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Bladder instability. Is the primary defect in the urethra?

J R Hindmarsh, P T Gosling, A M Deane

    British Journal of Urology
    |December 1, 1983
    PubMed
    Summary
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    Bladder instability involves urethral relaxation before detrusor contraction. Re-educating proximal urethral muscles may be more effective than treating detrusor overactivity for patients with this condition.

    Area of Science:

    • Urology
    • Physiology

    Background:

    • Bladder instability is a common condition characterized by involuntary detrusor contractions.
    • Understanding the urethral response during bladder filling is crucial for managing bladder dysfunction.

    Purpose of the Study:

    • To investigate the urethral response to bladder filling in patients with bladder instability.
    • To compare the sequence of events in bladder instability with normal voiding.

    Main Methods:

    • Synchronous measurement of four points in the proximal urethra and bladder using microtip transducers.
    • Urodynamic assessment of twelve male patients with proven bladder instability.

    Main Results:

    • A significant drop in urethral closure pressure (30 cm H2O) occurred 3 seconds prior to unstable detrusor contractions.

    Related Experiment Videos

  • Patients lacked awareness of urethral relaxation, experiencing urgency only upon detrusor contraction.

    • Conclusions:

    • The sequence in bladder instability mirrors normal voiding, with urethral relaxation preceding detrusor contraction.
    • Re-educating proximal urethral muscles may be a more appropriate therapeutic strategy than solely treating detrusor instability.