What is detrusor muscle instability?
Detrusor instability is a pathological entity in which uninitiated contractions of the detrusor muscle occur. The principal symptoms are wetting and recurrent urinary tract infection. It is essential to exclude by examination and investigation any underlying neurological cause for the condition.
What are detrusor contractions?
The primary function of the detrusor muscle is to contract during urination to push the urine out of the bladder and into the urethra. The detrusor muscle will relax to allow the storage of urine in the urinary bladder.
How is detrusor instability diagnosed?
Detrusor instability is a urodynamic diagnosis made when the detrusor is shown objectively to contract, spontaneously or on provocation, during the filling phase of a cystometrogram while the patient is attempting to inhibit micturition.
Can the detrusor muscle be strengthened?
Using cellular regenerative techniques, the detrusor smooth muscle can be targeted so the result is to increase detrusor smooth muscle function.
What is detrusor myectomy?
This is a major operation indicated for Overactive Bladder and the symptoms of urge and urgency. It involves removing part or all of the outer muscle layer that surrounds the bladder. This aims to reduce the amount and strength of bladder contractions. The operation usually takes 1 to 2 hours.
What happens when detrusor muscle contracts?
The detrusor muscle is essentially what most people refer to as “the bladder.” The detrusor muscle relaxes to allow urine to fill the bladder and stretches to hold more urine. When it is time to urinate, the detrusor muscle contracts to push urine out of the bladder. The detrusor muscle impacts urination.
What does detrusor overactivity feel like?
If you have an overactive bladder, you may: Feel a sudden urge to urinate that’s difficult to control. Experience unintentional loss of urine immediately after an urgent need to urinate (urgency incontinence) Urinate frequently, usually eight or more times in 24 hours.
Is overactive bladder a disability?
If you have experienced leaking or the urgency to urinate, these are all symptoms of urinary incontinence. If you are a veteran, these are symptoms that may entitle you to disability benefits, but the VA may limit this access due to their complex claims process.
What is terminal detrusor overactivity?
The term, terminal detrusor overactivity (TDO), is defined as a single involuntary detrusor contraction that cannot be suppressed and that occurs when the maximum bladder capacity is reached, resulting in urinary incontinence and often complete bladder emptying (Figure 2) (1).
What is reflex incontinence?
Reflex incontinence Reflex incontinence occurs when the bladder muscle contracts and urine leaks (often in large amounts) without any warning or urge. This can happen as a result of damage to the nerves that normally warn the brain that the bladder is filling.
What causes detrusor failure?
There are multiple etiologies of DU. The most well recognized mechanisms include myogenic dysfunction from fibrosis and the disruption of efferent neural pathways from traumatic neurologic injury or disease5. More recently, bladder and urethral afferent damage has been proposed in the development of DU6.
What are detrusor contractions in urge syndrome?
In the urge syndrome, the detrusor contractions are seen as electrical pulses and consequent pressure changes during filling. As there is a spectrum of disease, so there are various modalities for treatment of detrusor instability.
What is the clinical presentation of detrusor instability?
The clinical presentation of a child with detrusor instability will depend on the reaction (conscious or otherwise) to the bladder attempting to empty. Daytime wetting is the hallmark of detrusor instability and the most common reason for referral.
What is the definition of unstable bladder?
A bladder is defined as unstable if urodynamic investigation shows detrusor contractions during the filling phase while the patient is attempting to inhibit voiding. Contractions occurring as a result of a diagnosed neurological disease are ascribed to detrusor hyperreflexia; those unrelated to proven disease are caused by detrusor instability. 1
Which medications are used in the treatment of detrusor stability?
Drugs with antimuscarinic activity e.g. oxybutinin, are used in the pharmacologic management of detrusor stability because they inhibit the cholinergically innervated unstable detrusor muscle contractions. oxybutynin – this drug