title: A medium-term analysis of the subjective efficacy of treatment for women with detrusor instability and low bladder compliance.
abstract: OBJECTIVE
  The aims of this study were to determine the medium-term subjective outcome of treatment for women with a urodynamic diagnosis of detrusor instability and low bladder compliance.
  
  
  METHODS
  A tertiary referral urogynaecology clinic.
  
  
  METHODS
  One thousand one hundred and five women referred for the investigation of their urinary symptoms were entered into a prospective, long term, quality of life study. Of these, 348 had a videourodynamic diagnosis of detrusor instability or low bladder compliance and form the basis of this paper. Women were contacted by post at least six months following their urodynamic assessment and asked to complete a questionnaire detailing their treatment, its efficacy and side effects, and any residual urinary symptoms.
  
  
  RESULTS
  Two hundred and fifty-six women (73.6%) responded to follow up; only 5.5% were cured of their urinary symptoms. The majority (90.2%) had received anticholinergic medication, although only 18.2% continued with this treatment in excess of six months. Many women had residual urinary symptoms following their investigation and treatment.
  
  
  CONCLUSIONS
  The medium term efficacy of the treatment of detrusor instability and low compliance is disappointing, and a large part of this failure may be attributable to poor treatment efficacy, side effects of medication, or inadequate follow up following the diagnosis and instigation of therapy.
authors.affiliation: Department of Urogynaecology, Kings College Hospital, London.
authors.forename: C J
authors.initials: CJ
authors.lastname: Kelleher
authors.forename: L D
authors.initials: LD
authors.lastname: Cardozo
authors.forename: V
authors.initials: V
authors.lastname: Khullar
authors.forename: S
authors.initials: S
authors.lastname: Salvatore
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D018680:Cholinergic Antagonists / Q000009:adverse effects / Q000627:therapeutic use; D005081:Exercise Therapy; D005260:Female; D006801:Humans; D016496:Incontinence Pads / Q000706:statistics & numerical data; D008333:Mandelic Acids / Q000009:adverse effects / Q000627:therapeutic use; D008875:Middle Aged; D011446:Prospective Studies; D011788:Quality of Life; D016896:Treatment Outcome; D001745:Urinary Bladder Diseases / Q000628:therapy*; D016055:Urinary Retention / Q000628:therapy; D014555:Urination Disorders / Q000628:therapy*
chemical_list: D018680:Cholinergic Antagonists; D008333:Mandelic Acids; C005419:oxybutynin