Underactive Bladder

The EAU 2026 underactive bladder pathway — a failure of emptying, not a failure of storage. Underactive bladder is the symptom complex, detrusor underactivity the urodynamic diagnosis, and invasive pressure-flow study the only widely accepted way to make it. Management is deliberately pragmatic, and new Figure 7 finally maps it: the man who declines treatment goes to active surveillance, and the man who wants it is banded by post-void residual — behavioural measures and an alpha-blocker trial at 150–300 mL, intermittent catheterisation above 300 mL or where the upper tracts are at risk. Alpha-blockers before more-invasive techniques, never parasympathomimetics, then a fork on the prostate. Switch between the visual Pathway map and the phase-by-phase Explorer.