Letter to Editor

Comment on the Levin hypothesis on the role of detrusor rigidity in the lower urinary tract dysfunction

P. Petros

University of NSW, Professorial Dept of Surgery, St Vincent's Hospital, Sydney


As a pelvic foor surgeon with a major interest in bladder and anorectal function, I found Dr Levin’s hypothesis most interesting. His hypothesis starts from the known, symptoms of bladder emptying and urgency increase with age. He provides evidence of fibrosis within the detrusor smooth muscles then proceeds seamlessly to elaborate his hypothesis. The hypothesis is an admirable example of deductive logic.
However, it fails on one major point, it cannot explain reported surgical cures of overactive ‘OAB’ and underactive bladder ‘UAB’. Furthermore it fails to mention the external mechanisms which open and close the urethra ...

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