最終更新日: 2026年5月18日

Female abnormal urination problems are increasingly common in my female urology clinic. Today we will discuss about “Underactive bladder” disease in female. Normally, the bladder’s function is to store urine and squeeze all urine out when we urinate, but underactive bladder prevents the bladder from contracting as strongly as it should, leading to the following symptoms.

Underactive bladder function
Normal bladder must have an ability to squeeze all urine out — which underactive bladder cannot do.
Underactive bladder weak stream
トイレでより多くの時間を費やしている弱い尿の流れは、膀胱が活動していないことの兆候です。

After urological assessment rules out other common causes such as bladder infection, we focus on underactive bladder disease and its etiology.

の病因 underactive bladder disease

  1. Neurologic-related conditions – the bladder is controlled by the brain and spinal cord; disorders affecting either can impair bladder function.
    • 脳卒中
    • 脳または脊髄腫瘍
    • 脊髄損傷
    • 椎間板ヘルニア
    • Multiple sclerosis
  2. Aging process – the detrusor muscle surrounding the bladder weakens with age, leading to reduced contraction strength.
Underactive bladder aging
Underactive bladder is commonly found in aging patients.
  1. Prolonged bladder over-distension – commonly following postoperative spinal anesthesia.
  2. Diabetes Mellitus – poor DM control leads to reduced sensation of bladder fullness and weakened bladder contraction.
Diabetes and underactive bladder
Reduced bladder sensation and contraction are classical endpoints of poorly controlled diabetes mellitus.

Treatment options for underactive bladder disease:

  1. 行動療法
    • Timed voiding – urinating on a regular schedule to prevent overdistension
    • Assisted voiding by abdominal straining
    • Double-voiding technique – attempting to urinate again 20 minutes after the first void
  2. Oral medications – agents that increase bladder sensation and facilitate the voiding mechanism
  3. Clean intermittent self-catheterization (CIC) – indicated when high post-void residual urine causes complications such as urinary retention, recurrent bladder infections, or renal impairment
Clean intermittent self-catheterization
CIC is considered when patients experience complications from high residual urine volume.

Female underactive bladder is always a challenging issue for both urologist and patient. Better understanding the cause and selecting the proper treatment will bring out the best outcome.

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Frequently Asked Questions About Female Underactive Bladder

What is underactive bladder in females and what are the symptoms?

Underactive bladder is a condition where the bladder muscle (detrusor) cannot contract with sufficient strength to empty the bladder completely. In women, this typically presents as a weak urinary stream, prolonged time needed to urinate, and a persistent sense of incomplete emptying. Unlike overactive bladder, it is caused by insufficient bladder contraction rather than excessive urgency, and is often underdiagnosed.

What causes underactive bladder?

The main causes include neurological conditions affecting the brain or spinal cord (stroke, spinal cord injury, disc herniation, multiple sclerosis), natural aging of the detrusor muscle, prolonged bladder over-distension (such as after spinal anesthesia), and poorly controlled diabetes mellitus which damages the nerve supply to the bladder. Identifying the underlying cause is essential for choosing the right treatment approach.

How is underactive bladder treated?

Treatment starts with behavioral therapy: timed voiding schedules, assisted voiding by straining, and double-voiding techniques. Oral medications that increase bladder sensation or facilitate emptying may be added. When high residual urine causes complications such as urinary retention, recurrent infections, or kidney impairment, clean intermittent self-catheterization (CIC) is recommended as a safe and effective long-term solution.

If you are experiencing abnormal voiding symptoms such as weak stream or incomplete bladder emptying, Dr. Soarawee Weerasopone offers specialist consultations at Bangkok Hospital Headquarters. 診療をご予約.

**免責事項:** このコンテンツは、バンコク病院本部の認定泌尿器科医であるSoarawee Weerasopone博士によって作成およびレビューされました。教育目的のみのものであり、医学的アドバイスを構成するものではありません。いかなる医療処置を開始する前にも、必ず資格のある医療専門家にご相談ください。.

医学的に記述・監修: ソアラウィー・ウィーラソポーン医師(ポム医師) — バンコク病院本社 泌尿器科専門医。 国際フェロー:ベイラー医科大学(米国)、順天堂大学(日本)、長庚紀念医院(台湾)。.

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Dr. Soarawee Weerasopone — Urologist Bangkokをもっと見る

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