{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,21]],"date-time":"2026-07-21T09:55:35Z","timestamp":1784627735328,"version":"3.55.0"},"reference-count":37,"publisher":"F1000 Research Ltd","license":[{"start":{"date-parts":[[2016,1,25]],"date-time":"2016-01-25T00:00:00Z","timestamp":1453680000000},"content-version":"unspecified","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["f1000research.com"],"crossmark-restriction":false},"short-container-title":["F1000Res"],"abstract":"<ns4:p>The inability to generate a voiding contraction sufficient to allow efficient bladder emptying within a reasonable time frame is a common problem seen in urological practice. Typically, the symptoms that arise are voiding symptoms, such as weak and slow urinary flow. These symptoms can cause considerable bother to patients and impact upon quality of life. The urodynamic finding of inadequate detrusor contraction has been termed detrusor underactivity (DUA). Although a definition is available for this entity, there are no widely accepted diagnostic criteria. Drawing parallels to detrusor overactivity and the overactive bladder, the symptoms arising from DUA have been referred to as the \u201cunderactive bladder\u201d (UAB), while attempts to crystallize the definition of UAB are now ongoing. In this article, we review the contemporary literature pertaining to the epidemiology and etiopathogenesis of DUA as well as discuss the definitional aspects that are currently under consideration.<\/ns4:p>","DOI":"10.12688\/f1000research.7344.1","type":"journal-article","created":{"date-parts":[[2016,1,25]],"date-time":"2016-01-25T05:45:09Z","timestamp":1453700709000},"page":"102","update-policy":"https:\/\/doi.org\/10.12688\/f1000research.crossmark-policy","source":"Crossref","is-referenced-by-count":21,"title":["The underactive bladder: detection and diagnosis"],"prefix":"10.12688","volume":"5","author":[{"given":"Nadir","family":"Osman","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Altaf","family":"Mangera","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Christopher","family":"Hillary","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6721-5418","authenticated-orcid":false,"given":"Richard","family":"Inman","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Christopher R.","family":"Chapple","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"2560","published-online":{"date-parts":[[2016,1,25]]},"reference":[{"key":"ref-1","doi-asserted-by":"publisher","first-page":"167-78","DOI":"10.1002\/nau.10052","article-title":"The standardisation of terminology of lower urinary tract function: report from the Standardisation Sub-committee of the International Continence Society.","volume":"21","author":"P Abrams","year":"2002","journal-title":"Neurourol Urodyn."},{"key":"ref-2","doi-asserted-by":"publisher","first-page":"351-3","DOI":"10.1016\/j.eururo.2015.02.030","article-title":"The underactive bladder: a new clinical concept?","volume":"68","author":"C Chapple","year":"2015","journal-title":"Eur Urol."},{"key":"ref-3","doi-asserted-by":"publisher","first-page":"389-98","DOI":"10.1016\/j.eururo.2013.10.015","article-title":"Detrusor underactivity and the underactive bladder: a new clinical entity? 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Aging detrusor: normal versus impaired contractility.","volume":"150","author":"A Elbadawi","year":"1993","journal-title":"J Urol."},{"key":"ref-7","first-page":"1668-80","article-title":"Structural basis of geriatric voiding dysfunction. III. Detrusor overactivity.","volume":"150","author":"A Elbadawi","year":"1993","journal-title":"J Urol."},{"key":"ref-8","first-page":"1681-95","article-title":"Structural basis of geriatric voiding dysfunction. IV. 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knowledge.","volume":"182","author":"F Daneshgari","year":"2009","journal-title":"J Urol."},{"key":"ref-19","doi-asserted-by":"publisher","first-page":"1011-2","DOI":"10.1097\/01.ju.0000051323.18096.53","article-title":"Editorial: bladder failure--a condition to reckon with.","volume":"169","author":"D Griffiths","year":"2003","journal-title":"J Urol."