0 the muscle that controls the emptying of the bladder (= the organ where urine is stored):
Most incontinent women have either genuine stress incontinence or detrusor instability.
A general reduction in the number of autonomic nerves in detrusor smooth muscle of elderly patients with atonic bladder has been observed.
There were no detectable differences in terms of voiding dysfunction, urge incontinence or detrusor instability between suburethral slings and abdominal or needle suspensions.
There is still no effective drug therapy for the treatment of retention and no very effective drug treatment for unstable detrusor contractions.
They block transmission of nerve impulses from sacral efferents to the detrusor muscles, inhibiting contraction.
They involve regular contraction of perivaginal musculature and cause muscular hypertrophy and possibly inhibition of detrusor contraction by a local inhibitory neural reflex.
In 20% of these patients incomplete voiding occurs due to dyssynergic contraction of the detrusor and sphincter muscles or due to mechanical outflow obstruction.
With spinal cord pathology, incomplete bladder emptying may occur due to a combination of detrusor-sphincter dyssynergia and poor detrusor contraction during attempts at voiding.
However, detrusor overactivity is present in up to half of continent elderly individuals.
