Pharmacological treatments available for the management of underactive bladder in neurological conditions

ABSTRACT

Introduction: Underactive bladder (UAB) is a common cause of lower urinary tract dysfunction which has an increasing incidence with aging. It is characterized as an incompetent detrusor contraction with reduced strength and/or duration to completely empty the bladder. UAB is observed in both men and women. The exact definition, classification, and pathophysiological mechanism responsible for UAB is still debatable, however neurologic, myogenic, and iatrogenic causes are explained. The symptom complex related to UAB includes hesitancy, diminished sensation of bladder filling, a slow urinary stream, increased post-void residue, and etc.

Areas covered: We reviewed the current understanding of UAB with special focus on pharmacological treatments and potential pharmacotherapy options particularly in neurological conditions. Also, the definition, etiology, symptoms, diagnosis and management of UAB were discussed in this review.

Expert commentary: The underlying mechanism of UAB is not clear yet. Therefore; the lack of efficient pharmacotherapies is evident in such patients. Prior to any decision for pharmacological or surgical interventions, the underlying causes of UAB and detrusor impairment in each patient should be distinguished. Future researches need to address the exact dynamics of detrusor contraction and the muscular and neurological contributors to UAB.

KEYWORDS:

• Underactive bladder
• detrusor underactivity
• lower urinary tract
• neuropathic underactive bladder
• bladder dysfunction
• detrusor hypocontractility

Declaration of interest

The authors have no relevant affiliations or financial involvement with any organization or entity with a financial interest in or financial conflict with the subject matter or materials discussed in the manuscript. This includes employment, consultancies, honoraria, stock ownership or options, expert testimony, grants or patents received or pending, or royalties. Peer reviewers on this manuscript have no relevant financial or other relationships to disclose.

Additional information

Funding

This paper was not funded.