detrusor instability


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Related to detrusor instability: neurogenic bladder

instability

 [in-stah-bil´ĭ-te]
lack of constancy; excessive likelihood of change.
detrusor instability the occurrence during bladder filling of contractions that compromise capacity or produce urinary leakage.

de·tru·sor in·sta·bil·i·ty

uninhibitable bladder contractions that typically occur at bladder volumes below capacity.

detrusor instability

A physiological mechanism in which contractions of the muscles of the urinary bladder during the filling phase of a urodynamic study or during coughing, sneezing, or other activities result in an increase of intra-abdominal pressures. Such a pressure increase may lead to urinary urges or to urinary incontinence, esp. in women. Some experts believe that detrusor instability is the most common cause of urinary incontinence in older adults. Underlying causes include urethral obstruction, cystitis, bladder carcinoma, stroke, Parkinson's disease, and multiple sclerosis. Synonym: detrusor hyperactivity with impaired contractility; detrusor overactivity;
See also: instability

detrusor instability

Involuntary contractions of the bladder muscle causing an undesired escape of urine. This is one of the most important causes of incontinence, being, in women, second only to incompetence of the urethral sphincter. The condition is often associated with excessive thickness of the muscular bladder wall.
References in periodicals archive ?
A psychological approach to detrusor instability incontinence in women.
Urodynamic differentiation of detrusor instability and detrusor hyperreflexia.
The treatment of detrusor instability in post menopausal women with oxybutynin chloride: a double blind placebo controlled study.
Detrusor instability becomes more complicated when it is accompanied by incomplete bladder emptying.
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 [11].
Two subjects who did not respond had detrusor instability diagnosed in pretreatment urodynamics.
Reports of transient urinary retention or de novo detrusor instability have been rare.
Three main categories with different symptom patterns have been identified, namely uninhibited overactive bladder (UOB), characterized by impaired perception of bladder fullness and loss of voluntary inhibition of micturition contractions, phasic detrusor instability (PDI), with spontaneous or provoked abortive detrusor contractions during the bladder filling phase, and spinal detrusor hyperreflexia (SDH), following spinal upper motor neuron lesions with impaired voluntary command and unco-ordinated micturition reflexes.
Careful history and a physical to rule out detrusor instability preoperatively are important.
One review of short-term complication rates found bladder perforations in an average of 5% of cases (ranging up to 23%), de novo detrusor instability in 5% (ranging up to 2 1%), and hematoma in 1% (ranging up to 4%).
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.