bluuebunny/crossref_metadata_2025_split huggingface dataset:
Objective assessment of urinary incontinence: An evaluation of three different pad‐weighing tests
Authors: Jakobseny Henrik , Vedel Pernille , Andersen Jens Thorup 
Published: March 2007

AbstractIn 31 women with urinary incontinence the results of three different pad‐weighing tests were evaluated. The three tests were 1) a 48‐hour test performed by the patient at home and at work, 2) a 1‐hour test as recommended by the International Continence Society, and 3) a test including the activities from the 1‐hour test but modified so that the bladder was filled to 75% of the maximum cystometric bladder capacity at the beginning of the test (40‐minute test). The patients found the 48‐hour test and the modified test to be equally representative for their daily leakage, while the 1‐hour test was judged as being less representative than the others. Objectively, the modified test was found to produce a significantly larger urine loss when compared with the conventional tests (median 7 g vs median 3 g, p < 0.003). This may be explained by a significantly larger bladder volume in the modified test during performance of the activity programme. The modified padweighing test is easy to use and interpret owing to its standardized activities. Furthermore, it bypasses the problem of unknown bladder volume at the start of the test.
Effect of ileocystoplasty on contractile response of the bladder, ileum, and cystoplastic ileal segment
Authors: Batra Ashok K. , Wein Alan J. , Ruggieri Michael R. , Gill Harcharan S. , Levin Robert M. 
Published: March 2007

AbstractBladder augmentation or substitution with ileal segments is being used to a greater extent in recent years. The goal of the present study is to characterize the physiologic and pharmacologic changes in the ileal segment that occur following ileal cystoplasty. Four weeks following ileocystoplasty in rabbits, the contractile response of sections of normal terminal ileum, bladder body, and the cystoplastic segment of ileum (ileocystoplasty) was studied in isolated muscle baths. Results were as follows: 1) The ileum responded to a maximal dose of bethanechol with an increase in the amplitude and frequency of phasic contractions whereas the bladder displayed a rapid and sustained increase in basal tension. The cystoplastic ileal segment showed a marked increase in basal tension with superimposed phasic contractions. 2) Maximally effective doses of ATP and methoxamine reduced tension in the normal ileal segments but contracted both the bladder and cystoplastic ileal segments. 3) Isoproterenol reduced tension in all three segments. The pharmacological response of the cystoplastic segment of ileum significantly shifted from that of the ileum toward the response of the bladder. This effect is important as a manifestation of the functional plasticity of smooth muscle.
Bladder instability and abnormal micturition pattern in rats with infravesical outflow obstruction
Authors: Malmgren Anna 
Published: March 2007

AbstractNormal rats and rats with infravesical outflow obstruction were investigated with regard to micturition patterns and bladder pressure during the micturition cycle. Normal rats were found to have a micturition pattern characterized by a high micturition frequency and a small micturition volume. The most commonly occurring micturition intervals were between 50 and 75 min. The micturition volumes were between 0.2 and 0.4 ml. The obstructed rats could be divided into two types with regard to their micturition patterns. The majority of the obstructed rats (75%) voided similar volumes as control rats (between 0.2 and 0.4 ml) but the intervals were shorter (between 10 and 20 min). A minority of the obstructed rats (25%) showed a micturition pattern consisting of large volumes (between 1 and 2 ml) and long intervals (> 200 min).In control rats the bladder pressure was low during the micturition cycle and only minute bladder pressure fluctuations were noted until micturition. The obstructed rats, however, exhibited a marked spontaneous activity during the micturition cycle. The spontaneous activity became more and more pronounced until micturition occurred. Prior to micturition it exceeded 7 cm H2O. The altered micturition pattern and the development of a pronounced bladder instability seen during the micturition cycle reveal clear similarities with findings in man with infravesical outflow obstruction.
Comparison of the in vitro isolated strip methodology with the superfused strip technique
Authors: Levin Robert M. , Ruggieri Michael R. , Barasha Brenda , Kramen David , Wein Alan J. 
Published: March 2007

