Abstract
The unstable bladder is a common disorder associated with frequent voiding, urgency, nocturia and urge incontinence. Four consecutive patients (one male, three female; aged from 47 to 69 years) presented with an unstable bladder condition which failed to respond to firstโline treatment by a specialist nurse. Treatments included advice on fluids, reduction of caffeine intake and bladder training. Detrusor instability was confirmed on urodynamic testing. These patients were unable to tolerate anticholinergic drugs or had contraindications to their use. Treatment consisted of three oneโhour sessions of hypnotherapy, including anxiety control methods, egoโstrengthening, training in selfโhypnosis, age progression, explanation of stable bladder function and the handโonโabdomen technique used in the treatment of irritable bowel syndrome. Urinary symptoms had been present for a median of three years and three of the patients were experiencing regular episodes of urinary incontinence at the start of hypnotherapy. Two patients had an excellent response to treatment with complete remission of symptoms during a followโup period of six months. The other two patients derived some benefit from the treatment but continued to experience lower urinary tract symptoms. Brief hypnotherapy may offer some benefit to some patients who have failed to respond to firstโline treatment and are unable to take anticholinergic drugs. Copyright ยฉ 1999 British Society of Experimental and Clinical Hypnosis