Treatment of detrusor instability of the urinary bladder by selective sacral blockade

Detrusor instability and its associated incontinence frequently impair activity and the results of pharmacological and operative treatment have often been unsatisfactory. Twenty-two patients with idiopathic detrusor instability were treated by selective local anaesthesia of both sacral roots S3. The follow-up period ranged from 4 months to 2 years. In patients with neuropathic detrusor instability, local anaesthesia had no permanent effect, but in four such cases it was possible to achieve continence by permanent blockade of S3 using phenol injections. A disadvantage of the latter procedure was that bladder emptying was achieved only by manual abdominal compression or catheterisation.