Identifying an underactive bladder

Identifying when a person has an underactive bladder is difficult and consequently the condition is often mis-diagnosed.

Identifying the symptoms of an hypotonic bladder from other lower urinary tract symptoms can be challenging.

It is often a chronic condition so the person learns to adapt to their symptoms. To identify underactive bladder look for indications of the following symptoms:

• Frequency – they go to the toilet more often in the daytime
• Nocturia – also start getting up at night
• Hesitancy – they may need to wait a little longer for the urine to come, the stream will become less powerful and could become intermittent
• Clothing becoming tighter – they may think they are putting on weight, as their clothing becomes tighter due their enlarged bladder, and in view of this perceived weight gain they may reduce their dietary intake
• Reduced fluid intake – it is not uncommon for fluid intake to be reduced as well to try and reduce the frequency of voiding.

Reducing fluid and dietary intake will increased the risk of constipation and urinary tract infection.

Post-void bladder scanning is used to identify large residual urine volumes. If high residual urine volumes are measured consistently, this indicates an underactive bladder.

Your task

What is an acceptable post-void residual urine volume?

When would you consider a post-void residual urine volume to be high?

Share your thoughts with fellow learners.