Efficacy of trospium chloride in patients with detrusor instability
. BJU Int 2000;85:659-64.
With 2 years of experience using this drug, it has proven effective in reducing detrusor instability
without significant side effects.
Before patients were included in the study they underwent a physical examination, with assessment of cognitive function by the Folstein Mini Mental State Evaluation (MMSE) and detrusor instability was diagnosed by water cystometry, filling at 1 ml/s, using the criteria of the International Continence Society .
The results of this study also underline some important points in relation to the treatment of detrusor instability. The median dose of oxybutnin remained at or returned to 2.5 mg bd, the starting level, at the end of the study, although the protocol allowed upward titration of dose at each assessment until a satisfactory therapeutic response had been achieved, or until side-effects required a reduction or limited further increase.
Phasic detrusor instability
(PDI) (Figure 1B), is characterized by urgency of micturition and/or urge incontinence, normal or increased bladder sensation and phasic bladder contractions occurring spontaneously during bladder filling or being provoked by rapid filling, coughing, jumping or other external mechanical stimuli.
The history and physical examination are still the mainstays for evaluating suspected outflow obstruction, but urodynamics can determine the patient's bladder compliance, detrusor instability
, or voiding characteristics.
Additional urodynamic testing theoretically could be helpful in identifying patients whose incontinence symptoms are due to detrusor instability
alone because in these patients merely adding an anti-incontinence procedure to the prolapse repair would not improve incontinence symptoms, Dr.
There's detrusor instability
, stress incontinence, and abdominal pressure when voiding," he said.
African American women are more likely to have detrusor instability
(DI), while whites are more likely to have genuine stress incontinence (GSI), said Dr.
The main value of urodynamic testing (UDT) is its sensitivity for detecting detrusor instability
, said Dr.
In a separate study of 200 women with stress incontinence and/or detrusor instability
, pelvic muscle exercises were as effective in reducing incontinence episodes as bladder training or the exercises and bladder training combined (Am.J.
Patients were excluded from participation if they presented with detrusor instability
, internal sphincter dysfunction, overflow incontinence, inflammatory bowel disease, idiopathic fecal incontinence, or a history of rectal surgery.