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Current Bladder Dysfunction Reports

, Volume 13, Issue 4, pp 274–281 | Cite as

Detrusor Underactivity and Bladder Outlet Procedures in Men

  • Shu-Yu Wu
  • Yuan-Hong Jiang
  • Hann-Chorng KuoEmail author
Reconstructed Bladder Function & Dysfunction (M Kaufman, Section Editor)
  • 21 Downloads
Part of the following topical collections:
  1. Topical Collection on Reconstructed Bladder Function & Dysfunction

Abstract

Purpose of Review

Detrusor underactivity (DU) is a common but poorly understood clinical problem. The diagnosis and treatment of DU are difficult and full of uncertainties. There are many overlaps between DU and bladder outlet obstruction (BOO) in clinical symptoms and managements. In this review, we discuss the relationship of clinical diagnosis and treatment between DU and BOO in men, especially the outcome of bladder outlet surgery in patients with DU.

Recent Findings

DU could be resulted from many different etiologies, including psychogenic, neurogenic, myogenic, and the reduced detrusor contractility after increasing muscle work against the increase of bladder outlet resistance. Current managements are usually focused on relieving voiding difficulty and prevent urine retention to avoid urinary tract infection and upper urinary tract deterioration. Since there is no suitable medical treatment to enhance bladder contractility, most of the researches focus on reducing bladder outlet resistance and treat BOO. Many recent studies have reported the therapeutic outcome of transurethral incision of the bladder neck, transurethral resection of the prostate and urethral sphincter botulinum toxin A injection.

Summary

The current treatment options in DU are limited. Even if there are many clinical trials revealing good results in patients with DU after BOO surgery, the evidence that BOO surgeries benefit patients with DU are still controversial. The actual mechanism of detrusor function recovery after BOO surgery in men with DU has not been well elucidated. Nevertheless, a portion of men with DU can safely and effectively improve their voiding symptoms and voiding efficiency after BOO surgeries. Further research of the underlying pathophysiology between DU and BOO is mandatory.

Keywords

Benign prostatic hyperplasia Bladder outlet obstruction Detrusor underactivity Lower urinary tract symptoms 

Notes

Compliance with Ethical Standards

Conflict of Interest

Shu-Yu Wu declares that he has no conflict of interest.

Yuan-Hong Jiang declares that he has no conflict of interest.

Hann-Chorng Kuo declares that he has no conflict of interest.

Human and Animal Rights and Informed Consent

This article does not contain any studies with human or animal subjects performed by any of the authors.

References

Papers of particular interest, published recently, have been highlighted as: • Of importance •• Of major importance

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© Springer Science+Business Media, LLC, part of Springer Nature 2018

Authors and Affiliations

  1. 1.Department of Urology, Buddhist Tzu Chi General HospitalTzu Chi UniversityHualienTaiwan

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