AbstractThere are several methodologies available for determining the contractile effects of specific agents on isolated smooth muscle. The standard isolated bath technique utilizes strips mounted in a physiological buffer. The agent under study is added to the buffer and the response is recorded on a polygraph. The superfused strip technique utilizes strips in which buffer is pumped over the strip at relatively low flow rates. The agent under investigation is either infused into the stream of buffer bathing the tissue strip or administered directly onto the tissue. We have compared the response of these two methodologies using isolated strips of rabbit urinary bladder body.Isolated strips of rabbit urinary bladder were mounted in standard isolated baths containing 30 ml Tyrode's solution. The response of these strips to the autonomic agonists bethanechol, ATP, and isoproterenol were determined via cumulative addition at 5‐minute intervals. Similar strips were mounted as above, after equilibration, the Tyrode's was drained, and fresh oxygenated Tyrode's was pumped over the strip at a rate of 4 ml per minute. Flow was stopped and drugs were administered directly onto the tissue in 100‐μl aliquots. After either maximal response or 2 minutes, flow was resumed. Drugs were added at 10‐minute intervals.The results can be summarized as follows: 1) The superfused bladder strips responded to 100‐fold lower amounts of autonomic agonist than the strips in the isolated bath. 2) The maximum response to ATP (an agent that produces rapid desensitization) was threefold greater in the superfused model than in the bladder bath, and the rate of response of the tissues in the superfused system was significantly greater than in the isolated baths.In summary, the superfused isolated bladder preparation is an excellent methodology to use in specific investigations.
Detrusor inhibition on selective pudendal nerve stimulation in the perineum
Authors: Vodušek D. B. , Plevnik S. , Vrtačnik P. , Janež J. 
Published: March 2007

AbstractSelective electrical pudendal nerve stimulation calibrated to achieve a “maximal motor response” as recorded electromyographically in the periurethral sphincter was found to increase the micturition threshold in three neurological patients with detrusor hyperreflexia. Such electrical stimulation (0.2‐ms long pulses at 5 Hz and up to 2.0 mA) could conceivably be also supplied by an implanted “vesicoinhibitory” stimulator, and this report is considered as a pilot study towards formulation of such a therapeutic approach.
Measurement of intrapelvic peristaltic activity in the diagnosis of equivocal upper urinary tract obstruction
Authors: Payne S. R. , Gosling P. T. , Nagendran R. , Wickham J. E. A. 
Published: March 2007

AbstractDirect measurement of upper urinary tract dynamics during perfusive stress is an accepted method of investigating the dilated upper urinary tract when a clear diagnosis of obstruction cannot be refuted by indirect radiological or renographic means. Transparenchymal renal puncture for intrapelvic pressure transduction has become an accepted technique over the last 15 years, well‐defined “standard” fluid stresses being determined to uncover covert obstructions with strict criteria for the determination of such a state. These antegrade perfusion/pressure tests do not, however, take into account the role of upper tract peristalsis, an important factor for the promotion of renal drainage in multicalyceal animals.Fifteen patients with equivocal upper urinary tract obstruction had their upper urinary tract dynamics determined prospectively by a modification of the standard Whitaker test, results of these studies being compared with measurements of pelvic peristalsis and baseline intrarenal pressure made by using an intrapelvic microtransducer‐tipped catheter interfaced to a computerised recording system. This system enabled the measurement of pelvic dynamics in various postures without the necessity for transducer rezeroing. Six patients showed abnormalities of pelvic peristaltic activity indicative of the obstructed upper tract, only three of whom had unequivocally obstructed Whitaker tests. All obstructed patients had accentuation of their peristaltic abnormalities in the sitting position, underlining the importance of performing direct dynamic measurements in a physiological position. We have found that measurement of pelvic peristaltic activity as well as baseline intrapelvic pressure during perfusion is important for the delineation of the equivocally obstructed kidney, suggesting that the antegrade perfusion/pressure test should be modified to allow more physiological study of renal outflow dynamics.
Unstable urethral pressure: Toward a more relevant definition
Authors: Hilton Paul 
Published: March 2007

