem M Azadzoi
PURPOSE: Lower urinary tract symptoms (LUTS) are bothersome constellation of voiding symptoms in men and women as they age. Multiple factors and comorbidities are attributed to this problem but underlying mechanisms of nonobstructive nonneurogenic detrusor overactivity, detrusor underactivity and LUTS remain largely unknown. Our goal was to characterize detrusor function and voiding patterns in relation to muscarinic receptors expression, nerve fiber density, and neural ultrastructure in chronic bladder ischemia...
July 2016: Investigative and Clinical Urology
Yuan-Hong Jiang, Hann-Chorng Kuo
PURPOSE: The pathophysiology of detrusor underactivity remains unclear and impaired bladder afferent function is considered one of the important etiologies. We investigated urothelial barrier deficits, suburothelial inflammation and sensory proteins expressed in the bladder mucosa of patients with detrusor underactivity. MATERIALS AND METHODS: Bladder mucosa biopsies were performed in 34 patients with videourodynamic proven detrusor underactivity as the study group and in 10 women with stress urinary incontinence as controls...
July 17, 2016: Journal of Urology
Yuan-Hong Jiang, Chun-Hou Liao, Hann-Chorng Kuo
OBJECTIVES: Lower urinary tract symptoms (LUTS) in men result from a complex interplay of pathophysiology, including bladder and bladder outlet dysfunction. This study retrospectively analyzed bladder dysfunction in men with LUTS based on the results of video-urodynamic studies (VUDS). METHODS: Male patients (aged ≥40 years), with LUTS and an International Prostate Symptom Score of 8 or more, who were refractory to alpha-blocker treatment were retrospectively recruited and evaluated with VUDS and total prostate volume (TPV)...
July 1, 2016: Lower Urinary Tract Symptoms
Huiyi H Chang, Leif A Havton
Detrusor underactivity (DU) is defined as a contraction of reduced strength and/or duration during bladder emptying and results in incomplete and prolonged bladder emptying. The clinical diagnosis of DU is challenging when present alone or in association with other bladder conditions such as detrusor overactivity, urinary retention, detrusor hyperactivity with impaired contractility, aging, and neurological injuries. Several etiologies may be responsible for DU or the development of an underactive bladder (UAB), but the pathobiology of DU or UAB is not well understood...
May 21, 2016: Experimental Neurology
Gen Ishii, Kenichi Hata, Soichiro Aoki, Masayasu Suzuki, Takahiro Kimura, Shin Egawa
We report a case of meningitis-retention syndrome followed by urodynamic tests. A 48-year-old man was admitted to the hospital for an undiagnosed fever with headache and urinary retention. Aseptic meningitis was suspected according to cerebrospinal fluid analyses, and urodynamic test showed an underactive detrusor, leading to inadequate contraction of the bladder on voiding in spite of a normal sensation during bladder filling. Clean intermittent self-catheterization was required temporarily, but normal urinary voiding without the need for medication was restored in 2 weeks after discharge from the hospital, when urodynamic tests showed normal contractility of the bladder during voiding...
May 2016: Urology Case Reports
Arman A Kahokehr, Peter J Gilling
In this review, we have looked at three important areas in understanding male lower urinary tract symptoms. These are improvement in terminology, detrusor underactivity, and nocturia. Benign prostatic hyperplasia leading to bladder outlet obstruction has been covered in a previous review.
2016: F1000Research
Kajetan Juszczak, Tomasz Drewa
Higher incidence of functional urinary bladder dysfunction (detrusor overactivity - DO and detrusor underactivity - DU) occurs in elderly people. Effective therapy is widely used in patients with DO, in contrast DU seems to be a serious burden for the older population due to the lack of successful treatment. The aim of the study was to review the potential pharmacological targets in DU treatment in the animal model. This review is based on systemic literature research. The Medline/Pubmed, Scopus, Embase, and Web of Science databases were searched in order to identify original and review articles, as well as editorials relating to underactive bladder, detrusor underactivity...
August 2016: Pharmacological Reports: PR
Nadir Osman, Altaf Mangera, Christopher Hillary, Richard Inman, Christopher Chapple
The inability to generate a voiding contraction sufficient to allow efficient bladder emptying within a reasonable time frame is a common problem seen in urological practice. Typically, the symptoms that arise are voiding symptoms, such as weak and slow urinary flow. These symptoms can cause considerable bother to patients and impact upon quality of life. The urodynamic finding of inadequate detrusor contraction has been termed detrusor underactivity (DUA). Although a definition is available for this entity, there are no widely accepted diagnostic criteria...
2016: F1000Research
Kevin L Rademakers, Jamie M Drossaerts, Philip E van Kerrebroeck, Matthias Oelke, Gommert A van Koeveringe
INTRODUCTION: Detrusor underactivity (DU) is currently a topic that receives major attention within functional urology. Urologists are often confronted with men who present with voiding dysfunction without bladder outlet obstruction (BOO) or after desobstructive or neuromodulation treatment. Their impaired bladder emptying is suspected to be related to failure of detrusor contractile function. Earlier research indicated that patients with non-obstructive urinary retention (NOR), for example, detrusor underactivity (DU), have a lower success rate after sacral neuromodulation (SNM) compared to patients treated with SNM for storage dysfunction...
April 6, 2016: Neurourology and Urodynamics
Xing Li, Limin Liao
Underactive bladder (UAB) is a major component of lower urinary tract symptoms. The physiopathology mechanisms underlying UAB include detrusor underactivity, acontractile detrusor, and reduced or absent bladder sensation. UAB can influence lower and upper urinary tract function and lead to serious consequences; however, the symptom syndrome is poorly understood and incompletely researched at present. Moreover, there is no agreement among authorities regarding the terminology, definition, epidemiology, classification, risk factors, animal model, pathogenesis, diagnosis, and treatment of UAB...
June 2016: International Urology and Nephrology
Yuan-Hong Jiang, Cheng-Ling Lee, Hann-Chorng Kuo
PURPOSE: We investigated urothelial integrity, suburothelial inflammation and the expression of sensory proteins in the bladder urothelium of male patients with bladder outlet obstruction and various bladder dysfunctions. MATERIALS AND METHODS: We prospectively enrolled 33 men with urodynamically proven bladder outlet obstruction as the study group. Bladder biopsies were obtained from all study patients and 10 control patients. The expression of E-cadherin, zonula occludens-1, tryptase, apoptosis, TRPV (transient receptor potential vanilloid) 1 and 4, β3 adrenoreceptor, M2 and M3 muscarinic receptors, P2X3 receptor, and inducible/epithelial nitric oxide synthase were compared between study and control patients...
September 2016: Journal of Urology
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