Terminology report from the International Continence Society (ICS) Working Group on Underactive Bladder (UAB)

Chapple, Christopher R.; Osman, Nadir I.; Birder, Lori A.; Dmochowski, Roger R.; Drake, Marcus; Koeveringe, Gommert van; Νitti, Victor W.; Oelke, Matthias; Smith, Phillip P.; Yamaguchi, Osamu; Wein, Alan J.; Abrams, Paul

doi:10.1002/nau.23701

Cited by 99 publications

(91 citation statements)

References 21 publications

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“… Overactive bladder syndrome (OAB) is characterized by urinary urgency, with or without urgency urinary incontinence, usually with IDF and nocturia, if there is no proven infection or other obvious pathology Underactive bladder syndrome (UAB) is characterized by a slow urinary stream, hesitancy, and straining to void, with or without a feeling of incomplete bladder emptying sometimes with storage symptoms …”

Section: Lower Urinary Tract Symptomsmentioning

confidence: 99%

“…Underactive bladder syndrome (UAB) is characterized by a slow urinary stream, hesitancy, and straining to void, with or without a feeling of incomplete bladder emptying sometimes with storage symptoms. 3 OAB is applicable during the storage phase of the micturition cycle, and UAB during the voiding phase, so it is possible for one individual to manifest both symptom syndromes.…”

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confidence: 99%

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Fundamentals of terminology in lower urinary tract function

Drake

2018

Neurourology and Urodynamics

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Aims To summarize basic definitions in the International Continence Society (ICS) Standardization of Terminology in lower urinary tract (LUT) function and their application. Methods Fundamental terminology in the ICS Standardization of Terminology LUT Function was identified and summarized. Results Evaluation of LUT requires appreciation of symptoms, signs and urodynamic observations. Symptoms are categorized according to their occurrence during the micturition cycle into storage symptoms (eg, increased daytime frequency [IDF], urgency, nocturia, or incontinence) or voiding and post‐voiding symptoms (eg, slow stream or post micturition dribbling). Several problems may be present, giving rise to symptom syndromes, notably overactive bladder (during the storage phase) or underactive bladder (during the voiding phase). Signs may be derived from a bladder diary or may be elicited on physical examination. Urodynamic observations may be made by assessing flow rate, and this is combined with pressure measurement when undertaking filling cystometry and pressure flow studies. Key elements of flow and pressure measurement are described. Conclusions The review provides a succinct summary of symptoms, signs, and urodynamic observations as set out in the ICS Standard on LUT Function.

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Section: Lower Urinary Tract Symptomsmentioning

confidence: 99%

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confidence: 99%

Fundamentals of terminology in lower urinary tract function

Drake

2018

Neurourology and Urodynamics

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“…2 In contrast, underactive bladder (UAB) has been characterized by a slow urinary stream, hesitancy and straining to void, with or without a feeling of incomplete bladder emptying sometimes with storage symptoms. 3 While UAB is a clinical syndrome that includes DUA, DUA can only be diagnosed by an invasive pressure-flow study during urodynamics. The ICS definition of DUA is limited by the ambiguity of what constitutes a reduced contraction strength or length of prolonged voiding.…”

Section: Definitions and Diagnosismentioning

confidence: 99%

Detrusor underactivity in women: A current understanding

Hartigan

Reynolds

Dmochowski

2019

Neurourology and Urodynamics

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Aims To examine the current understanding and management of detrusor underactivity (DUA) and underactive bladder (UAB) in women. Methods A review of the current literature was performed with a specific focus on new management strategies and treatment options for women with DUA and UAB. Results DUA has become an area of increased interest in recent years. Affecting up to 45% of older women undergoing urodynamic evaluation for non‐neurogenic lower urinary tract symptoms, DUA is common. There are a variety of possible etiologies including neurogenic or myogenic dysfunction. As there is currently no cure for DUA and no way to restore the ability of the detrusor muscle to contract, management of DUA in women is mostly focused on effective bladder drainage by urinary catheterization. Clean intermittent catheterization is the gold standard for bladder drainage however for a variety of reasons, women with DUA often are managed with indwelling urethral catheter or suprapubic tube. Medications, sacral neuromodulation, and the inFlow urinary prosthesis are also treatment alternatives or additions to catheterization. Novel therapies using stem cells and gene therapy are also under investigation for the treatment of DUA and UAB. Conclusions DUA is likely more prevalent than recognized and undertreated in women. It is vital that further research in treatment options beyond catheterization be developed for these patients to offer patients a variety of treatment options.

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“…In 2018 the ICS group did not opine any further as to what would be the best definition. 3 Appreciating the difficulty with the definitions, Olesen et al state that the determinants for nocturia include functional bladder capacity, 24-hour urine output, nocturnal output and BMI. Focusing on those factors, they say, can help guide the provider to the at-risk patient.…”

Section: The Articles In This Issue Of the International Journal Of Cmentioning

confidence: 99%

“…The 2012 definition from the same group states this should be a production of 90 mL/h during sleeping hours. In 2018 the ICS group did not opine any further as to what would be the best definition . Appreciating the difficulty with the definitions, Olesen et al state that the determinants for nocturia include functional bladder capacity, 24‐hour urine output, nocturnal output and BMI.…”

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confidence: 99%

It's All About the Urine, Dad

Rosenberg¹

2019

Int J Clin Pract

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Terminology report from the International Continence Society (ICS) Working Group on Underactive Bladder (UAB)

Cited by 99 publications

References 21 publications

Fundamentals of terminology in lower urinary tract function

Fundamentals of terminology in lower urinary tract function

Detrusor underactivity in women: A current understanding

It's All About the Urine, Dad

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