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The role of denervation in the treatment of detrusor instability

The bladder can function autonomously after complete denervation [Denny Brown and Robertson, 1933] and the activity of the spastic paraplegic bladder may be improved after extensive anterior rhizotomy [Munro, 1945]. Because of such observations denervation (better termed decentralisation) has been used sporadically over the last 40 years to control bladder overactivity. This denervation may be attempted at many levels: