ABSTRACT
According to the standardization of terminology from the International Continence Society, detrusor underactivity (DU) is urodynamically defined as a contraction of reduced strength and/or duration, resulting in prolonged bladder emptying and/or a failure to achieve complete bladder emptying within a normal time span. Acontractile detrusor (AD) is one that cannot be demonstrated to contract during urodynamic studies. This chapter lists some bladder outlet conditions associated with DU/AD. The overarching themes when evaluating patients for DU/AD are focused on safety and quality of life. Safety issues, such as hydronephrosis and urinary tract infections, are generally addressed first. Bladder drainage may be achieved with clean intermittent catheterization or an indwelling catheter. Sacral neuromodulation was US Food and Drug Administration approved for treatment of nonobstructive urinary retention in 1999. While multiple transurethral options are now available, electrosurgical transurethral resection of the prostate remains the gold standard in endoscopic treatment of lower urinary tract symptoms/benign prostatic hyperplasia.
