Management of Stress Urinary Incontinence in Patients with Underactive Bladder

The coexistence of detrusor underactivity (DUA) and female stress urinary incontinence presents a challenge for urologists. The various DUA definitions used in the literature and the predominantly retrospective nature of most studies contribute to a low level of evidence regarding optimal management for these patients. However, efficacy outcomes appear to be quite similar to those observed for patients without DUA, albeit with a slight increase in voiding symptoms. The role of adjustable slings, bulking agents, and artificial urinary sphincters remains unclear, so identification of the most appropriate solution via a shared decision-making process with the patient is essential. PATIENT SUMMARY: For women who have stress urinary incontinence, management can be difficult for those who also have an underactive bladder. This mini review discusses the treatment options available and their advantages and disadvantages. Shared decision-making between the doctor and patient is crucial in choosing the option that best suits an individual patient's needs.