Bladder instability is undoubtedly a major cause of incontinence. The condition is reasonably well-defined and advances in the last 20 years in the urodynamic diagnosis of the condition have stimulated a number of leading clinicians and research workers to focus their attention on this problem. The aim of this paper is to produce a better understanding of the unstable bladder.
BatesC.P.: Continence and incontinence. Ann. R. Coll. Surg. Engl., 49: 18–35.
2.
International Continence Society Commitee on Standardisation of Terminology:The standardisation of terminology of lower urinary tract function. Scand. J. Urol. Nephrol., Suppl. 144, 1988.
3.
GoslingJ.A.DixonJ.G.: Detrusor morphology in relation to bladder outflow obstruction and instability. In: Benign Prostatic Hypertrophy, ed. HinmanF.Jr., New York, Springer, 666–671, 1983.
4.
YallaS.: Instabilità del detrusore: luci ed ombre. In: Proceedings S.I.U.D., Perugia, 229–231, 1989.
5.
VignoliG.C.: Instabilità non neurogena non ostruttiva. Proceeding S.I.U.D., Perugia, 207–210, 1989.
6.
Di BenedettoP.: Aspetti clinici e terapeutici della instabgilità detrusoriale. Proceedings S.I.U.D., Perugia, 195–199, 1983.
GuJ.RestorickJ.M.BlankM.A.HuangW.M.PolakJ.M.BloomS.R.MundyA.r.: Vasoactive intestinal polypeptide in the normal and unstable bladder. Br. J. Urol., 55: 645–647, 1983.
9.
MurrayK.H.A.FeneleyR.C.L.: Endorphins play a role in lower urinary tract function? The effect of opioid blockade on the detrusor and urethral sphincter mechanism. Br. J. Urol., 54: 638–640, 1982.
SpeakmanM.J.SethiaK.K.FellowsG.J.SmithJ.C.: A study of the pathogenesis, urodynamic assessment and outcome of detrusor instability associated with bladder outflow obstruction. Br. J. Urol., 59: 40–44, 1987.
12.
CucchiA.: Detrusor instability and bladder outflow obstruction. Evidence for a correlation between the severity of obstruction and the presence of instability. Br. J. Urol., 61: 420–422, 1988.
13.
AbramsP.N.: Urodynamic result of surgery. In: Benign Prostatic Hypertrophy, ed. HinmanF.Jr., Springer, New York, 948–956, 1983.
14.
Van MastrightR.: A proposal for a detrusor instability index. In: Proceedings of the Second Joint Meeting of the International Continence Society and Urodynamics Society, 399–401, 1983.
15.
SussetJ.G.: Development of nomograms for application of uroflowmetry. In: Benign Prostatic Hypertrophy, ed. HinmanF.Jr., New York, Springer, 528–537, 1983.
FrewenW.K.: The management of urgency and frequency of micturition. Br. J. Urol., 52: 367–369, 1980.
18.
FrewenW.K.: An objective assessment of the unstable bladder of psychosomatic origin. Br. J. Urol., 50: 246–249, 1978.
19.
MundyA.R.: Detrusor instability. Br. J. Urol., 62: 393–397, 1988.
20.
SpeakmanM.J.BradingA.F.GilpinC.J.DixonJ.G.GilpinS.A.GoslingJ.A.: Bladder outflow obstruction. A case of denervation supersensitivity. J. Urol., 138: 1461–1466, 1987.
21.
SibleyJ.N.A.: An experimental model of detrusor instability in the obstructed pig. Br. J. Urol., 57: 292–298, 1985.
22.
KinderR.B.MundyA.R.: Inhibition of spontaneous contractile activity in isolated human detrusor muscle strips by vasoactive intestinal polypeptide. Br. J. Urol., 57: 20–23, 1985.
23.
EatonA.C.BatesC.P.: An in vitro physiological study of normal and unstable human detrusor muscle. Br. J. Urol., 54: 653–657, 1982.
24.
DixonJ.S.GilpinS.A.GilpinC.J.GoslingJ.A.: Intramural ganglia of the human urinary bladder. Br. J. Urol., 55: 195–198, 1983.
25.
KinderR.B.MundyA.R.: Pathophysiology of idiopathic detrusor instability and detrusor hyper-reflexia. Br. J. Urol., 60: 509–515, 1987.
26.
TanaghoE.A.MillerE.R.: Initiation of voiding. Br. J. Urol., 52: 539–541, 1970.
27.
LowJ.A.: Urethral behaviour during involuntary detrusor contraction. Am. J. Obstet. Gynecol., 52: 538–541, 1977.
28.
McGuireE.J.: Reflex urethral instability. Br. J. Urol., 50: 200–204, 1978.
29.
VenemaP.L.KramerE.J.L.: Continuous urethral pressure measurements as an alternative to sphincter EMG. In: Proceedings of the International Continence Society, Leiden, 8–9, 1982.
30.
HindmarshJ.R.GoslingP.T.DeaneA.M.: Bladder instability. Is the primary defect in the urethra? Br. J. Urol., 1983, 55: 648–651, 1983.
31.
KleinL.A.: Urge incontinence can be a disease of bladder sensors. J. Urol., 139: 1010–1014, 1988.
