The effect of ephedrine, an adrenergic receptor agonist, was investigated in 24 elderly patients with urinary incontinence associated with unstable detrusor contractions. After 3 weeks of oral ephedrine repeat cystometry showed mean increases of 21 per cent in bladder capacity and of 23 per cent in urethral pressure. Of 21 patients studied 7 became continent and 12 were improved. However, the urodynamic improvement did not reach statistical significance even in the continent group and, thus, the clinical improvement was unlikely to be owing to ephedrine. Therefore, open studies of drug treatment for detrusor instability may be misleading unless clinical and cystometric data are obtained.
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