Current pharmacological and surgical treatment of underactive bladder
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 ac...
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| Format: | Article |
| Language: | English |
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Wolters Kluwer Medknow Publications
2017-01-01
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| Series: | Tzu-Chi Medical Journal |
| Subjects: | |
| Online Access: | http://www.tcmjmed.com/article.asp?issn=1016-3190;year=2017;volume=29;issue=4;spage=187;epage=191;aulast=Jiang |
| _version_ | 1819208196946919424 |
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| author | Yuan-Hong Jiang Cheng-Ling Lee Jia-Fong Jhang Hann-Chorng Kuo |
| author_facet | Yuan-Hong Jiang Cheng-Ling Lee Jia-Fong Jhang Hann-Chorng Kuo |
| author_sort | Yuan-Hong Jiang |
| collection | DOAJ |
| description | 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. |
| first_indexed | 2024-12-23T05:35:33Z |
| format | Article |
| id | doaj.art-b7db80d44db847fe9a28f2a2fd20d40c |
| institution | Directory Open Access Journal |
| issn | 1016-3190 2223-8956 |
| language | English |
| last_indexed | 2024-12-23T05:35:33Z |
| publishDate | 2017-01-01 |
| publisher | Wolters Kluwer Medknow Publications |
| record_format | Article |
| series | Tzu-Chi Medical Journal |
| spelling | doaj.art-b7db80d44db847fe9a28f2a2fd20d40c2022-12-21T17:58:20ZengWolters Kluwer Medknow PublicationsTzu-Chi Medical Journal1016-31902223-89562017-01-0129418719110.4103/tcmj.tcmj_122_17Current pharmacological and surgical treatment of underactive bladderYuan-Hong JiangCheng-Ling LeeJia-Fong JhangHann-Chorng KuoUnderactive 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.http://www.tcmjmed.com/article.asp?issn=1016-3190;year=2017;volume=29;issue=4;spage=187;epage=191;aulast=JiangBladder functionDetrusor underactivityMedical treatmentUrinary retention |
| spellingShingle | Yuan-Hong Jiang Cheng-Ling Lee Jia-Fong Jhang Hann-Chorng Kuo Current pharmacological and surgical treatment of underactive bladder Tzu-Chi Medical Journal Bladder function Detrusor underactivity Medical treatment Urinary retention |
| title | Current pharmacological and surgical treatment of underactive bladder |
| title_full | Current pharmacological and surgical treatment of underactive bladder |
| title_fullStr | Current pharmacological and surgical treatment of underactive bladder |
| title_full_unstemmed | Current pharmacological and surgical treatment of underactive bladder |
| title_short | Current pharmacological and surgical treatment of underactive bladder |
| title_sort | current pharmacological and surgical treatment of underactive bladder |
| topic | Bladder function Detrusor underactivity Medical treatment Urinary retention |
| url | http://www.tcmjmed.com/article.asp?issn=1016-3190;year=2017;volume=29;issue=4;spage=187;epage=191;aulast=Jiang |
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