Epidemiology of underactive bladder: Common but underresearched

Detrusor underactivity (DU) or underactive bladder is a common cause of lower urinary tract symptoms (LUTS), but it is still poorly understood and underresearched. Although there has been a proposed definition by International Continence Society in 2002, no widely accepted diagnostic criteria have been established for this entity in clinical practice. Therefore, it has been rare to identify community-based researches on the epidemiology of DU until now. Only certain studies have reported the prevalence of DU in community-dwelling cohorts with significant LUTS using arbitrary urodynamic criteria for DU and these investigations have indicated that DU accounts for 25%-48% and 12%-24% of elderly men and women, respectively. However, these prevalence data based on the urodynamic definition apparently are limited in their extrapolation to the general population. Despite the clinical ambiguity of DU, its clinical effects on quality of life are quite significant, especially in the elderly population. An overall and proper comprehension of epidemiologic studies of DU may be crucial for better insight into DU, relevant decision making, and a more reasonable allocation of health resources. Therefore, researchers should find clues to the solution for the clinical diagnosis of this specific condition of LUTS from contemporary epidemiologic studies and try to develop a possible definition of 'clinical' DU from further studies.