DETRUSOR INSTABILITY

Detrusor instability is a common cause of urgency and urge incontinenc e in neurologically normal patients. It is defined as an involuntary p hasic detrusor contraction of any pressure associated with symptoms of urge or leakage while the patient is attempting to inhibit micturitio n. The etiology is unknown but it has been associated with congenital causes, aging, stress incontinence, and bladder outlet obstruction. Di agnosis relies on a urologic history and physical examination, a voidi ng diary, and a urodynamic evaluation. Treatment is primarily pharmaco logic and behavioral, with surgical options being reserved for selecte d patients.