Tzu Chi Medical Journal

REVIEW ARTICLE
Year
: 2017  |  Volume : 29  |  Issue : 4  |  Page : 187--191

Current pharmacological and surgical treatment of underactive bladder


Yuan-Hong Jiang, Cheng-Ling Lee, Jia-Fong Jhang, Hann-Chorng Kuo 
 Department of Urology, Buddhist Tzu Chi General Hospital and Tzu Chi University, Hualien, Taiwan

Correspondence Address:
Hann-Chorng Kuo
Department of Urology, Buddhist Tzu Chi General Hospital, 707, Section 3, Chung-Yang Road, Hualien
Taiwan

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.


How to cite this article:
Jiang YH, Lee CL, Jhang JF, Kuo HC. Current pharmacological and surgical treatment of underactive bladder.Tzu Chi Med J 2017;29:187-191


How to cite this URL:
Jiang YH, Lee CL, Jhang JF, Kuo HC. Current pharmacological and surgical treatment of underactive bladder. Tzu Chi Med J [serial online] 2017 [cited 2021 Jan 22 ];29:187-191
Available from: https://www.tcmjmed.com/article.asp?issn=1016-3190;year=2017;volume=29;issue=4;spage=187;epage=191;aulast=Jiang;type=0