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Jiang YH, Lee CL, Jhang JF, et al. Current pharmacological and surgical treatment of underactive bladder. Ci Ji Yi Xue Za Zhi. 2017;29(4):187-191doi: 10.4103/tcmj.tcmj_122_17.
Jiang, Y. H., Lee, C. L., Jhang, J. F., & Kuo, H. C. (2017). Current pharmacological and surgical treatment of underactive bladder. Ci ji yi xue za zhi = Tzu-chi medical journal, 29(4), 187-191. https://doi.org/10.4103/tcmj.tcmj_122_17
Jiang, Yuan-Hong, et al. "Current pharmacological and surgical treatment of underactive bladder." Ci ji yi xue za zhi = Tzu-chi medical journal vol. 29,4 (2017): 187-191. doi: https://doi.org/10.4103/tcmj.tcmj_122_17
Jiang YH, Lee CL, Jhang JF, Kuo HC. Current pharmacological and surgical treatment of underactive bladder. Ci Ji Yi Xue Za Zhi. 2017 Oct-Dec;29(4):187-191. doi: 10.4103/tcmj.tcmj_122_17. PMID: 29296045; PMCID: PMC5740689.
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Ci Ji Yi Xue Za Zhi. 2017 Oct-Dec;29(4):187-191. doi: 10.4103/tcmj.tcmj_122_17.

Current pharmacological and surgical treatment of underactive bladder.

Ci ji yi xue za zhi = Tzu-chi medical journal

Yuan-Hong Jiang, Cheng-Ling Lee, Jia-Fong Jhang, Hann-Chorng Kuo

Affiliations

  1. Department of Urology, Buddhist Tzu Chi General Hospital and Tzu Chi University, Hualien, Taiwan.

PMID: 29296045 PMCID: PMC5740689 DOI: 10.4103/tcmj.tcmj_122_17

Abstract

Underactive bladder (UAB) or detrusor underactivity (DU) is a common yet still poorly understood urological problem. In addition to true detrusor failure and neuropathy, the inhibitory effects of detrusor contraction by the striated urethral sphincter and the bladder neck through alpha-adrenergic activity may also play a role in the development of UAB or DU. Treatment of UAB or DU aims to reduce the postvoid residual (PVR) urine volume and increase voiding efficiency, either by spontaneous voiding or abdominal straining. Pharmacotherapy with parasympathomimetics or cholinesterase inhibitors might be tried, and benefits can be achieved in combination with alpha-blockers. Bladder outlet surgeries, including urethral onabotulinumtoxinA injection, transurethral incision of the bladder neck, and transurethral incision or resection of the prostate can effectively improve voiding efficiency and decrease the PVR in most patients with DU. The mechanisms have not been well elucidated. It is likely that ablation of the bladder neck or prostatic urethra might not only decrease bladder outlet resistance but also abolish the sympathetic hyperactivity which inhibits detrusor contractility in patients with idiopathic UAB or DU.

Keywords: Bladder function; Detrusor underactivity; Medical treatment; Urinary retention

Conflict of interest statement

There are no conflicts of interest.

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