GYN TRIAD
Hypotonic Bladder
Involuntary loss of urine
Detrusor muscle not contracted
Urine loss day and nightHistory. Loss of urine occurs intermittently in small amounts. This can take
place both day and night. The patient may complain of pelvic fullness.
Examination. Pelvic examination may show normal anatomy; however, the
neurologic examination will show decreased pudendal nerve sensation.
Investigative studies. Urinalysis and culture are usually normal, but may
show an infection. Cystometric studies show markedly increased residual
volume, but involuntary detrusor contractions do not occur.
Management. Possible intermittent self-catheterization, discontinuation of
the offending systemic medications, cholinergic medications to stimulate
bladder contractions, and α-adrenergic blocker to relax the bladder neck.