AbstractThere is confusion in the literature over the use of the terms unstable urethra and unstable urethral pressure, which are often held inappropriately to be synonymous. The importance of the former condition, as a cause of incontinence, is beyond doubt, although it appears to be an uncommon condition; the finding of unstable urethral pressure is reported much more frequently, although its clinical significance remains in debate. An analysis of urethral pressure recordings in a group of 131 women with urodynamically proven genuine stress incontinence, and 14 urodynamically normal women entirely free from urinary symptoms has been carried out in an attempt to define the differences between the two and thus to establish a more clinically relevant definition for the phenomenon of “unstable urethral pressure.”The variation in urethral pressure was calculated first in absolute terms, as the variation in cm H2O above and below the mean maximum urethral closure pressure (MUCP), and second in relative terms, as a percentage of the mean MUCP itself; these two parameters are described as “delta‐MUCP (absolute)” and “delta‐MUCP (relative),” respectively.The mean delta‐MUCP (absolute) values were 9.5 and 13.4 cm H2O for the symptomatic and control groups, respectively (not significant); the mean delta‐MUCP (relative) values were 27.0% and 17.1% of the MUCP (p < 0.001). Examination of various potential points of discrimination for the diagnosis of “unstable urethral pressure” showed a delta‐MUCP (relative) of 30% to be the best discriminator, allowing the identification of a subgroup of stress incontinent women whose urethral pressure variation was likely to be of relevance in the determination of symptoms.
Voiding dysfunction associated with cervical spondylotic myelopathy
Authors: Katz P. Gary , Alberico Anthony M. , Zampieri Thomas A. , Fox Lorick 
Published: March 2007

AbstractPatients with cervical spondylotic myelopathy who were neurosurgical candidates were prospectively evaluated for voiding abnormalities. The patients had relatively advanced neurologic disease because of delays in presentation and in diagnosis. The 22 consecutive patients included 20 males and 2 females with average age of 57 years. Sixteen patients had voiding symptoms with 12 noting a change in voiding pattern following the onset of their neurologic symptoms. Detrusor hyperreflexia was present in 16 (73%) of the patients and external sphincter dyssynergia in 8 (36%) of the patients. Neurologically mediated voiding dysfunction was common in patients with myelopathy secondary to cervical spondylosis.
Electrical membrane events underlying contraction of guinea pig bladder muscle
Authors: Mostwin Jacek L. 
Published: March 2007

AbstractThe relationship of electrical to mechanical activity of guinea pig bladder muscle has been studied in vitro by intracellular microelectrode and sucrose gap techniques. A discrete relationship between individual electrical action potentials and muscle contractions of small amplitude can be seen in muscle which is spontaneously active or stimulated by muscarinic activation or electrical current. An increase in the frequency of action potentials is associated with an increase in the frequency of small‐amplitude contractions and the generation of muscle tension. The frequency of action potential firing is sensitive to changes in the resting membrane potential of the muscle. The findings suggest that an increase in the frequency of action potential firing may be a major mechanism in the development of muscular tension in the wall of the bladder.
Experimental studies with total and static urethral pressures in canine urethra and their clinical significance
Authors: Yalla Subbarao V. , Cravalho Ernest , Resnick Neil M. , Chiang Rossanna 
Published: March 2007

AbstractCanine experiments were conducted in order to determine potential sources of error in measurement of total and static urethral pressures during urodynamic studies. Transmural urethral cannulas were inserted at various urethral sites, downstream and upstream of an elastic constriction, and attempts were made to study 1) the effect of increasing rates of urethral perfusion, 2) the differences in static and total urethral pressures at a urethral site, and 3) the differences between the static pressures recorded through the transmural cannulas and the intraurethral catheter. More than 300 pressure measurements were made in 14 dogs (both male and female). The results suggested that 1) static pressure increases with increasing rates of infusion, 2) when constrictions are applied in the midurethra, the increase of pressure is greater in the proximal (upstream) than the distal (downstream) urethral segments, 3) the total urethral pressures were (4 to 10%) higher than the static pressures, and 4) although statistically not significant, the static pressures recorded through the urethral catheter were lower than those recorded through the extraluminal transmural cannula.
Micturition‐facilitating mechanism in benign prostatic hypertrophy: A theory
Authors: Cucchi A. 
Published: March 2007

