bluuebunny/crossref_metadata_2025_split huggingface dataset:
Preoperative screening for latent stress incontinence in women with cystocele
Authors: Fianu Stefan , Kjaeldgaard Anders , Larsson Bertil 
Published: March 2007

AbstractA preoperative urodynamic investigation with and without a vaginal pessary ring including simultaneous urethrocystometry and urethral pressure profiles in supine and standing position during coughing was evaluated in 41 continent women with cystocele. Following the application of the vaginal pessary ring, loss of urine was demonstrated in six patients, in whom a negative urethral closure pressure was found only when the pessary ring was inserted, suggesting that latent stress incontinence might become manifest after surgical repair of the cystocele. These patients were all continent during the follow‐up period of 12–18 months after Manchester repair combined with urethrocystopexy. The remaining 35 patients with normal urodynamic registrations with and without an inserted pessary ring had no signs of urinary incontinence during the follow‐up period after the Manchester repair. Thus, the present urodynamic screening was found to be valuable for preoperative selection of an adequate surgical method in order to avoid postoperatively manifest stress incontinence after anterior colporaphy.
Urethral sphincter EMG activity registered with surface electrodes in the vagina
Authors: Colstrup H. , Jørgensen L. , Lose G. , Kristensen J. K. , Andersen J. T. , Blaivas Jerry G. 
Published: March 2007

AbstractTransvaginal registration of urethral sphincter EMG with surface electodes at the anterior vaginal wall has been compared to simultaneous registrations of urethral ring electrode EMG and anal surface electrode EMG in 12 patients. We found that the transvaginal EMG was almost identical to the intraurethral EMG during different pelvic floor muscle activities but differed considerably from the perianal EMG. The clinical applicability was investigated during medium‐fill water cystometry followed by pressure‐flow studies, and in 21 out of 25 patients, a satisfactory EMG was registered.
Ultrastructure of vesicourethral innervation: IV. Evidence for somatomotor plus autonomic innervation of the male feline rhabdosphincter
Authors: Elbadawi Ahmad , Atta Mohamed A. 
Published: March 2007

AbstractThe male feline rhabdosphincter was studied ultrastructurally to define the patterns of innervation of its fibers. Two types of neural junctions were observed: classical neuromuscular junctions with motor end‐plates (of both the en plaque and en grappe types), and surface junctions without any specialization of the related muscle fibers. The former represent somatomotor cholinergic, and the latter most likely autonomic cholinergic, adrenergic, and probable co‐peptidergic neuromuscular junctions. These findings confirm the theory of triple innervation of the male feline rhabdosphincter, which was introduced originally on a histochemical basis.
Sympathetic inhibition of reflex activation of bladder motility during filling at a physiological‐like rate in urethane anaesthetized rats
Authors: Maggi Carlo Alberto , Santicioli Paolo , Meli Alberto , Downie John W. 
Published: March 2007

AbstractThe mean volume of saline (infused at a physiological‐like rate) required to elicit neurogenic rhythmic contractions of the detrusor muscle (micturition threshold) in urethane anaesthetized rats was reduced by reserpine pretreatment, as well as by chemical (6‐hydroxydopamine) or surgical sympathectomy (bilateral section of the hypogastric nerves). Propranolol pretreatment had no significant effect on micturition threshold but increased the intraluminal pressure at which the rhythmic contractions occurred. In spinal rats (T12L1) a flat pressure volume curve was obtained with only a minor phasic contractile activity. Propranolol administration or bilateral section of the hypogastric nerves significantly increased the intraluminal pressure response to saline filling in spinal rats. Topical tetrodotoxin increased the intraluminal pressure response to saline filling in control spinal rats but not following propranolol administration or bilateral section of the hypogastric nerves. These findings provide evidence for a sympathetic inhibition of the reflex activation of the detrusor muscle in response to a physiological‐like filling of the urinary bladder.
The routine assessment of detrusor contraction strength
Authors: Griffith D. J. , van Mastrigt R. 
Published: March 2007

