Detrusorunderaktivitet

Detrusor underactivity, also known as detrusor hypocontractility or an underactive bladder, is a condition characterized by a diminished or absent contraction of the detrusor muscle, the smooth muscle in the wall of the bladder. This impaired contraction leads to incomplete bladder emptying and potentially urinary retention. The condition can affect both men and women and is often associated with aging.

Several factors can contribute to detrusor underactivity. Neurological conditions such as diabetes mellitus, spinal cord injury, stroke, and Parkinson's disease can damage the nerves that control bladder function. Bladder outlet obstruction, prolonged overdistension of the bladder, and certain medications can also lead to detrusor underactivity. In some cases, the exact cause remains unknown.

Symptoms of detrusor underactivity can include a weak or slow urinary stream, a feeling of incomplete bladder emptying, hesitancy in initiating urination, and the need to strain to void. In more severe cases, individuals may experience urinary retention, leading to overflow incontinence, recurrent urinary tract infections, and kidney damage due to back-pressure.

Diagnosis typically involves a medical history, physical examination, and urodynamic studies. Urodynamic testing, such as uroflowmetry and a cystometrogram, can objectively assess bladder pressure and the strength of detrusor contractions.

Treatment aims to improve bladder emptying and prevent complications. Options may include timed voiding schedules, double voiding techniques, and Crede's maneuver (manual pressure on the abdomen to assist emptying). Intermittent self-catheterization is often necessary for complete bladder emptying when other methods are insufficient. Pharmacological interventions are generally limited in their effectiveness for severe detrusor underactivity.