Last update 01 Nov 2024

Urinary Bladder, Underactive

Last update 01 Nov 2024

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

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.Startup

Active Indication-

Inactive Indication

Urinary Bladder, Underactive

Drug Highest PhasePending

First Approval Ctry. / Loc.-

First Approval Date20 Jan 1800

ASP-8302

Target

M3 receptor

Mechanism

M3 receptor modulators

Active Org.-

Originator Org.

Astellas Pharma, 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

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-

NCT06020963 / RecruitingNot ApplicableIIT

Can Acupoint Low Intensity Shockwave Therapy Improve Bladder Voiding Efficiency: A Pilot Study.

With the increasing of the elderly population, patients with urinary dysfunction caused by inefficiency of bladder emptying becomes much often than before. However, the current treatments for this kind of bladder dysfunction are limited and unsatisfactory. Low-intensity extracorporeal shockwave therapy (LiESWT) is a very popular emerging treatment in recent years, and abundant of literatures have confirmed that this treatment is safe and effective in myofascial pain and male erectile dysfunction. Recently, many animal experiments have showed that LiESWT could improve urinary dysfunction caused by bladder dysfunction. Taiwan based studies also reported that LiESWT could improve symptoms of overactive bladder. LiESWT is a non-drug, low-invasive and high-safety treatment, which is very suitable for elderly patients. In this study investigator combine the LiESWT and acupuncture to treat the patients with underactive bladder. Investigator hypothesize that LiESWT could improve bladder voiding efficiency.

Start Date11 Aug 2023

Sponsor / Collaborator-

JPRN-jRCT2071230011 / RecruitingPhase 2IIT

ZG-802 Phase IIa Trial - Randomized, Double-blind, Placebo-controlled Trial of ZG-802 in patients with Underactive Bladder -

Start Date12 Jul 2023

Sponsor / Collaborator-

100 Clinical Results associated with Urinary Bladder, Underactive

100 Translational Medicine associated with Urinary Bladder, Underactive

0 Patents (Medical) associated with Urinary Bladder, Underactive

406

Literatures (Medical) associated with Urinary Bladder, Underactive

01 Nov 2024·Neurourology and Urodynamics

A new nomogram for the evaluation of detrusor underactivity and bladder outlet obstruction in nonneurogenic female patients with lower urinary tract symptoms who undergo urodynamic studies

Article

Author: Castaño, Juan Carlos ; Rangel Amaya, Jaime ; Sotelo Perilla, Melida ; Barco‐Castillo, Catalina

AbstractIntroductionMicturition physiology differs in men and women. However, the results in standard urodynamic studies in women with lower urinary tract symptoms (LUTS) were extrapolated from studies in men. Nowadays, the only validated nomogram for females is Solomon–Greenwell's. However, it only evaluated bladder outlet obstruction (BOO) without considering detrusor underactivity (DU). This study aims to create a nomogram that includes an evaluation of DU and BOO in nonneurogenic women and validate it against videourodynamic studies along with other nomograms.Materials and MethodsFor the first analysis (creation cohort), we included 183 women with LUTS who underwent videourodynamic study between 2022 and 2023. Exclusion criteria were females with neurologic diseases, renal transplantation, and trouble performing the flow‐pressure study. Baseline characteristics of the patients, urodynamic parameters, and classifications on different nomograms and indexes were evaluated. A logistic regression found Qmax and PdetQmax as predictors for DU and BOO. The Barco–Castillo nomogram was created by clustering analysis and adjusted by the results of the logistic regression. A second (test) cohort was evaluated from 2023 to 2024, including 142 patients for the validation of the nomogram. A p < 0.05 was considered significant.ResultsAll urodynamic parameters were compared between both cohorts, with no significant differences. The median age of the creation cohort was 50 years old (interquartile range [IQR] 39–63). All patients had LUTS and a previous standard urodynamic study without a clear diagnosis. The cluster analysis had a p < 0.05 for two groups of BOO (yes/no) and two of DU (yes/no). We created the graph based on the logistic regression results and adjusted it according to the data. The median age of the test cohort was 44 years old (IQR 33.75–59) and had the same indication for the videourodynamic study. The receiver operating characteristic (ROC) curve for BOO showed an accuracy of 85.4% for Barco–Castillo nomogram, 68.5% for Blaivas–Groutz, 58.1% for Solomon–Greenwell, 57.1% for BOOI, and 50% for LinPURR. For DU, accuracy was 80.5% for PIP‐1, 80.2% for Barco–Castillo, 76.6% for BCI, and 70.1% for LinPURR.ConclusionsWhen evaluating women's urodynamic studies, it is important to focus on female physiology and discourage the use of parameters previously standardized in men. We encourage using the new Barco–Castillo nomogram to determine BOO and DU in women as the currently easiest and more accurate tool.