AbstractA method is described for the semiquantitative assessment of the strength of the detrusor contraction during any voiding for which the detrusor pressure, flow rate, and residual urine are measured. A computer is used to produce plots of detrusor pressure vs detrusor shortening velocity throughout voiding. The adequacy of the contraction can be followed through micturition until the bladder is nearly empty. In some cases the isovolumetric detrusor pressure and the maximum potential velocity of shortening of the detrusor can be estimated. The ranges of values found are comparable with those deduced from the stop test, although there are slight discrepancies. The median values of these two parameters form the basis of the routine method that can be used for any detrusor contraction.
Simultaneous urethrocystometry and hyperactive bladders: A manometric differential diagnosis
Authors: Penders L. , De Leval J. 
Published: March 2007

AbstractThe authors reviewed simultaneous urethrocystometry (SUCM) in 96 patients with hyperactive bladders subclassified into four groups (pure detrusor instability, mixed instability, suprasacral spinal lesion, and CNS lesion) and compared the incidence of various urethral parameters. The absence of urethral relaxation before or during the augmentation of the detrusor pressure is the most specific sign of suprasacral spinal lesions. It constitutes what we call passive or tonic dyssynergia. When, at the beginning of SUCM, the maximal closure pressure is > 30 cm H2O, or when a sphincteric contraction is associated with, either before (“kick”) or during (active or clonic dyssynergia) the detrusor contraction, this urethral nonrelaxation is pathognomic of such a spinal lesion. A “kick” is also specific of hyperreflexia but is less constant. On the contrary, in this series and with this technique, an active dyssynergia has no etiological significance; it only reflects the degree of the vesico‐urethral imbalance. This study further supports the importance of the brain stem in controlling and coordinating the vesicosphincteric unit.
Neurogenic bladder dysfunction in sacral agenesis and dysgenesis
Authors: Jakobsen Henrik , Holm‐Bentzen Merete , Hald Tage 
Published: March 2007

AbstractIn seven adult patients suffering from congenital caudal spinal malformations including total agenesis, dysgenesis, and dysraphism of the sacral bones, the neurological and the neurogenic bladder disorders are described. Based upon clinical, radiological, and urodynamic investigations, previous observations were confirmed of the wide spectrum of micturition disorders in this type of patient. In three females and four males (median age 30 years, range 19–51 years) a wide spectrum of neurogenic bladder disorders ranging from complete suprasacral to complete infrasacral lesions was found. In one patient, no evidence of sensory‐motor bladder nerve deficiency was found. The finding of neurologic damage not corresponding to the levels of bone lesions and the high proportion of patients suffering from concurrent genitourinary developmental defects should emphasize the need for thorough and frequent investigations including urodynamics and monitoring of renal function.
Bladder and urethral pressures during bladder filling in patients with multiple sclerosis and urge incontinence
Authors: Kinn Anne‐Charlotte , Nergårdh Arne , Sidén ÅKe 
Published: March 2007

AbstractTwenty patients with multiple sclerosis and distressing urge incontinence underwent continuous measuring of bladder and urethral pressures during bladder filling. Hyperreflexia with high‐pressure peaks resulted in more excessive leakage than detrusor instability with frequent recurring pressure rises of low amplitude and short duration. Atropine reduced leakage by decrease of amplitude as well as frequency of the detrusor contractions. In some patients atropine also normalized urethral instability. Thus it seems probable that both hyperreflexia and instability in patients with multiple sclerosis are mediated by cholinergic neurones in the bladder wall.
Directional differences in urethral pressure recordings: Contributions from the stiffness and weight of the recording catheter
Authors: Plevnik Stanislav , Janež Janez , Vrtašnik Peter , Brown Malcolm 
Published: March 2007

AbstractThe difference between urethral pressures measured along the anterior wall and those measured along the posterior wall was found to increase markedly as the stiffness of the catheter was increased and to increase by a greater amount if the weight of the catheter was increased. A method of grading the stiffness of catheters is proposed and the use of stiff catheters in past reports of urethral measurements is discussed.
Superimposition of urethral closure pressure profiles using urethral electric conductance measurements
Authors: Plevnik Stanislav , Vrtačnik Peter , Janež Janez 
Published: March 2007

AbstractThe external urethral meatus (EUM) was located on the urethral closure pressure profile by simultaneous measurement of the urethral electric conductance profile. The EUM was further used as a reference point for accurate superimposition of urethral closure pressure profiles.
Calcium antagonist affinity for adrenergic and cholinergic receptors in rabbit urinary bladder
Authors: Malkowicz S. Bruce , Wein Alan J. , Levin Robert M. 
Published: March 2007

