The many faces of impaired bladder emptying

摘要

PURPOSE OF REVIEW: Impaired bladder emptying is a common clinical problem for which currently no effective drug treatment is available. There has been an increasing interest in the condition, and the present review updates the terminology issues, common causes, and potential future pharmacological treatment possibilities. RECENT FINDINGS: Impaired bladder emptying can be described in many ways, but general agreement on the terminology has not yet been reached. The disorder can have many underlying causes, including aging, bladder outflow obstruction, diabetes mellitus, and neurogenic disturbances. There is no effective pharmacological treatment, and to what extent drug treatment of the associated morbidities (e.g., diabetes mellitus, Parkinson's disease, and multiple sclerosis) also can improve impaired bladder emptying has only been investigated to a limited extent. SUMMARY: Impaired bladder emptying may be caused by a spectrum of pathophysiologically defined disorders. To describe the condition, underactive bladder (UAB) can be used as a general term, covering detrusor underactivity as the urodynamic diagnosis, and the UAB syndrome for its symptomatic manifestations. In order to understand UAB, identification of the underlying cause(s) is necessary. Effective pharmacologic therapy is lacking and further basic research is needed to find targets for treatment.