AbstractForty males aged 46–82 years (mean, 65 years) with bladder outflow obstruction due to benign prostatic hypertrophy were chosen among a group referred for prostatism. They were assessed by means of symptom analysis, rectal examination, intravenous urography and/or cystoscopy, and urodynamic testing (medium‐fill water cystometry and pressure flow study). Only those patients were considered who had compensated bladders with no severe trabeculation. A significant correlation was found in this series between urethral resistance and opening time (r = −.41, p < .01), the best fit being a negative exponential relationship (the higher the degree of obstruction, the lesser the time needed to reach the threshold pressure at which flow begins). This was supposed to describe a real micturition‐facilitating mechanism, which might be explained by abnormal activation of a nerve pathway relaying through the spinal cord between the proximal urethra and detrusor muscle. Such a mechanism would be valid for those proximally obstructed bladders with mild to moderate detrusor collagenosis.
Effects of nifedipine and Bay K8644 on normal and hypertrophied rat detrusor
Authors: Malmgren A. , Andersson K.‐E. , Andersson P.‐O. , Fovaeus M. , Sjögren C. 
Published: March 2007

AbstractBladder strip preparations from normal female Sprague‐Dawley rats as well as from rats with bladder outflow obstruction were mounted in organ baths, and isometric tension responses to electrical stimulation were recorded. Preparations of normal rat detrusor exhibited a minute spontaneous contractile activity. Addition of the calcium channel “agonist” Bay K8644 increased the basal tension and markedly enhanced spontaneous activity. In the presence of the drug the sensitivity to electrical field stimulation was enhanced; maximum amplitude increased, and the frequency producing 50% of maximum tension decreased. The calcium antagonist nifedipine had the opposite effects. In the presence of tetrodotoxin (TTX), the electrically induced responses were markedly depressed. Addition of Bay K8644 only partly restored these responses.Detrusor strips from rats with infravesical outflow obstruction exhibited marked spontaneous activity. They were less sensitive to electrical field stimulation than strips from normal bladder. Bay K8644 increased basal tension and spontaneous activity and also the maximum response to electrical stimulation. Nifedipine abolished spontaneous activity, induced a rightward shift of the frequency‐response curve, and decreased the maximum amplitude. Electrically induced responses were significantly more resistant to TTX than in normal detrusor, and in the presence of TTX addition of Bay K8644 increased electrically induced response to control level.Provided that TTX completely blocks nervous transmission and that Bay K8644 and nifedipine both have a preference for voltage‐operated calcium channels, these data suggest that hypertrophied bladder muscle has a nonspecific smooth muscle hypersensitivity to depolarizing stimuli. Possibly such changes can be linked to detrusor instability associated with outflow obstruction in man.
New diagnostic criteria in obstruction of the pyeloureteral junction
Authors: Kinn Anne‐Charlotte , Ohlson Lars , Coolsaet Bo , Constantinou Christos E. 
Published: March 2007

AbstractThe peristalsis of the upper urinary tract was studied with kinetic urography in 34 patients in whom conventional urography indicated obstruction of the pyeloureteral junction (PUJ). The fluoroscopic image at urography was recorded and manually transferred to plastic film for later analysis. In 18 patients the following features were found to deviate from normal peristalsis and were considered to be due to obstruction: (1) ectopic starts of retrograde contractions from the pyeloureteral junction, (2) absence of the injection of urine across the PUJ, (3) inhibition of impulse conduction across the PUJ, (4) absence of the postcontraction injection. In the remaining 16 patients the peristalsis was normal. Manometry of the renal pelvis during perfusion was performed in 24 and diuresis renography in 32 of the patients. The findings at kinetic urography were in accordance with manometry in 83%; and with diuresis renography in 71%; In a clinical follow‐up of nonoperated patients as well as patients who had undergone pyeloplasty, kinetic urography proved to be a correct predictive method in 94% of the patients, manometry in 88%, and diuresis renography in 72%, respectively. Kinetic urography thus proved to be a valuable technique for selecting patients likely to benefit from pyeloplasty.
The distal urethral electrical conductance test: Standardisation of method and clinical reliability
Authors: Mayne C. J. , Hilton P. 
Published: March 2007