AbstractCalcium antagonists have the ability to relax vesical smooth muscle in vitro and in vivo. The presumed mechanism of action is through the inhibition of calcium translocation, yet these agents have also been shown to bind to several different pharmacological receptors. By employing radioligand binding assays, the affinity of verapamil and diltiazem for several receptor populations in the rabbit detrusor was studied. Verapamil and diltiazem displayed binding affinities for receptor populations in the following order: alpha1‐ and alpha2‐ adrenergic > muscarinic cholinergic > beta‐adrenergic. In all instances verapamil affinity was greater than that of diltiazem. The relatively high Ic50's for both muscarinic and beta receptors indicate that the interactions of verapamil and diltiazem with these receptors are of little physiological significance.
The role of urodynamic testing in the evaluation of subtle neurologic lesions
Authors: Blaivas Jerry G. , Salinas Jesús M. , Katz Gary P. 
Published: March 2007

AbstractSeventy‐five patients with equivocal neurologic findings were prospectively evaluated to determine the presence or absence of “neurogenic bladder.” All were referred by neurologists or neurosurgeons because of their inability to make a definitive diagnosis of neurologic impairment of bladder function. On the basis of sophisticated urodynamic studies, a definite diagnosis of “neurogenic bladder dysfunction” was made in 23% of the patients. In 40%, the findings were equivocal, and in 37%, “neurogenic bladder” was excluded.
Intrinsic neuromuscular defects in the neurogenic bladder: IV. Loss of somatomotor and preservation of autonomic innervation of the male feline rhabdosphincter following bilateral sacral ventral rhizotomy
Authors: Atta Mohamed A. , Elbadawi Ahmad 
Published: March 2007

AbstractInnervation of the male feline rhabdosphincter was studied ultrastructurally 1 and 2 weeks following bilateral sacral ventral rhizotomy. In all samples, there was virtual loss of myelinated axons, degeneration and loss of the axonal element of all motor end‐plates, and preservation of autonomic nonrnyelinated (cholinergic, adrenergic, and probable copcptidergic) axons, as well as their nonspecialized surface contacts with myofibers of the rhabdosphincter. These observations provide solid evidence for the existence of both somatomotor and autonomic cholinergic innervation of the male feline rhabdosphincter and indicate that its potential neural control shortly after somatic denervation is exercised exclusively by autonomic axonlmyofiber surface contacts.
Bladder compliance and detrusor activity during the collection phase
Authors: Coolsaet Bo 
Published: March 2007

AbstractThe bladder wall is composed of passive (collagen, elaftin) and active (smooth muscle) elements. Some of the smooth muscle cells have properties of “pacemakers” in that they show spontaneous activity at rest. Moreover, when these cells are stretched, the resting membrane potentials decrease and the frequency of action potentials increase. It has been further demonstrated that both in vitro muscle strips and in vivo bladder preparations show spontaneous activity which may generate both tonic and phasic changes in bladder wall forces. The rate and duration of stretch both affect the force that the cell can generate. Thus, the filling pressureivolume curve obtained by systometry represents an interaction between the active and passive elements of the bladder wall. Since the cystornetric curve is time dependent, it is impossible to compare cystometrograms unless this time dependency is taken into account. With these principles in mind it is possible to standardize the terminology for characterizing detrusor activity during the collection phase as outlined in this report.
Subthreshold detrusor instability
Authors: Coolsaet B. L. R. A. , Blok C. , Van Venrooij G. E. P. M. , Tan B. 
Published: March 2007

AbstractAt the present time there is a paucity of clinical information on subthreshold (less than 15 cm of water) detrusor instability. In this study of 334 women with stress and/or urge incontinence, it was calculated that subthreshold detrusor instability resulted in urinary incontinence in 10% and urgency and frequency in 85%.
Detrusor instability and bladder outlet obstruction
Authors: Abrams Paul 
Published: March 2007