},{"key":"ref-20","doi-asserted-by":"publisher","first-page":"129-34","DOI":"10.1111\/j.1464-410X.1979.tb02846.x","article-title":"The assessment of prostatic obstruction from urodynamic measurements and from residual urine.","volume":"51","author":"P Abrams","year":"1979","journal-title":"Br J Urol."},{"key":"ref-21","first-page":"405-7","article-title":"A simplified graphic procedure for detailed analysis of detrusor and outlet function during voiding.","volume":"8","author":"W Sch\u00e4fer","year":"1989","journal-title":"Neurourol Urodyn."},{"key":"ref-22","doi-asserted-by":"publisher","first-page":"388-94","DOI":"10.1002\/nau.20537","article-title":"Definition of normality of pressure-flow parameters based on observations in asymptomatic men.","volume":"27","author":"D Rosario","year":"2008","journal-title":"Neurourol Urodyn."},{"key":"ref-23","doi-asserted-by":"publisher","first-page":"1458-63","DOI":"10.1016\/S0022-5347(05)64473-4","article-title":"Urodynamic patterns of normal male micturition: influence of water consumption on urine production and detrusor function.","volume":"168","author":"F Schmidt","year":"2002","journal-title":"J Urol."},{"key":"ref-24","doi-asserted-by":"publisher","first-page":"405-12","DOI":"10.1111\/j.1532-5415.2005.00613.x","article-title":"The effect of age on lower urinary tract function: a study in women.","volume":"54","author":"M Pfisterer","year":"2006","journal-title":"J Am Geriatr Soc."},{"key":"ref-25","doi-asserted-by":"publisher","first-page":"497-507","DOI":"10.1111\/j.1464-410X.1973.tb06812.x","article-title":"The mechanics of the urethra and of micturition.","volume":"45","author":"D Griffiths","year":"1973","journal-title":"Br J Urol."},{"key":"ref-26","doi-asserted-by":"publisher","first-page":"1-18","DOI":"10.1002\/nau.1930100102","article-title":"Assessment of Detrusor Contraction Strength or Contractility.","volume":"10","author":"D Griffiths","year":"1991","journal-title":"Neurourol Urodyn."},{"key":"ref-27","doi-asserted-by":"publisher","first-page":"621-35","DOI":"10.1002\/(SICI)1520-6777(1998)17:6<621::AID-NAU6>3.0.CO;2-4","article-title":"The maximum watts factor as a measure of detrusor contractility independent of outlet resistance.","volume":"17","author":"H Lecamwasam","year":"1998","journal-title":"Neurourol Urodyn."},{"key":"ref-28","doi-asserted-by":"publisher","first-page":"47-58","DOI":"10.1007\/BF00182666","article-title":"Analysis of bladder-outlet function with the linearized passive urethral resistance relation, linPURR, and a disease-specific approach for grading obstruction: from complex to simple.","volume":"13","author":"W Sch\u00e4fer","year":"1995","journal-title":"World J Urol."},{"key":"ref-29","doi-asserted-by":"publisher","first-page":"93-100","DOI":"10.1080\/03008880410015426","article-title":"Detrusor contractility--order out of chaos.","volume":"38","author":"D Griffiths","year":"2004","journal-title":"Scand J Urol Nephrol Suppl."},{"key":"ref-30","doi-asserted-by":"publisher","first-page":"1023-7","DOI":"10.1097\/01.ju.0000043810.43273.d7","article-title":"Which stop test is best? Measuring detrusor contractility in older females.","volume":"169","author":"T Tan","year":"2003","journal-title":"J Urol."},{"key":"ref-31","first-page":"7-10","article-title":"Functional studies to assess bladder contractility.","volume":"14","author":"M Sullivan","year":"2007","journal-title":"J urol Urogyn\u00e4kol."},{"key":"ref-32","doi-asserted-by":"publisher","first-page":"1834-40","DOI":"10.1016\/S0022-5347(01)66795-8","article-title":"Continuous occlusion test to determine detrusor contractile performance.","volume":"154","author":"M Sullivan","year":"1995","journal-title":"J Urol."},{"key":"ref-33","doi-asserted-by":"publisher","first-page":"75-9","DOI":"10.1016\/j.urology.2007.03.041","article-title":"Urodynamic findings suggesting two-stage development of idiopathic detrusor underactivity in adult men.","volume":"70","author":"A Cucchi","year":"2007","journal-title":"Urology."