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Related Experiment Videos

The unstable bladder.

A R Mundy

    The Urologic Clinics of North America
    |May 1, 1985
    PubMed
    Summary
    This summary is machine-generated.

    Urinary urgency, a common issue, stems from involuntary bladder contractions. Treatment progresses from bladder drill and medication to surgical options like phenol injections or ileocystoplasty for refractory cases.

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    Area of Science:

    • Urology
    • Continence Medicine

    Background:

    • The unstable bladder is a frequent clinical issue with unclear causes.
    • In vitro studies reveal distinct behaviors in unstable human detrusor muscle compared to normal.
    • The primary urodynamic issue is involuntary detrusor contractions leading to urgency.

    Purpose of the Study:

    • To outline a treatment strategy for the unstable bladder, starting with conservative measures and progressing to surgical interventions.
    • To guide clinicians in managing patients with urgency and involuntary detrusor contractions.

    Main Methods:

    • Initial assessment involves a 48-hour voided volume chart after excluding outflow obstruction.
    • Treatment escalation includes bladder drill for minimal dysfunction, followed by pharmacotherapy (oxybutynin).
    • Refractory cases may undergo transvesical pelvic plexus phenol injection or "clam" ileocystoplasty.

    Main Results:

    • Conservative treatments like bladder drill and oxybutynin are effective for many patients.
    • Phenol injections offer worthwhile results for those unresponsive to conservative measures.
    • "Clam" ileocystoplasty provides a curative solution for intractable cases, particularly in men.

    Conclusions:

    • A stepwise approach, from conservative to surgical management, is effective for unstable bladder.
    • Early intervention based on voided volume charts can guide treatment decisions.
    • Advanced surgical options ensure high success rates for complex and refractory unstable bladder conditions.