The two main types of idopathic bladder instability are described using pressure recordings and the relationship to incontinence defined. In combination with urodynamic studies, using a micturating cysto-urethrogram recorded on videotape for future analysis, it is possible to correlate bladder pressures with physiological events.
Management of the unstable bladder is difficult and a variety of drug regimens have been attempted. Baclofen reduced detrusor-activity and produced a significant benefit in diurnal and nocturnal frequency and episodes of incontinence but not in enuresis. Seventy per cent of patients maintained this improvement three months after stopping treatment.
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