Stressinduced Detrusor Instability

Increased abdominal pressure during coughing may trigger uninhibited detrusor contractions in some patients. If the contractions are associated with incontinence, the leakage occurs because of the contractions and not the increased abdominal pressure itself. This phenomenon is responsible for 7% of 98 women with stress incontinence.13 Identification of stress-induced instability can have important implications in the treatment of this type of incontinence. Anticholinergics and timed voiding are the treatment of choice in such situations. Skilled Kegel exercises (i.e.,pelvic floor muscle contractions) before an anticipated cough may abort such contractions.

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