Is the treatment of urgency incontinence a placebo response? Results of a five-year follow-up.

The treatment and symptomatic outcome were reviewed in 50 women who had presented with urgency incontinence as their main symptom 5 years previously. All had idiopathic urgency incontinence and, on the basis of urodynamic investigation, 40 were considered to have detrusor instability and 10 sensory urge incontinence. The results indicate that the natural history of sensory urgency is one of spontaneous resolution; all treatments of detrusor instability (including surgery) produced an unsustained short-term symptomatic response. This pattern of response to therapy may be interpreted as being largely of a placebo nature and this emphasises the need for long-term follow-up in the assessment of new treatment modalities.