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Related Experiment Videos

[Urinary urgency and reflex incontinence].

H Madersbacher1

  • 1Urologische Universitätsklinik Innsbruck, Osterreich.

Der Urologe. Ausg. A
|July 1, 1991
PubMed
Summary
This summary is machine-generated.

Urge and reflex incontinence stem from detrusor dysfunction. Treatment focuses on managing bladder hyperactivity and hypersensitivity through conservative methods like medication and electrostimulation, with surgery as a last resort.

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Area of Science:

  • Urology
  • Neuroscience
  • Pharmacology

Context:

  • Urge and reflex incontinence are linked to detrusor dysfunction, including hyperactivity and hypersensitivity.
  • Neurogenic detrusor hyperactivity manifests as detrusor hyperreflexia, stemming from suprasacral lesions.
  • Understanding the pathophysiology of symptomatic and idiopathic detrusor hyperactivity is crucial for effective management.

Purpose:

  • To describe the pathophysiology of detrusor hyperactivity and hypersensitivity.
  • To outline the therapeutic options for managing bladder dysfunction.
  • To provide an overview of conservative and surgical treatment strategies.

Summary:

  • Conservative treatments, including bladder drill, biofeedback, and spasmolytic pharmacotherapy, form the cornerstone of managing detrusor hyperactivity and hypersensitivity.

Related Experiment Videos

  • Electrostimulation of pudendal nerve afferents offers an alternative therapeutic approach.
  • Surgical interventions like bladder augmentation (clam ileocystoplasty) or cystectomy with bladder substitution are reserved for refractory cases.

    • Impact:

    • Most patients (80-90%) achieve successful outcomes with conservative management.
    • Therapy aims to convert detrusor hyperreflexia to hyporeflexia, often utilizing potent spasmolytic drugs.
    • Inadequate bladder emptying due to detrusor-sphincter dyssynergia necessitates careful treatment selection.