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The underactive bladder: diagnosis and surgical treatment options
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 revie...
Autores principales: | , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
AME Publishing Company
2017
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5522796/ https://www.ncbi.nlm.nih.gov/pubmed/28791238 http://dx.doi.org/10.21037/tau.2017.04.07 |
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author | Gani, Johan Hennessey, Derek |
author_facet | Gani, Johan Hennessey, Derek |
author_sort | Gani, Johan |
collection | PubMed |
description | 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. |
format | Online Article Text |
id | pubmed-5522796 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2017 |
publisher | AME Publishing Company |
record_format | MEDLINE/PubMed |
spelling | pubmed-55227962017-08-08 The underactive bladder: diagnosis and surgical treatment options Gani, Johan Hennessey, Derek Transl Androl Urol Review Article 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. AME Publishing Company 2017-07 /pmc/articles/PMC5522796/ /pubmed/28791238 http://dx.doi.org/10.21037/tau.2017.04.07 Text en 2017 Translational Andrology and Urology. All rights reserved. |
spellingShingle | Review Article Gani, Johan Hennessey, Derek The underactive bladder: diagnosis and surgical treatment options |
title | The underactive bladder: diagnosis and surgical treatment options |
title_full | The underactive bladder: diagnosis and surgical treatment options |
title_fullStr | The underactive bladder: diagnosis and surgical treatment options |
title_full_unstemmed | The underactive bladder: diagnosis and surgical treatment options |
title_short | The underactive bladder: diagnosis and surgical treatment options |
title_sort | underactive bladder: diagnosis and surgical treatment options |
topic | Review Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5522796/ https://www.ncbi.nlm.nih.gov/pubmed/28791238 http://dx.doi.org/10.21037/tau.2017.04.07 |
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