Underactive bladder causes contractions that don’t fully empty your bladder. There are several possible causes of an underactive bladder, and treatment depends on factors such as underlying causes and symptoms.
Underactive bladder is a condition that occurs when your bladder doesn’t contract the way it needs to for complete bladder emptying. This leads to symptoms such as slow urination, feeling as if you need to struggle and strain while passing urine, and urinary leakage.
Several underlying conditions can cause underactive bladder, including diabetes, surgeries in the pelvic region, bladder flow blockages, and some neurological conditions.
Treatment depends on the underlying condition but can include bladder training, medication, catheterization, or surgery.
An underactive bladder is a condition that happens when your bladder contractions are unable to empty the bladder fully.
This can be because they’re weaker than typical contractions, shorter than typical contractions, or both. It can lead to slow bladder emptying and the inability to completely empty the bladder.
There are several possible causes of an underactive bladder. It can be the result of damage to the nerves that control the bladder or to your bladder. Sometimes, an underactive bladder develops without an identifiable underlying cause.
- multiple sclerosis
- Parkinson’s disease
- surgery in the pelvic region
- surgery around the rectum
- fractures that affect the pelvic bones and lower back
- slips of lower spinal discs
- infections that affect nervous system function
Underactive bladder caused by conditions that damage or affect the bladder muscle is also called myogenic underactive bladder. It may be caused by:
- chronic over-stretching of the bladder
- chronic blockage of bladder flow
- chronic benign prostate enlargement
Sometimes, myogenic underactive bladder can also result from learned or habitual bathroom patterns, but this is rare.
Underactive bladder can cause multiple symptoms, including:
- a urine flow that starts and stops
- feeling like you need to strain to pass urine
- needing to wait for the flow of urine to begin
- a slow or weak urine stream
- feeling as though your bladder isn’t completely empty
- feeling like you need to pass uring a second time immediately after using the bathroom
- urinary urgency
- frequent urination
- urinary leaks
Many bladder conditions have overlapping symptoms. Diagnostic testing can help confirm a diagnosis. If your doctor suspects you might have underactive bladder. They’ll likely order tests such as:
- Flow rate testing: This type of testing measures how fast urine is passed out of your body.
- Residual volume ultrasound: This test uses an ultrasound to see how much urine remains in your bladder after urination.
- Electromyography: An electromyography uses electrodes to measure the nerve and muscle activity around your bladder and urinary tract.
- Cystometry: During cystometry, a thin catheter is inserted so that your bladder’s pressure can be measured and tested. You can read more about this test here.
Treatment of underactive bladder varies and depends on the individual. Not everyone is bothered by the symptoms of underactive bladder, and not everyone needs treatment. Sometimes, monitoring is the only action you and your doctor will take.
For other people, bladder training can be helpful. This typically involves timed voiding. Timed voiding means urinating on a fixed schedule rather than waiting to feel the sensation of bladder fullness. It can help reduce symptoms of underactive bladder.
Medications can help some people with underactive bladder manage their condition and reduce symptoms. However, it depends on the underlying cause and on the individual person. Not all bladder medications are appropriate for everyone with this condition.
Catheterization is another treatment option for underactive bladder. This can be intermittent self-catheterization (ISC) or an indwelling catheter. ISC is a technique people with underactive bladder can do at home when needed by inserting a temporary catheter to drain urine. Indwelling catheters are permanent and can be an option for those who aren’t able to use ISCs.
Other options might used depending on the underlying cause. For instance, When an underactive bladder is the result of prostate enlargement blocking bladder flow, surgery can sometimes help. Your doctor can help explain all your treatment options.
An underactive bladder can lead to complications. Common complications include increased urinary tract infections (UTIs) and incontinence. If the condition progresses, it can lead to more serious complications, such as kidney stones, bladder stones, kidney damage, and even kidney failure.
The exact outlook for people with underactive bladder depends on the underlying cause. However, treatments can help reduce symptoms and can promote bladder emptying. They don’t cure the condition, but they can help keep it well-managed.
Can I live with an underactive bladder?
Yes. Some people have no symptoms or very mild symptoms with an underactive bladder. However, it’s still important to get a diagnosis so that your doctor can monitor the condition.
Is underactive bladder progressive?
It can be. It depends on the underlying cause and on any treatment you receive.
What exercises can help underactive bladder?
If your underactive bladder is connected to muscle problems, then pelvic floor or kegel exercises can help. Your doctor might give you specific exercises to do.
Underactive bladder happens when bladder contractions don’t work well enough to fully empty the bladder. There are multiple causes of underactive bladder, including conditions that can manage the nerves, such as Parkinson’s disease, and conditions that affect bladder muscle, such as chronic bladder blockage.
Underactive bladder doesn’t always need treatment. When it does, treatment options depend on the symptoms and the underlying cause but can include bladder training, medications, catheterization, and surgery.