title: Prevalence and significance of urethral instability in women with detrusor instability.
abstract: The phenomenon of urethral instability has been poorly defined and its significance is disputed. The aim of this study was to investigate the prevalence and significance of urethral instability in a group of women with idiopathic detrusor instability. Urethral instability was defined as a spontaneous fall in maximum urethral pressure of one-third or more, in the absence of detrusor activity, over a 2-min period. Urethral instability occurred in 42% of patients with detrusor instability and was strongly associated with the sequence of relaxation of the urethra prior to unprovoked detrusor contraction. Women with detrusor instability and a stable urethra exhibited primary contraction of the detrusor. The symptom of stress incontinence was more common in women with urethral instability. Women with detrusor instability may be subdivided into 2 groups on the basis of urethral instability, the presence of which suggests a primary dysfunction of the urethra. Such patients may derive more benefit from treatment with an alpha adrenoceptor agonist in addition to (or instead of) standard anticholinergic therapy.
authors.affiliation: Department of Obstetrics and Gynaecology, King's College Hospital, London.
authors.forename: B G
authors.initials: BG
authors.lastname: Wise
authors.forename: L D
authors.initials: LD
authors.lastname: Cardozo
authors.forename: A
authors.initials: A
authors.lastname: Cutner
authors.forename: C J
authors.initials: CJ
authors.lastname: Benness
authors.forename: G
authors.initials: G
authors.lastname: Burton
mesh_terms: D005260:Female; D006801:Humans; D009119:Muscle Contraction; D011312:Pressure; D014521:Urethra / Q000503:physiopathology*; D014549:Urinary Incontinence / Q000503:physiopathology*; D014563:Urodynamics