Cohn Joshua A, Brown Elizabeth T, Kaufman Melissa R, Dmochowski Roger R, Reynolds W Stuart
Department of Urologic Surgery, Vanderbilt University Medical Center, Medical Center North, Nashville, Tennessee, USA.
Curr Opin Urol. 2016 Jul;26(4):309-14. doi: 10.1097/MOU.0000000000000280.
Underactive bladder (UAB) is a clinical symptom complex only recently gaining recognition as a clinical diagnosis. Lack of consensus agreement on a definition of UAB has limited its recognition and diagnosis in clinical practice. The purposes of this review are to: present existing definitions of UAB, review recent data regarding clinical and urodynamic diagnosis of the condition, and examine up-to-date hypotheses regarding its pathophysiology, with a focus on women.
The process to develop a consensus definition for UAB as a clinical symptom complex is ongoing. Symptoms associated with UAB, such as weak stream, straining to void, and history of urinary retention are well correlated to detrusor underactivity on urodynamics, which frequently develops in elderly women. In addition to aging, UAB may be the end stage of a variety of contributing pathologic conditions such as diabetes and ischemic disease. In some women, UAB may result from a progression from overactive bladder to UAB.
Existing evidence supports UAB in women as a symptom complex with a clinical and pathophysiologic profile distinguishable from other lower urinary tract-associated clinical conditions. Consensus definitions of clinical and urodynamic diagnostic parameters will be essential to more widespread recognition of UAB.
膀胱过度活动症（UAB）是一种临床症状复合体，直到最近才作为一种临床诊断得到认可。对UAB定义缺乏共识限制了其在临床实践中的识别和诊断。本综述的目的是：介绍UAB的现有定义，回顾有关该病症临床和尿动力学诊断的最新数据，并研究其病理生理学的最新假说，重点关注女性。
将UAB作为一种临床症状复合体制定共识定义的过程正在进行中。与UAB相关的症状，如尿流无力、排尿费力和尿潴留史，与尿动力学检查中逼尿肌活动不足密切相关，这在老年女性中经常出现。除了衰老，UAB可能是多种致病病理状况（如糖尿病和缺血性疾病）的终末期。在一些女性中，UAB可能是从膀胱过度活动症发展而来的。
现有证据支持女性UAB是一种症状复合体，其临床和病理生理学特征与其他下尿路相关临床病症不同。临床和尿动力学诊断参数的共识定义对于更广泛地认识UAB至关重要。
