De novo detrusor instability after Burch colposuspension

After successful surgery for stress incontinence, detrusor instability can develop in a previously stable bladder. A review of six studies with a total of 396 patients is presented. Sixty-eight of these patients (17%) developed de novo DI. The prevalence varied from 5 to 27% in the different studies. The highest cure rate was 98%; the lowest 64%. It is concluded that the prevalence of de novo DI may be dependent on the details of the cystometric and surgical technique as well as unknown patient characteristics. Since the exact pathophysiologic mechanism of this phenomenon is unknown, it is difficult to predict it preoperatively in the individual patient.