Underactive Bladder UAB and Retention

Underactive Bladder UAB

 

Underactive Bladder is where the bladder muscle (detrusor) doesnt contract properly resulting in slow or incomplete bladder emptying.

There are many causes that can damage the nerves to the bladder or the bladder muscle to impact on bladder emptying.

UAB can result in difficulty to start urination, a slow flow, needing to strain or lean forwards to pass urine.  some people have a stop start stream and a feeling of incomplete emptying.  Some patients may have no symptoms at all and be completely unaware that they are not completely emptying their bladder when they pass urine.

Incomplete bladder emptying can lead to urine infections, incontinence or a frequent need to pass urine.  It can progess to kidney damage and kidney failure and kidney or bladder stones.

A ultrasound scan after passing urine can show if the bladder has emptied fully but wont be able to determine why.  UAB is usually diagnosed by urodynamics studies.

Behavioural therapy, emptying techniques and pelvic floor relaxation methods can help.

Some patients use a catheter to empty the bladder.  They may pass the catheter themselves at intervals to drain the bladder rather than having the catheter pemanently in place.  This is called intermittent self catheterisation.  (Male intermittent self-catheterisation, Female intermittent self-catheterisation).

Sacral Nerve Neuromodulation therapy may also improve bladder emptying.

Sometimes a permanent (indwelling) catheter either via the urethra or suprapubic catheter is used to drain the bladder.

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