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Neurophysiological evaluation in detrusor instability

U Del Carro¹, D Riva, G C Comi

¹IV Neurological (U.D.C., G.C.C., T.L., G.M., N.L., N.C.) Clinics, University of Milan, S. Raffaele Hospital, Italy.

Neurourology and Urodynamics

|January 1, 1993

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This study found no evidence of nerve damage in women with idiopathic detrusor instability. Neurophysiological tests confirmed normal sensory and motor pathways, suggesting other mechanisms may be involved.

Area of Science:

Neuroscience
Urology
Physiology

Background:

Continence control involves complex neuronal systems.
Detrusor overactivity is classified into detrusor instability and detrusor hypereflexia.
Neurological damage is associated with detrusor hypereflexia, but mechanisms remain unclear.

Purpose of the Study:

To investigate sensory and motor pathways in idiopathic detrusor instability.
To compare neurophysiological findings in patients with healthy controls.

Main Methods:

Subtracted cystometrogram (CMG)
Anal sphincter electromyography (EMG)
Sacral reflex analysis
Somatosensory and motor evoked potentials
Muscle recordings

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Main Results:

All neurophysiological tests were normal in patients with detrusor instability.
No significant differences were observed between patients and healthy controls.
Absence of clinical or subclinical damage in central sensory or motor pathways confirmed.

Conclusions:

Idiopathic detrusor instability does not appear to involve damage to central sensory or motor pathways.
Alterations in suprasegmental control mechanisms cannot be ruled out.