underactive bladder; bladder atony

Etiology

• drugs
• fecal impaction
• neurologic conditions (neurogenic bladder)
  • diabetic neuropathy
  • low spinal cord injury
  • weakening of the detrusor muscle
    • vitamin B12 deficiency
    • idiopathic causes
• radical pelvic surgery

Pathology

• bladder contraction of inadequate magnitude &/or duration effects bladder emptying in a normal timespan
• bladder underactivity may cause overdistension of the bladder, resulting in overflow incontinence

Diagnostic procedures

• measurement of postvoid residual in men (prior to medication discontinuation)
  • postvoid residual <= 450 mL is not suggestive of longstanding urinary retention with bladder atony
• urodynamic studies

Management

• self intermittent catherization
• intraurethral valve pump
• sacral nerve stimulation may be effective
• also see overflow incontinence

More general terms

• sign/symptom
• urologic disease

More specific terms

• neurogenic bladder

Additional terms

• overflow incontinence