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      Detrusor instability and low compliance may represent different levels of disturbance in peripheral feedback control of the micturition reflex.

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      Neurourology and urodynamics

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          Abstract

          Detrusor instability is a major cause of urinary incontinence in females. Its cause is unknown. Diagnosis is made with cystometry. A phasic pressure rise during cystometry diagnoses the unstable detrusor, and a non-phasic pressure rise the stable "low-compliance" detrusor. The aim was to test the hypothesis that such cystometric findings may represent different levels of disturbance in peripheral feedback control of a prematurely activated, but otherwise normal micturition reflex. Of 169 neurologically normal female incontinent patients (mean age, 50; mean parity, 3) urodynamically tested, 40 had detrusor instability and 16 had low compliance. Digital support of bladder base tested the peripheral control mechanism, and hand-washing the central control mechanism. The data were applied to a non-linear feedback equation with one variable, X(NEXT) = cX(1 - X), where c = central inhibition and X = fraction of possible nerve impulses in the micturition circuit.

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          Author and article information

          Journal
          Neurourol. Urodyn.
          Neurourology and urodynamics
          0733-2467
          0733-2467
          1999
          : 18
          : 2
          Affiliations
          [1 ] Department of Obstetrics and Gynaecology, University of Uppsala, Sweden. kvinno@highway1.com.au
          Article
          10.1002/(SICI)1520-6777(1999)18:2<81::AID-NAU3>3.0.CO;2-Z
          10081947
          2fd7b049-13ad-4018-972a-d707a88a8f1a
          History

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