01 Sep 2024·European Urology

Summary Paper on Underactive Bladder from the European Association of Urology Guidelines on Non-neurogenic Male Lower Urinary Tract Symptoms

Review

Author: Herrmann, Thomas ; Gacci, Mauro ; Cornu, Jean-Nicolas ; Tutolo, Manuela ; Hashim, Hashim ; Karavitakis, Markos ; Creta, Massimiliano ; De Nunzio, Cosimo ; Netsch, Christopher ; Rieken, Malte ; Bhatt, Nikita ; Schouten, Natasha ; Baboudjian, Michael ; Malde, Sachin ; Sakalis, Vasileios ; Moris, Lisa

BACKGROUND AND OBJECTIVEThe European Association of Urology (EAU) Guidelines Panel on non-neurogenic male lower urinary tract symptoms (LUTS) aimed to develop a new subchapter on underactive bladder (UAB) in non-neurogenic men to inform health care providers of current best evidence and practice. Here, we present a summary of the UAB subchapter that is incorporated into the 2024 version of the EAU guidelines on non-neurogenic male LUTS.METHODSA systematic literature search was conducted from 2002 to 2022, and articles with the highest certainty evidence were selected. A strength rating has been provided for each recommendation according to the EAU Guideline Office methodology.KEY FINDINGS AND LIMITATIONSDetrusor underactivity (DU) is a urodynamic diagnosis defined as a contraction of reduced strength and/or duration, resulting in prolonged bladder emptying and/or failure to achieve complete bladder emptying within a normal time span. UAB is a terminology that should be reserved for describing symptoms and clinical features related to DU. Invasive urodynamics is the only widely accepted method for diagnosing DU. In patients with persistently elevated postvoid residual (ie, >300 ml), intermittent catheterization is indicated and preferred to indwelling catheters. Alpha-adrenergic blockers are recommended before more invasive techniques, but the level of evidence is low. In men with DU and concomitant benign prostatic obstruction (BPO), benign prostatic surgery should be considered only after appropriate counseling. In men with DU and no BPO, a test phase of sacral neuromodulation may be considered.CONCLUSIONS AND CLINICAL IMPLICATIONSThe current text represents a summary of the new subchapter on UAB. For more detailed information, refer to the full-text version available on the EAU website (https://uroweb.org/guidelines/management-of-non-neurogenic-male-luts).

01 Sep 2024·Clinical Case Reports

Spontaneous atraumatic rupture of the urinary bladder following alcohol intoxication: A rare case report

Article

Author: Adhikari, Dipendra ; Adhikari, Sugat ; Singh, Manbir ; Koirala, Bishal ; Lamichhane, Samiksha ; Bhola, Harsha ; Devkota, Shritik

Key Clinical MessageConsideration of spontaneous urinary bladder rupture in the differential diagnosis of acute abdominal pain for alcohol‐abusing patients is crucial for ensuring timely surgical intervention and preventing life‐threatening complications due to its high associated morbidity and mortality.AbstractSpontaneous rupture of the urinary bladder (SRUB) is a rare but critical urological emergency, typically associated with malignancy, neurogenic dysfunction, or previous radiation therapy. Here, we present a unique case of SRUB in a 65‐year‐old chronic alcoholic male who presented with acute lower abdominal pain following heavy alcohol consumption. Initial evaluations revealed leukocytosis, elevated serum creatinine levels, and ultrasound findings suggestive of bladder rupture. Computed tomography confirmed the diagnosis, indicating an intraperitoneal rupture with associated hematoma. Immediate surgical repair was performed, leading to a successful outcome. This case underscores the importance of considering SRUB in patients with acute abdominal pain, especially in the context of alcohol intoxication, and highlights the diagnostic and therapeutic challenges associated with this condition. Early recognition and intervention are crucial to prevent life‐threatening complications associated with urinary bladder rupture.

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