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Last update 08 May 2025

Urinary Bladder, Underactive

Last update 08 May 2025

Basic Info

Synonyms

Bladder muscle dysfunction - underactive, Bladder muscle dysfunction - underactive (disorder), Bladder, Underactive

+ [21]

Introduction

Symptom of underactive detrusor muscle of the URINARY BLADDER that contracts with abnormally reduced strength or duration resulting in an incomplete and/or prolonged bladder emptying.

Drugs associated with Urinary Bladder, Underactive

Acotiamide Hydrochloride Hydrate

Target

A1R x ACHE x M1 receptor x M2 receptor

Mechanism

A1R antagonists [+3]

Active Org.

Zeria Pharmaceutical Co., Ltd. [+2]

Originator Org.

Zeria Pharmaceutical Co., Ltd.

Active Indication

Dyspepsia [+1]

Inactive Indication

Nausea

Drug Highest PhaseApproved

First Approval Ctry. / Loc.

Japan

First Approval Date25 Mar 2013

ONO-8055

Target

EP2 x EP3

Mechanism

EP2 agonists [+1]

Active Org.-

Originator Org.

Ono Pharmaceutical Co., Ltd.

Active Indication-

Inactive Indication

Urinary Bladder, Underactive

Drug Highest PhaseDiscontinued

First Approval Ctry. / Loc.-

First Approval Date20 Jan 1800

ART-002

Target-

Mechanism-

Active Org.-

Originator Org.

ARTham Therapeutics, Inc.

Active Indication-

Inactive Indication

Urinary Bladder, Underactive

Drug Highest PhasePending

First Approval Ctry. / Loc.-

First Approval Date20 Jan 1800

Clinical Trials associated with Urinary Bladder, Underactive

NCT06944743

/ RecruitingNot ApplicableIIT

Predictors of Improvement Afetr Trasurtheral Resection of Prostate in Patients With Underactive Bladder and Bladder Outlet Obstruction

The study is for aproved that Transurtheral Resection of prostate is good for patient with underactive bladder or not.

Start Date01 Apr 2025

Sponsor / Collaborator

Sohag University

NCT06452927

/ Not yet recruitingNot ApplicableIIT

Endoscopic Enucleation of the Prostate in Patients With Urodynamically Proven Detrusor Underactivity/Acontractility

The aim of this project is to create und evaluate a multicentral, retro-/prospective database for patients with urodynamically proven detrusor underactivity (DU) or acontractility (DA) secondary to a non-neurogenic aetiology, who undergo endoscopic, anatomic enucleation of the prostate (EEP).

Start Date01 Sep 2024

Sponsor / Collaborator-

NCT06753071

/ CompletedPhase 4IIT

The Efficacy of Pyridostigmine Therapy After Transurethral Resection of Prostate in Cases with Underactive Urinary Bladder: Prospective Randomized Trial

The efficacy of pyridostigmine therapy after transurethral resection of prostate in cases with underactive urinary bladder

Start Date01 Apr 2024

Sponsor / Collaborator

Menoufia University

100 Clinical Results associated with Urinary Bladder, Underactive

100 Translational Medicine associated with Urinary Bladder, Underactive

0 Patents (Medical) associated with Urinary Bladder, Underactive

858

Literatures (Medical) associated with Urinary Bladder, Underactive

01 Apr 2025·Neurourology and Urodynamics

Urodynamic Changes Following a Staged Trial of Sacral Neuromodulation in Patients With Detrusor Underactivity

Article

Author: Qu, Liang G. ; Vuthiwong, Jaraspong ; Whalen, Stewart ; Gani, Johan

ABSTRACTObjectiveSacral neuromodulation (SNM) is an established treatment for detrusor underactivity (DU) and nonobstructive urinary retention. The mechanism of action for SNM in DU, however, remains poorly understood. The objective of this study was to investigate the urodynamic study (UDS) changes in DU patients during the trial period following first stage tined‐lead placement (FSTLP).Materials and MethodsRetrospective chart review was performed to identify patients diagnosed with DU on initial UDS, who had repeat UDS during the 2‐week trial period following FSTLP by a single clinician. Urodynamic parameters including maximum flow rate (Qmax), detrusor pressure at maximum flow (PdetQmax), post‐void residual (PVR), voiding efficiency (VE), and detrusor contractility index (DCI) were collected. Using the definition of improvement in baseline VE of ≥ 50% post‐FSTLP or improvement in DCI of ≥ 50% in complete voiders, patients were divided into “responders” and “nonresponders.” Pre‐ and post‐FSTLP urodynamic findings were compared using Wilcoxon signed‐rank tests.ResultsA total of 17 patients were identified who met the inclusion criteria. Repeat UDS were done on account of inability or unwillingness to perform clean intermittent catheterization and thus inability to chart an accurate bladder diary. There were 9 female and 8 male patients. Four patients (23.5%) had pure DU while the other 13 (76.5%) had concurrent detrusor overactivity (DO–DU). Among all patients, there was a statistically significant improvement in PdetQmax (14 vs. 29 cmH2O, p < 0.01) and DCI (62 vs. 92, p < 0.01). Six patients (35.3%) responded to the trial of SNM for DU. Among responders, statistically significant improvements in Qmax (5 vs. 15.5 mL/s, p = 0.03), PVR (215 vs. 80 mLs, p = 0.04), VE (22.9% vs. 82.5%, p = 0.04), and DCI (29 vs. 97.5, p = 0.03) were observed. Nonresponders had improvement in PdetQmax (14 vs. 29 cmH2O, p = 0.02), but not in Qmax (9 vs. 10 mL/s, p = 0.89).ConclusionsAmong all patients, an improvement in PdetQmax and DCI was observed. Responders exhibited improvement in Qmax, PVR, VE, and DCI without statistically significant improvement in PdetQmax. Nonresponders had statistically significant improvement in PdetQmax, but not in Qmax. Possible mechanisms of action of SNM in DU patients based on our data are inhibition of the guarding reflex/relaxation of the urethra (shown by improvement in Qmax in responders only) and direct strengthening of bladder contractility (shown by improvement in PdetQmax in all patients). Improvement in Qmax was observed exclusively in responders suggesting the former mechanism is the predominant one. Further larger prospective studies are required to confirm these findings.

