The surgical treatment of detrusor instabiiity

The surgical treatment of detrusor instability is still in its infancy. At the present time there are two main types: operations designed to ablate the nerve supply and those designed to circumvent the problem by enlarging the bladder sufficiently such that the unstable contractions are either ineffectual or occur at such a large volume that they are clinically insignificant. The former approach is rarely successful, except possibly in patients over the age of 55 years; the latter seems to be effective in the majority of patients, but the data should still be considered to be preliminary. Hydrodistension of the bladder is ineffective.