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Related Experiment Videos

Detrusor instability. Is the bladder the cause or the effect?

A Bergman1, P P Koonings, C A Ballard

  • 1Department of Obstetrics and Gynecology, Women's Hospital, Los Angeles County/University of Southern California Medical Center 90033.

The Journal of Reproductive Medicine
|October 1, 1989
PubMed
Summary

This study on detrusor instability found anticholinergics effective for bladder contraction preceding urethral pressure changes. Sympathomimetics were more successful for urethral relaxation preceding bladder contraction.

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Area of Science:

  • Urology
  • Pharmacology

Background:

  • Detrusor instability is a common condition affecting bladder control.
  • Urodynamic evaluation is crucial for diagnosing bladder dysfunction.
  • Differentiating detrusor vs. urethral pathology is key for effective treatment.

Purpose of the Study:

  • To evaluate the efficacy of anticholinergics and sympathomimetics in treating detrusor instability.
  • To correlate urodynamic findings with treatment response.
  • To differentiate between detrusor and urethral pathology based on urodynamic patterns.

Main Methods:

  • Seventy-two patients with detrusor instability underwent urodynamic evaluation.
  • Initial treatment involved four weeks of oxybutynin (anticholinergic).
  • Non-responders were treated with phenylpropanolamine (sympathomimetic) for four weeks.

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Main Results:

  • 57% of patients responded favorably to anticholinergics.
  • Group I (bladder contraction preceding urethral pressure change) showed 86% response to anticholinergics.
  • Group II (urethral relaxation preceding bladder contraction) showed 68% response to sympathomimetics (P < .001).

Conclusions:

  • Anticholinergics are effective for detrusor instability characterized by bladder contraction preceding urethral pressure changes.
  • Sympathomimetics show significant efficacy in cases of urethral relaxation preceding bladder contraction.
  • Urodynamic patterns can help distinguish detrusor from urethral pathology, guiding treatment selection.