01 Apr 2025·Neurourology and Urodynamics

Potential for Misdiagnosis of Detrusor Underactivity Due to Urodynamic Voiding Position and Seating Characteristics

Article

Author: Vancavage, Rachel ; Patel, Shreya ; Rogers, Rebecca G. ; Feustel, Paul ; De, Elise J. B. ; Ilaka, Oyenike ; Zurlo, Rosalie ; Roberts, Brittany L.

ABSTRACTBackgroundDetrusor underactivity (DUA) is a lower urinary tract (LUT) diagnosis that is diagnosed with multichannel urodynamic studies (UDS). The effect of voiding position and DUA detection is unclear.ObjectivesWe investigated whether moving individuals from the UDS chair to their typical voiding position would more accurately assess detrusor function in cases of absent or nonrepresentative voiding. We hypothesized that patients unable to achieve a representative void while on the UDS chair may be misdiagnosed with DUA, and that changing position may reveal intact detrusor function.MethodsWe retrospectively studied patients who underwent UDS with a single provider over 2 years. Studies were included if a patient was moved to a new position after unsuccessful or unrepresentative void attempts on the UDS chair. Two neurourologists reanalyzed the studies and recorded: time spent attempting to void on UDS chair and after moving position, whether a bladder contraction occurred on UDS chair, pdet Q max and Q max when voiding occurred, presence of a bladder contraction in new position, and pdet Q max and Q max in new position, and Valsalva effort.Results503 patients underwent UDS; 94/503 patients were moved to a new position and 81/94 studies were interpretable. 71% of patients without a bladder contraction on the UDS chair demonstrated contraction in new position.ConclusionUDS voiding position and surface can impact whether patients produce a bladder contraction and representative void during urodynamic testing. Positional change to more natural voiding positions and surfaces improves detection of intact detrusor function.

31 Mar 2025·International Neurourology Journal

Effect of Acotiamide on Detrusor Underactivity Induced Through Bilateral Pelvic Nerve Crush Injury in Rats

Article

Author: Takaoka, Ei-Ichiro ; Kamei, Jun ; Sugihara, Toru ; Fujimura, Tetsuya ; Ando, Satoshi ; Yoshimura, Naoki ; Nagahama, Kenji

Purpose: To investigate the effectiveness of acotiamide on lower urinary tract dysfunction by using a rat model of neurogenic underactive bladder induced through pelvic nerve crush (PNC) injury.Methods: Bilateral PNC injuries were performed on 8-week-old female Sprague-Dawley rats (PNC group); the sham surgery group was used as control (control group). Two weeks after surgery, awake cystometrography (CMG) was performed, and acotiamide (10 or 100 mg/kg) was subcutaneously administered to the control and PNC groups. Subsequently, CMG parameter values obtained before and after treatment were compared.Results: In baseline CMG, compared to control group, PNC group revealed statistically significant elevations in the intercontraction intervals (ICIs), number of nonvoiding contractions, baseline pressure, threshold pressure, bladder capacity, voided volumes, and postvoid residual. However, contraction amplitudes and voiding efficiency were significantly decreased. In the control group, compared with the baseline values, 10-mg/kg acotiamide resulted in statistically significant elevations in contraction amplitudes. Treatment with 100-mg/kg acotiamide led to statistically significant elevations in contraction amplitudes and decreases in ICI and bladder volume. In the PNC group, there were no statistically significant changes noted in CMG parameters after treatment with 10-mg/kg acotiamide (n=6). Compared with the baseline values, the administration of 100-mg/kg acotiamide significantly decreased ICI (1,025±186 seconds vs. 578±161 seconds; P=0.012), bladder capacity (1,841±323 µL vs. 871±174 µL, respectively; P=0.0059) and postvoid residual (223±46 µL vs. 44±22 µL, respectively; P=0.023), and increased contraction amplitudes (22.09±1.76 cm H<sub>2</sub>O vs. 43.84±6.87 cm H<sub>2</sub>O, respectively; P=0.012) and voiding efficiency (0.87±0.02 vs. 0.94±0.03, respectively; P=0.029).Conclusions: Acotiamide showed effectiveness in the treatment of underactive bladder, possibly through activation of bladder afferent and detrusor activities.

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