Urodynamic aspects of detrusor mechanics and contractility

Summary The mechanical properties of detrusor muscle remain difficult to define. In vitro assessment may not represent accurately the behaviour of the in vivo organ, particularly as the bladder muscle must be regarded as a syncytium of inter-connecting fibres running in all directions. Detrusor mechanics have been described according to basic physical principles and according to intravesical pressure recorded during isometric detrusor contractions with the bladder outlet closed. This data, taken with measurements obtained during voiding, has led to the concept of the detrusor as a limited energy source. This concept challenges previously accepted views on the effect of outlet obstruction on detrusor function.