Detrusor instability syndrome: the use of bladder retraining drills with and without anticholinergics

Ninety-two (24.6%) of 374 patients referred to our gynecologic urology unit were found to have instability of the detrusor muscle with no recognizable associated pathologic conditions: idiopathic detrusor instability. Thirty-nine (42.4%) of these 92 patients demonstrated the instability only after detrusor activation maneuvers such as coughing, heel bouncing, or positional changes. The cure rate among patients with both "spontaneous" and "provoked" contractions of the detrusor muscle was comparable to the cure rate among those whose bladder contractions were apparent only after detrusor activation maneuvers (p greater than 0.9). The success rate of bladder retraining drills (BRD) as the sole mode of therapy was not significantly different from that observed with BRD combined with anticholinergics (p greater than 0.6).