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Urethral pressure changes in women with detrusor instability. Bladder or urethral pathologic process?
1Department of Obstetrics and Gynecology, Los Angeles County/University of Southern California Medical Center.
Urology
|June 1, 1991
Summary
Oxybutynin chloride effectively treated detrusor instability in 58% of women. However, patients with preceding urethral relaxation showed significantly poorer response to this anticholinergic therapy.
Area of Science:
- Urology
- Pharmacology
Background:
- Detrusor instability is a common condition affecting bladder control.
- Anticholinergic medications like oxybutynin chloride are frequently used for treatment.
Purpose of the Study:
- To evaluate the efficacy of oxybutynin chloride in treating detrusor instability.
- To identify potential urodynamic predictors of treatment response.
Main Methods:
- 114 female patients with diagnosed detrusor instability received oxybutynin chloride (5 mg t.i.d.) for four weeks.
- Patients were categorized into two groups based on urethrocystometry findings: Group I (bladder contraction precedes urethral pressure change) and Group II (urethral pressure drop precedes detrusor contraction).
- Treatment response was assessed after four weeks.
Main Results:
- 58% (66/114) of patients responded favorably to oxybutynin chloride.
- Group I patients (n=73) showed an 84% (61/73) favorable response rate.
- Group II patients (n=41) had a significantly lower favorable response rate of 12% (5/41) (P < 0.01).
Conclusions:
- Oxybutynin chloride is effective in a majority of patients with detrusor instability.
- Urodynamic findings, specifically the timing of urethral pressure changes relative to detrusor contraction, can predict treatment response.
- Women with urethral relaxation preceding detrusor contraction may represent a distinct pathophysiological entity unresponsive to standard anticholinergic therapy.