Hypnotherapy for the unstable bladder: four case reports

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 first‐line 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 one‐hour sessions of hypnotherapy, including anxiety control methods, ego‐strengthening, training in self‐hypnosis, age progression, explanation of stable bladder function and the hand‐on‐abdomen 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 follow‐up 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 first‐line treatment and are unable to take anticholinergic drugs. Copyright © 1999 British Society of Experimental and Clinical Hypnosis