Hypnotherapy for incontinence caused by the unstable detrusor

Fifty incontinent women with proved detrusor instability completed 12 sessions of hypnosis (symptom removal by direct suggestion and "ego strengthening") over one month. This was continued at home with a prerecorded cassette, and all patients were followed up for at least six months. At the end of the 12 sessions 29 patients were entirely symptom free, 14 improved, and seven unchanged. Three months later cystometry in 44 of the patients showed conversion of the cystometrogram to stability in 22 and a significant improvement in a further 16; only six showed no objective improvement. Seven patients relapsed (three after bereavement). Further treatment was given and five out of six patients were rendered symptom free again. Patients with detrusor instability were not found to have a noticeably increased susceptibility to hypnosis. It is concluded that psychological factors are very important in "idiopathic" detrusor instability and that hypnotherapy is effective for incontinence due to this disorder.