The unstable detrusor (detrusor instability), a common condition in men and women, causes significant morbidity in sufferers and a great financial expense to health care providers. The condition is associated with symptoms of urinary frequency, urgency and urge incontinence. The embarrassing nature of these symptoms means patients are often reluctant to seek medical help and as a consequence there is under-reporting. Epidemiological studies are difficult to perform but appear to show that incidence increases with age and that the unstable detrusor is the commonest cause of male urinary incontinence. The aetiology is still much debated with reasoned arguments for both neurogenic and myogenic causes, though in truth, the likely explanation is multifactorial rather than a single underlying pathological process. The diagnosis can only be made on urodynamic testing. Before deciding on suitable treatment, the clinician must assess the disease severity and also its impact on patient quality of life. This is because perceived improvement in patient quality of life must outweigh any potential morbidity associated with treatment. Pharmacotherapy is based on blocking bladder muscarinic receptors. Unfortu-nately, no treatment is bladder specific and therefore most drug therapies have unwanted systemic anticholinergic side effects. Surgical treatment often involves a degree of bladder denervation to reduce bladder activity. This can consequently produce voiding difficulties which necessitate patients to self-catheterise on a longterm basis.

This content is only available via PDF.
© 2004 S. Karger AG, Basel
2004
Copyright / Drug Dosage / Disclaimer
Copyright: All rights reserved. No part of this publication may be translated into other languages, reproduced or utilized in any form or by any means, electronic or mechanical, including photocopying, recording, microcopying, or by any information storage and retrieval system, without permission in writing from the publisher.
Drug Dosage: The authors and the publisher have exerted every effort to ensure that drug selection and dosage set forth in this text are in accord with current recommendations and practice at the time of publication. However, in view of ongoing research, changes in government regulations, and the constant flow of information relating to drug therapy and drug reactions, the reader is urged to check the package insert for each drug for any changes in indications and dosage and for added warnings and precautions. This is particularly important when the recommended agent is a new and/or infrequently employed drug.
Disclaimer: The statements, opinions and data contained in this publication are solely those of the individual authors and contributors and not of the publishers and the editor(s). The appearance of advertisements or/and product references in the publication is not a warranty, endorsement, or approval of the products or services advertised or of their effectiveness, quality or safety. The publisher and the editor(s) disclaim responsibility for any injury to persons or property resulting from any ideas, methods, instructions or products referred to in the content or advertisements.
You do not currently have access to this content.