Basil Razi, Kevin Zhuo, Dane Cole-Clark, Amanda Chung
{"title":"The underappreciated underactive bladder.","authors":"Basil Razi, Kevin Zhuo, Dane Cole-Clark, Amanda Chung","doi":"10.21037/tau-2025-61","DOIUrl":null,"url":null,"abstract":"<p><p>Slow urinary flow is a common lower urinary tract symptom (LUTS) that frequently prompts men to consult their primary care physician. While bladder outlet obstruction (BOO) is well recognised, underactive bladder (UAB) remains underappreciate despite its significant impact on quality of life. This review highlights the pathophysiology, clinical features, and diagnostic challenges and approach to UAB in men. Improving recognition of UAB as a distinct condition separate from other LUTS aetiologies, it can facilitate earlier diagnosis and management. Slow urinary flow is highly prevalent, particularly in an ageing population. UAB is characterised by impaired detrusor muscle activity, leading to slow urinary flow, hesitancy, straining and incomplete bladder emptying. The overlap in symptoms with BOO often leads to misdiagnosis, delaying appropriate intervention. UAB has multiple underlying causes including, neurogenic, myogenic, iatrogenic and idiopathic factors. Diagnosis is further complicated by the limited availability of urodynamic studies, the gold standard for assessing detrusor underactivity. Current management options remain limited with no definitive treatments. Current strategies focus on behavioural modifications, pelvic floor exercises, timed voiding, sacral neuromodulation and intermittent catheterisation. Increased awareness of UAB among primary care physicians and urologists is essential for timely diagnosis and intervention. Recognition of UAB as a distinct clinical entity will lead to a reduction in potential complications and significant improvement in the quality of life of affected men.</p>","PeriodicalId":23270,"journal":{"name":"Translational andrology and urology","volume":"14 3","pages":"841-847"},"PeriodicalIF":1.9000,"publicationDate":"2025-03-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11986530/pdf/","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Translational andrology and urology","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.21037/tau-2025-61","RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"2025/3/26 0:00:00","PubModel":"Epub","JCR":"Q4","JCRName":"ANDROLOGY","Score":null,"Total":0}
引用次数: 0
Abstract
Slow urinary flow is a common lower urinary tract symptom (LUTS) that frequently prompts men to consult their primary care physician. While bladder outlet obstruction (BOO) is well recognised, underactive bladder (UAB) remains underappreciate despite its significant impact on quality of life. This review highlights the pathophysiology, clinical features, and diagnostic challenges and approach to UAB in men. Improving recognition of UAB as a distinct condition separate from other LUTS aetiologies, it can facilitate earlier diagnosis and management. Slow urinary flow is highly prevalent, particularly in an ageing population. UAB is characterised by impaired detrusor muscle activity, leading to slow urinary flow, hesitancy, straining and incomplete bladder emptying. The overlap in symptoms with BOO often leads to misdiagnosis, delaying appropriate intervention. UAB has multiple underlying causes including, neurogenic, myogenic, iatrogenic and idiopathic factors. Diagnosis is further complicated by the limited availability of urodynamic studies, the gold standard for assessing detrusor underactivity. Current management options remain limited with no definitive treatments. Current strategies focus on behavioural modifications, pelvic floor exercises, timed voiding, sacral neuromodulation and intermittent catheterisation. Increased awareness of UAB among primary care physicians and urologists is essential for timely diagnosis and intervention. Recognition of UAB as a distinct clinical entity will lead to a reduction in potential complications and significant improvement in the quality of life of affected men.
期刊介绍:
ranslational Andrology and Urology (Print ISSN 2223-4683; Online ISSN 2223-4691; Transl Androl Urol; TAU) is an open access, peer-reviewed, bi-monthly journal (quarterly published from Mar.2012 - Dec. 2014). The main focus of the journal is to describe new findings in the field of translational research of Andrology and Urology, provides current and practical information on basic research and clinical investigations of Andrology and Urology. Specific areas of interest include, but not limited to, molecular study, pathology, biology and technical advances related to andrology and urology. Topics cover range from evaluation, prevention, diagnosis, therapy, prognosis, rehabilitation and future challenges to urology and andrology. Contributions pertinent to urology and andrology are also included from related fields such as public health, basic sciences, education, sociology, and nursing.