What is Underactive Bladder Syndrome?

The Underactive Bladder is a symptom complex suggestive of detrusor underactivity and is usually characterized by prolonged urination time with or without a sensation of incomplete bladder emptying, usually with hesitancy, reduced sensation on filling, and a slow stream.

Underactive Bladder Syndrome is a chronic, complex and debilitating disease which affects the urinary bladder with serious consequences. Patients with an underactive bladder can hold unusually large amounts of urine but has a diminished sense of when the bladder is full and is not able to contract the muscles sufficiently and as forcefully as it should, resulting in incomplete bladder emptying.

The symptoms and severity of underactive bladder vary from one person to another and the course of the disease is often unpredictable.

Today, there is no way to prevent underactive bladder and there is no silver bullet. Treatments are available for some, but not all of the most serious complications of the disease. Current treatments include medications such as Bethanechol, Doxazosin, and Finasteride. Presently, most treatments focus on techniques to promote and assist bladder emptying such as intermittent self-catheterization and indwelling catheters. These techniques act to slow the progression of the disease and limit damage rather than truly arresting the disease. In addition, some of the drugs currently in use can have serious side effects. There is much work that remains to be done.

Despite the number of people affected by underactive bladder and the devastating effect the disease can have, bladder research remains critically underfunded by the National Institutes of Health. Until new therapies are made possible by advances in medical research, people living with underactive bladder syndrome continue to have hope, knowing that scientists are working every day on their behalf.

The International Continence Society (2002) refers to the condition of detrusor underactivity, 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 usual time span. This condition has also been referred to as Hypotonic Bladder, Flaccid bladder, Lazy bladder and Detrusor Hypoactivity. Detrusor underactivity is a medical diagnostic term based on urodynamic testing that requires catheter insertion into the bladder and rectum. Progress on cures targeting detrusor under activity is painfully slow. For patients and their families, meaningful progress may be contingent on a pivot to a symptomatic based framework over urodynamic testing.

The symptoms and severity of underactive bladder vary from one person to another and the course of the disease is often unpredictable. The disease most often strikes between the ages of 40 and 60; however, young adults and those above age 60 across all ethnic groups are also affected.

The Underactive Foundation’s highest priority remains funding research to deliver a cure for underactive bladder and its complications. At the same time, the Foundation is also focused on efforts to strategize about methods to optimize thinking on underactive bladder syndrome to encourage meaningful progress to keep future generations from developing the disease. The Foundation strives to keep you informed of headlines, reports and announcements affecting the underactive bladder community.

UAB Definition: Chapple CR, et al. The Underactive Bladder: A New Clinical Concept?, Eur Urol (2015), http://dx.doi.org/10.1016/j.eururo.2015.02.030

Ref: Abrams P, Cardozo L, Fall M, et al: The standardization of terminology of lower urinary tract function: Report from the Standardisation Subcommittee of the International Continence Society. Neurourol Urodyn 22: 167-178, 2002.