detrusor hyperactivity with impaired bladder contractility (DHIC)

Pathology

• involuntary detrusor contractions
• weakness of the detrusor muscle
• incomplete bladder emptying

Clinical manifestations

• may mimic urinary stress incontinence
• urinary frequency, urgency, urge incontinence
• leakage of urine when bending over & walking up or down stairs
• urinary retention
  • sensation of incomplete bladder emptying
  • patients either are unable to empty their bladder completely or can empty their bladder completely only with straining due to poor contractility of the detrusor

Diagnostic procedures

• elevated post-void residual

Differential diagnosis

• cholinesterase inhibitors increase bladder contractility
• severe pelvic prolapse due to cystocele can cause urethral obstruction
  • not so much with moderate pelvic prolapse
• stress incontinence not associated with urinary retention

More general terms

• detrusor instability

Additional terms

• detrusor muscle (musculi detrusor vesicae)
• detrusor sphincter dyssynergia (DSD)
• neurogenic bladder