},{"key":"ref-34","doi-asserted-by":"publisher","first-page":"229-33","DOI":"10.1016\/j.juro.2009.08.162","article-title":"Different evolution of voiding function in underactive bladders with and without detrusor overactivity.","volume":"183","author":"A Cucchi","year":"2010","journal-title":"J Urol."},{"key":"ref-35","doi-asserted-by":"publisher","first-page":"844-8","DOI":"10.1016\/j.urology.2007.11.145","article-title":"Development of idiopathic detrusor underactivity in women: from isolated decrease in contraction velocity to obvious impairment of voiding function.","volume":"71","author":"A Cucchi","year":"2008","journal-title":"Urology."},{"key":"ref-36","doi-asserted-by":"publisher","first-page":"215-20","DOI":"10.1016\/S0022-5347(05)68009-3","article-title":"Urodynamic assessment of the bashful bladder.","volume":"163","author":"D Rosario","year":"2000","journal-title":"J Urol."},{"key":"ref-37","doi-asserted-by":"publisher","first-page":"508-13","DOI":"10.1111\/j.1464-410X.2009.08790.x","article-title":"The additional value of ambulatory urodynamic measurements compared with conventional urodynamic measurements.","volume":"105","author":"G van Koeveringe","year":"2010","journal-title":"BJU Int."}],"container-title":["F1000Research"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/f1000research.com\/articles\/5-102\/v1\/xml","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/f1000research.com\/articles\/5-102\/v1\/pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/f1000research.com\/articles\/5-102\/v1\/iparadigms","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2019,3,22]],"date-time":"2019-03-22T10:42:46Z","timestamp":1553251366000},"score":1,"resource":{"primary":{"URL":"https:\/\/f1000research.com\/articles\/5-102\/v1"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2016,1,25]]},"references-count":37,"URL":"https:\/\/doi.org\/10.12688\/f1000research.7344.1","relation":{"has-review":[{"id-type":"doi","id":"10.5256\/f1000research.7915.r12060","asserted-by":"subject"},{"id-type":"doi","id":"10.5256\/f1000research.7915.r12061","asserted-by":"subject"},{"id-type":"doi","id":"10.5256\/f1000research.7915.r12061","asserted-by":"object"},{"id-type":"doi","id":"10.5256\/f1000research.7915.r12060","asserted-by":"object"}]},"ISSN":["2046-1402"],"issn-type":[{"value":"2046-1402","type":"electronic"}],"subject":[],"published":{"date-parts":[[2016,1,25]]},"assertion":[{"value":"Indexed","URL":"https:\/\/f1000research.com\/articles\/5-102\/v1#article-reports","order":0,"name":"referee-status","label":"Referee status","group":{"name":"current-referee-status","label":"Current Referee Status"}},{"value":"10.5256\/f1000research.7915.r12060, Naoki Yoshimura, Department of Urology, University of Pittsburgh, Pittsburgh, PA, USA, 25 Jan 2016, version 1, indexed","URL":"https:\/\/f1000research.com\/articles\/5-102\/v1#referee-response-12060","order":0,"name":"referee-response-12060","label":"Referee Report","group":{"name":"article-reports","label":"Article Reports"}},{"value":"10.5256\/f1000research.7915.r12061, Peter F.W.M Rosier, Department of Urology, University Medical Center Utrecht, Utrecht, The Netherlands, 25 Jan 2016, version 1, indexed","URL":"https:\/\/f1000research.com\/articles\/5-102\/v1#referee-response-12061","order":1,"name":"referee-response-12061","label":"Referee Report","group":{"name":"article-reports","label":"Article Reports"}},{"value":"Nadir Osman has received a grant from Astellas. Christopher R. Chapple has received grants and personal fees from Astellas, Allergan, and Recordati. All the other authors have no conflicts of interest to declare.","order":2,"name":"grant-information","label":"Grant Information"},{"value":"This is an open access article distributed under the terms of the Creative Commons Attribution Licence, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.","order":0,"name":"copyright-info","label":"Copyright"}]}}