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Title: The underactive bladder: diagnosis and surgical treatment options.
Austin Authors: Gani, Johan ;Hennessey, Derek B
Affiliation: Department of Urology, Austin Health, Heidelberg, Victoria, Australia
Department of Urology, Western Health, Footscray, Victoria, Australia
Issue Date: Jul-2017
Publication information: Translational andrology and urology 2017; 6(Suppl 2): S186-S195
Abstract: The underactive bladder (UAB)/detrusor underactivity (DU) is a relatively common condition. It is difficult to diagnose and can be difficult to manage. The aim of this review is to provide a review of the diagnosis and different surgical treatment options for UAB/DU. A comprehensive literature review using medical search engines was performed. The search included a combination of the following terms, UAB, DU, TURP, reduction cystoplasty, bladder diverticulectomy and sacral neuromodulation (SNM). Search results were assessed for their overall relevance to this review. Definitions, general overview and management options were extracted from the relevant medical literature. DU affects up to 45% of men and women >70 years of age. The symptoms of DU overlap significantly with overactive bladder (OAB) and bladder outlet obstruction (BOO). Urodynamic findings include low voiding pressure combined with slow intermittent flow and incomplete bladder emptying. Non-operative management for DU is acceptable; only 1 in 6 male patients may need a TURP and acute urinary retention (AUR) is rare. TURP for DU is feasible and is associated with good short and medium term outcomes, but over time, there is a return to baseline symptoms. Bladder diverticulectomy can also improve DU, but there is a paucity of guidelines on patient selection. SNM provides excellent outcomes for DU, but patient selection is important.
DOI: 10.21037/tau.2017.04.07
ORCID: 0000-0002-7372-0100
PubMed URL: 28791238
ISSN: 2223-4691
Type: Journal Article
Subjects: Bladder diverticulectomy
sacral neuromodulation (SNM), underactive bladder (UAB)
transurethral resection of the prostate (TURP)
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