H C Taub1, M Stein. 1. Department of Urology, Montefiore Medical Center, Albert Einstein College of Medicine, Bronx, New York.
Abstract
OBJECTIVE: A retrospective review was undertaken to determine the efficacy of bladder distention therapy for the treatment of frequency and urgency, and to determine the relative value of prolonged versus short duration distention therapy. METHOD: Prolonged bladder distention therapy was performed on 14 patients and short duration distention on 8 patients over a ten-year period. Indications for the procedure included severe urgency, frequency, and incontinence from a variety of etiologies. RESULTS: Five of 14 patients (18 distentions, 2 bladder ruptures) who had prolonged distention, and 3 of 8 patients (9 distentions, 1 bladder rupture) who had short duration distention experienced symptomatic relief on follow-up (p > 0.7). Since there was no difference between the prolonged and short duration groups, the results were combined to yield 8 of 27 successful distentions (30%) in 8 of 22 patients (36%). All patients with detrusor hyperreflexia failed distention therapy. Complications included 3 cases of bladder rupture, 2 cases of urinary retention, and 1 case of urethral stricture. The rates of bladder rupture were identical in both groups (11%). CONCLUSIONS: The use of prolonged bladder distention therapy has no role in the treatment of detrusor hyperreflexia, and only limited success in the symptomatic relief of severe urgency, frequency, and incontinence of other etiologies. Equal efficacy of prolonged and short duration distention therapy would tend to favor the use of short duration distention to reduce possible anesthesia complications and cost.
OBJECTIVE: A retrospective review was undertaken to determine the efficacy of bladder distention therapy for the treatment of frequency and urgency, and to determine the relative value of prolonged versus short duration distention therapy. METHOD: Prolonged bladder distention therapy was performed on 14 patients and short duration distention on 8 patients over a ten-year period. Indications for the procedure included severe urgency, frequency, and incontinence from a variety of etiologies. RESULTS: Five of 14 patients (18 distentions, 2 bladder ruptures) who had prolonged distention, and 3 of 8 patients (9 distentions, 1 bladder rupture) who had short duration distention experienced symptomatic relief on follow-up (p > 0.7). Since there was no difference between the prolonged and short duration groups, the results were combined to yield 8 of 27 successful distentions (30%) in 8 of 22 patients (36%). All patients with detrusor hyperreflexia failed distention therapy. Complications included 3 cases of bladder rupture, 2 cases of urinary retention, and 1 case of urethral stricture. The rates of bladder rupture were identical in both groups (11%). CONCLUSIONS: The use of prolonged bladder distention therapy has no role in the treatment of detrusor hyperreflexia, and only limited success in the symptomatic relief of severe urgency, frequency, and incontinence of other etiologies. Equal efficacy of prolonged and short duration distention therapy would tend to favor the use of short duration distention to reduce possible anesthesia complications and cost.