Three13 118 Underactive bladder

  1. Underactive bladder ICS 2018 definition?
    Underactive bladder: Slow urinary stream, hesitancy and straining to void, with or without a feeling of incomplete bladder emptying sometimes with storage symptoms

    Acontractile bladder - that cannot be demonstrated to contract during urodynamic studies


    Detrusor underactivity (UDS diagnosis) - contraction of reduced strength and/or duration resulting in prolonged bladder emptying and/or failure to achieve complete bladder emptying within a normal life span

    No specific definition of any of the following descriptive terms - reduced strength on UDS, reduced duration in UDS, prolonged bladder emptying, complete bladder emptying, normal time span?
  2. What is detrusor underactivity?
    A contraction of reduced strength and/or duration, resulting in prolonged bladder emptying and/or failure to achieve complete bladder emptying within a normal time span - ICS 2002
  3. USG finding in detrusor underactivity?
    • Detrusor wall thickness (DWT) ≤ 1.23 mm + bladder capacity >445 ml have DU.
    • Combination of these two tests could help physicians to diagnose DU noninvasively in clinical practice. A prospective independent study should confirm these results

    [@ 12345 - 1.23, 450ml]]
  4. Treatment of detrusor underactivity?
    • Bladder related (increasing intravesical pressure or facilitating bladder contractility) 
    • - External compression, Valsalva 
    • - Promotion/initiating reflex contraction 
    • - Pharmacotherapy 
    • - Electrical stimulation
    • - Reduction cystoplasty 
    • - Bladder myoplasty 

    • Outlet related (decreasing outlet resistance) 
    • - at the site of obstruction - TURP, TUBNI, urethral stricture repair, intraurethral stent, balloon dilatation 
    • - at the level of smooth sphincter - pharmacological therapy, transurethral incision, YV plasty 
    • - at the level of striated sphincter - behaviour therapy, biofeedback, pharmacotherapy, urethral over dilatation,m surgical sphincterotomy

    • Circumventing the problem 
    • - CISC 
    • - Indwelling catheterization 
    • - Urinary diversion (conduit)

    Image Upload 1
  5. Monitoring the patient with DU?
    • PVRU 
    • Biochemistry 
    • Upper tracts 
    • Bladder wall thickness
Author
prem7777
ID
352130
Card Set
Three13 118 Underactive bladder
Description
Underactive bladder
Updated