AbstractUrethral electrical conductance was recorded throughout standard exercise test in a group of 40 women with known urinary incontinence. Analysis of the results has shown it to be of little diagnostic value (sensitivity = 33%). It is, however, a sensitive means of detecting leakage (sensitivity = 97%), and a comparison of the total change in conductance during the exercise test with weighed perineal pads shows this parameter to be a reasonable index of the severity of leakage.
Uroflowmetric observations in pregnancy
Authors: Hong Peter L. , Leong Mary , Seltzer Vicki 
Published: March 2007

AbstractUroflowmetric studies were performed on 752 antepartum patients at various stages of pregnancy and 153 patients 6 weeks postpartum. The mean voided volume in the antepartum group (203.4 ml) was significantly lower (P < .001) than that of the postpartum group (261.1 ml). In the antepartum group, the data suggests a significant decrease in voided volume in the third trimester. The uroflowmetric parameters (FT, Q‐max, T‐Q‐max) studied were observed to be directly related to voided volumes. This is an observation known in the nonpregnant female. Presenting stations of zero and above do not appear to influence the uroflowmetric parameters. Subjective increases in frequency of urination during pregnancy are correlated with objective decreases in the volumes voided, and the converse is also found to be true. The contributory roles of the mechanical and endocrinological factors on micturition in pregnancy are discussed. It appears that the predominant factor may be mechanical.
Predictive value of detrusor instability index in surgery for female urinary incontinence
Authors: Lose Gunnar , Jørgensen Lisbeth , Johnsen Anni 
Published: March 2007

AbstractPre‐ and postoperative data were reviewed in 33 female patients with urinary incontinence associated with demonstrated detrusor instability who underwent conventional anti‐incontinence surgery (anterior colporrhaphy or colposuspension).Generally, the surgical result was poor. Only 27% (95% confidence limits 13–46%) were subjectively and objectively cured. In patients with a detrusor instability index ≤0.4 cure rate was significantly better compared to patients with an index > 0.4.In conclusion, simple cystometric data, in particular the detrusor instability index, seem to provide valuable predictive information regarding the outcome of conventional surgery in females with urinary incontinence associated with detrusor instability.
Lower urinary tract smooth muscle inhibitory nerve responses
Authors: Klarskov Peter 
Published: March 2007

AbstractDetrusor and trigone from man and detrusor, trigone, bladder neck, and urethral smooth muscle from pig were investigated in a series of experiments in vitro. A noncholinergic, nonadrenergic inhibitory nerve response was demonstrated. In the outlet smooth muscle, the onset of the relaxation was fast and sustained during stimulation. The amplitude of the relaxation was proportional to the basal tension and maximal with stimulation frequencies of 5‐10 Hz. In pig detusor, the relaxation was preceded by a contractile phase. Spontaneous or induced contractility and high tension favoured the relaxation in a nonlinear way. In human detrusor the relaxation was difficult to generate and the results were equivocal. No tested transmitter candidate mimicked exactly the relaxation evoked by electric nerve stimulation. Acetylcholine, noradrenaline, enkephalins, substance P, histamine, and prostaglandins were excluded. Vasoactive intestinal polypeptide induced relaxation in both detrusor and outlet muscles. Serotonin and ATP induced contraction in the detrusor and relaxation in pig outlet muscle. However, the relaxationevoked pharmacologcally developed slowly and the amplitudes were submaximal. The relaxation evoked by ATP was probably caused by adenosine after degradation of ATP. No other known and tested transmitter candidate evokes relaxation in lower urinary tract smooth muscle.Bladder neck smooth muscle biopsies from men with bladder neck dyssynergia, median‐sized benign prostatic hypertrophy, and normal infravesical outlet were analysed for vasoactive intestinal polypeptide by radioimmunoassay and by immunohistochemistry. No diferences were found between the groups. Pressure‐flow‐EMG studies were performed in men and urethrocystometry was performed in women before, during, and after vasoactive intestinal polypeptide 3 μg/kg × h intravenously. No systematic changes developed in any of the urodynamic parameters.