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Updated: Apr 27, 2026

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Voiding dysfunction due to detrusor underactivity: an overview.

Marcus J Drake1, Jonathan Williams1, Dominika A Bijos1

  • 1Urology Department, University of Bristol and Bristol Urological Institute, Southmead Hospital, Bristol, Avon BS10 5NB, UK.

Nature Reviews. Urology
|July 9, 2014
PubMed
Summary
This summary is machine-generated.

Detrusor underactivity (DUA) impairs bladder emptying, causing urinary symptoms. Current treatments are ineffective, and developing new therapies for DUA faces significant challenges.

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Area of Science:

  • Urology
  • Lower Urinary Tract Symptoms

Background:

  • Detrusor underactivity (DUA) is a condition characterized by reduced bladder contractility, leading to incomplete emptying and prolonged urination.
  • It is associated with voiding dysfunction, urinary tract infections, and acute urinary retention, with causes including aging, obstruction, and neurological conditions.

Purpose of the Study:

  • To review the current understanding of detrusor underactivity (DUA), including its definition, etiology, diagnosis, and treatment limitations.
  • To highlight the challenges and future directions for developing more effective therapies for DUA.

Main Methods:

  • Literature review of DUA definition, causes, and diagnostic methods.
  • Analysis of current treatment efficacy and adverse effects.
  • Discussion of challenges in developing novel therapeutic agents for DUA.

Main Results:

  • DUA diagnosis relies on urodynamic testing, assessing bladder pressure-flow relationships or detrusor pressure changes.
  • Existing treatments, such as muscarinic receptor agonists, show limited efficacy and poor tolerability.
  • Alternative management includes straining, catheterization, and sacral nerve stimulation, with limited success.

Conclusions:

  • Current treatments for DUA are largely inadequate, necessitating the development of novel therapeutic strategies.
  • Overcoming challenges in understanding DUA pathophysiology, achieving organ specificity, and improving outcome measures is crucial for advancing treatment options.