Urodynamic response of unstable bladder to flavoxate

Bladder instability provokes frequency, urgency, urge incontinence and enuresis in a great percentage of patients of both sexes, who undergo urodynamic examination when other clinical elements are not in evidence. The presence of bladder contractions of variable entity, even capable of inducing emptying, during filling are accompanied by a strong desire to micturate. Our study includes daily recordings of rhythm and quantity of micturitions and leaks, evaluation of urethral pressure, transurethral cystometry and uroflowmetry. The urethral pressure profile was performed with the technique of Brown and Wickham by infusing at 2 ml/min with 10-Ch catheter, withdrawn at a speed of 15 cm/min. Transurethral cystometry was performed by a continuous infusion at moderate speed (50 ml/min) of an isotonic solution at room temperature in a recumbent patient with two catheters in the bladder. When the contractions of the detrusor appear, we evaluate the pharmacological response to the filling with a myolitic agent (flavoxate) first, and with synthetic anticholinergic (emepronium bromide) after, with the purpose of discriminating the myogenic or neurogenic nature of the alteration and to propose suitable therapy.