Dysfunctional detrusor control.

Detrusor muscle dysfunction is a common reason for lower urinary tract symptomatology in women. This report summarizes observations in 35 patients diagnosed as having detrusor dysfunction. Similar involuntary detrusor contractions were observed in 25 incontinent patients and in five patients who were not incontinent but who had urgency and frequency of urination. The incontinent patients were separated into the "urge incontinence" group and the "detrusor dyssynergia" group, based on whether or not the detrusor contraction was preceded by a strong sensation of urge. The patients who were not incontinent were grouped as "urgency frequency syndrome." No patient had urinary tract infection, neurological, urologic, or metabolic disease. Thirty patients responded satisfactorily to similar management consisting of bladder drills and anticholinergic drug therapy. Decreased cortical inhibitory activity seems to be a common pathophysiologic mechanism.