This book is an excellent update on the concept of the underactive bladder. The authors and editors led by Chris Chapple address some of the controversies surrounding definitions, diagnosis and treatment. The International Continence Society (ICS) currently defines detrusor overactivity as a urodynamic finding, whereas the underactive bladder is more of a symptom complex.

The chapter on the pathophysiology behind the underactive bladder covers the effect of ageing, bladder outlet obstruction, diabetes mellitus, neurogenic disorders and ischaemic bladder disease.

Further chapters consider diagnostic tests, the epidemiology of the condition and finally appraising the evidence behind treatment options. The authors discuss the limitations of both medical and surgical treatments including bladder outlet reduction, neuromodulation / neurostimulation, reduction cystoplasty, bladder wrap procedures as well as the potential therapeutic aspects of tissue engineering. This is not a particularly well-understood area and this book has comprehensively summarised the existing evidence while providing expert opinions on the topic.

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Pravisha Ravindra

University Hospitals Leicester NHS Trust

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