Long-term follow-up of habit retraining for bladder instability in elderly patients.

Sixty patients with detrusor instability were contacted 2 to 3 years after their initial diagnosis and treatment. When first treated, 40 had improved, nine were catheterized and the remainder were unchanged. By the time of the first outpatient appointment 1 month later, a further 6% had been catheterized and 26% had lost control. Two to 3 years later, 17 of the 40 who had improved initially had maintained their improvement. The control in all the remainder had deteriorated and ten of the original 60 had died. Four of these deaths occurred in the group initially catheterized, only two of this group still had their catheter in situ, but were experiencing problems from it, and the remaining three had removed their catheter and were managing with pants and pads. Thus, two-thirds of elderly patients with bladder instability respond initially to treatment, but 2 to 3 years later only two-fifths of these are still deriving benefit.