The underappreciated underactive bladder.

IF 1.9 3区 医学 Q4 ANDROLOGY
Translational andrology and urology Pub Date : 2025-03-30 Epub Date: 2025-03-26 DOI:10.21037/tau-2025-61
Basil Razi, Kevin Zhuo, Dane Cole-Clark, Amanda Chung
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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.

不被重视的不活跃的膀胱。
尿流缓慢是一种常见的下尿路症状(LUTS),经常促使男性咨询他们的初级保健医生。尽管膀胱出口梗阻(BOO)得到了广泛的认识,但膀胱活动不足(UAB)仍未得到充分的重视,尽管它对生活质量有重大影响。本文综述了男性UAB的病理生理学、临床特征、诊断挑战和方法。提高对UAB作为一种与其他LUTS病因不同的独特疾病的认识,可以促进早期诊断和治疗。尿流缓慢是非常普遍的,特别是在老龄化人口中。UAB的特征是逼尿肌活动受损,导致尿流缓慢、犹豫、紧张和膀胱排空不完全。症状与BOO的重叠常导致误诊,延误适当的干预。UAB有多种潜在原因,包括神经源性、肌源性、医源性和特发性因素。尿动力学研究是评估逼尿肌活动不足的金标准,但由于可用性有限,诊断变得更加复杂。目前的管理选择仍然有限,没有明确的治疗方法。目前的策略集中在行为改变、盆底运动、定时排尿、骶骨神经调节和间歇性导尿。提高初级保健医生和泌尿科医生对UAB的认识对于及时诊断和干预至关重要。认识到UAB是一种独特的临床实体,将减少潜在的并发症,并显著改善受影响男性的生活质量。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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来源期刊
CiteScore
4.10
自引率
5.00%
发文量
80
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.
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