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Detrusor instability is defined as the spontaneous and strong need to urinate because of uncontrollable contractions or spasms of the detrusor muscle. This condition of urge incontinence tends to be common among older women and has symptoms involving frequent urination. Healthcare providers conduct physical exams and tests to diagnose the medical condition. Men and women experiencing detrusor instability are treated using a variety of methods, including medication, depending on the severity of the condition.
In most cases, the causes of detrusor instability are relatively unknown, but it can be associated with neurological diseases such as multiple sclerosis, spinal cord injuries and stroke. Other factors that may lead to women or men developing this condition include age, stress incontinence and various changes to the bladder. An enlarged prostate can cause urge incontinence in men if an obstruction of the bladder occurs. Complications such as inflammation, stones or cancer of the bladder are among the many changes that result in detrusor instability. There also are social complications, including social isolation and psychological troubles, associated with the condition.
Aside from the constant need to urinate, abdominal discomfort is a leading symptom of detrusor instability. Bladder muscle contractions often occur in patients who are neurologically normal. Difficulty delaying such a contraction results in leakage. Bladder muscles tend to contract at the wrong time or all throughout the day when detrusor instability is present. Healthcare providers may diagnose the condition by conducting a physical examination, blood tests, urinalysis and a urodynamic evaluation.
Treatment for detrusor instability can vary among patients but usually starts with at least six weeks of bladder training to strengthen pelvic muscles. Healthcare professionals also may use anticholinergic medication to reduce involuntary contractions of the pelvic muscles and increase the bladder's ability to hold more fluid. Antidepressants and other drugs also may be used while treating this condition.
Nerve stimulation is an additional method that doctors use to treat urge incontinence in patients who do not respond to initial treatment efforts. Medical experts believe nerve stimulation is effective in getting rid of symptoms such as urgency, frequent urination and incontinence. Surgery such as augmentation cystoplasty is only performed in severe cases of detrusor instability. Healthcare professionals believe behavioral therapy, when combined with medication, is effective in treating the instability experienced by most patients. This belief is attributed to long-term improvements in bladder control after using this treatment plan.