Clinical Case Database / Category: Patient Management

Detrusor instability

Publication details

Sadia Ismail MB, ChB, MRCP
Foundation Years Journal, volume 3, issue 9, p.16 (123Doc Education, London, November 2010)


This case based discussion focuses on an independent, community-dwelling 84-year-old lady presenting with urinary incontinence and discusses the assessment, differential diagnosis and treatment of urge incontinence due to detrusor instability.

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Sadia Ismail MB, ChB, MRCP

Specialist Registrar in Elderly Medicine
Leeds General Infirmary
Great George Street


1. Foundation Year Programme Curriculum: core competences and skills
2. NICE clinical guideline 40 – Urinary Incontinence in women
3. Bowker LK, Price JD, Smith SC. Incontinence. In: Oxford Handbook of Geriatric Medicine, 1st edn. New York: Oxford University Press 2006; 573–581
4. Bracewell M, Brown J, Chakravarty K et al. Neurological investigation of sphincter disturbance. In: Oxford Handbook of Clinical Investigations, 2nd edn 2005
5. NICE interventional procedure guidance 64 – Sacral nerve stimulation for urge incontinence and urgency-frequency
6. Clarke CRA. Neurological disease. In: Clark M, Kumar P eds. Clinical Medicine, 6th edn. London: Saunders Ltd


Conflict Of Interest

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About the Clinical Cases Database

T​he Foundation Years Clinical Cases Database is​ a selection of 600 peer-reviewed clinical cases in the field of patient safety and clinical practice, specifically focused on the clinical information needs of junior doctors, based around the Foundation Year Curriculum programme (MMC). The cases have been chosen to align with the Foundation Year Curriculum.

The database is fully searchable, or can be browsed by medical specialty. Abstracts can be read free of charge, however a subscription is required in order to read the complete cases.