AbstractDetrusor instability is found in a high percentage of children with voiding disorders and in elderly patients both with and without bladder outlet obstruction. An assumption that outlet obstruction leads to detrusor instability has arisen largely from the findings that prostatectomy results in a marked reduction in the incidence of instability. However, studies have shown that the incidence of instability is related to age both by virtue of a decreasing incidence in childhood and an increasing incidence in later life. In later life the increase reflects advancing age and is not related to the severity of any coexisting outlet obstruction. The reduction in instability following prostatectomy may be due to an interruption of sensory afferent impulses due to resection of prostatic, urethral, and bladder neck nerve tissues.In children, instability is likely to represent delayed maturation of cerebral control over the micturition reflex, or to be due to neurological disease such as meningomyelocele.More data are required for all groups of patients, both children and adults, to determine the influence of the relief of obstruction on the incidence of instability. Furthermore, additional data are required on the incidences of instability and obstruction in the “normal” population.
The surgical treatment of detrusor instabiiity
Authors: Mundy A. R. 
Published: March 2007

AbstractThe surgical treatment of detrusor instability is still in its infancy. At the present time there are two main types: operations designed to ablate the nerve supply and those designed to circumvent the problem by enlarging the bladder sufficiently such that the unstable contractions are either ineffectual or occur at such a large volume that they are clinically insignificant. The former approach is rarely successful, except possibly in patients over the age of 55 years; the latter seems to be effective in the majority of patients, but the data should still be considered to be preliminary. Hydrodistension of the bladder is ineffective.
A comparison of spontaneous and intubated urinary flow in female patients
Authors: Lose G. , Thunedborg P. , Jørgensen L. , Colstrup H. 
Published: March 2007

AbstractIn 60 female patients with lower urinary tract disorders the natural urinary flow was compared with the flow obtained with two 5 F urethral catheters in place. For the group as a whole there was no significant decrease in the intubated maximum flow rate whereas the intubated average flow decreased significantly. Among patients with a spontaneous flow rate of < 15 ml/sec no effect of the catheters was observed; actually the maximum flow rate increased significantly, which, however, may be due to increased voided volume.The transurethral technique for pressure‐flow studies offers a simple method for the assessment of detrusor contractility and for the identification of patients with infravesical obstruction. It can be performed without further invasion in conjunction with routine cystometry studies. Therefore this technique is recommended in the routine urodynamic workup in females with lower urinary tract disorders.
The one‐hour pad‐weighing test: Reproducibility and the correlation between the test result, the start volume in the bladder, and the diuresis
Authors: Lose Gunnar , Gammelgaard Jens , Jørgensen Tine J. 
Published: March 2007

AbstractTo evaluate the reproducibility of the one‐hour pad‐weighing test as proposed by the ICS and to study the association between the test results, the initial volume in the bladder, and the diuresis, 18 females with stress or mixed incontinence underwent two separate tests. Bladder volumes were estimated by transabdominal ultrasonic scanning.A significant intra‐individual variation in the test results was found. In about 50% of the patients the classification of the degree of leakage changed from one test to the other. This variation could be explained by variation in the fluid load on the bladder during the test, ie, the initial volume and the diuresis. For scientific purposes the one‐hour pad‐weighing test in its present design is not precise enough to allow reliable quantitation of urinary incontinence.
A computer‐based program for a neuro‐urology unit in a department of urology
Authors: Simon D. , Levy E. , Servadio C. , Nissenkorn I. 
Published: March 2007

AbstractA computer‐based record program for a Neuro‐Urology Unit and its practical applications are described.The advantages of the system are the following: “handy” day‐to‐day medical recording with instant access to medical records, accurate entry of followup notes, systematic analysis of urodynamic examination results, and upon completion of examinations, immediate issue of a typed medical report.The medical information collected is easily accessible for research purposes by the same system.
Functional voiding disorders in females
Authors: Paviakis Aristidis , Wheeler John S. , Krane Robert J. , Siroky Mike B. 
Published: March 2007

AbstractOne hundred fifty‐nine female patients with persistent and unexplained voiding symptoms were referred for urodynamic study. Sixty percent had frequency, and nearly half of these reported incontinence. Twenty‐five percent had obstructive symptoms, and half of these had urinary retention. Symptoms were long standing (mean 12.3 years) especially in those with detrusor hyperreflexia (DH). Also, a history of childhood enuresis was elicited in 50% of patients with DH. A psychosocial disturbance or psychosomatic illness was present in 70% of our patients. Urodynamic studies revealed DH in 44.5%, detrusor areflexia (DA) in 44.5 %, and normal studies in 11 %. Rapid pharmacologic testing using bethanechol (n = 67) and/or diazepam (n = 13) was performed in patients with DA as an aid in determining the etiology. The role of urodynamic testing in evaluating and treating functional voiding disorders in adult female patients is discussed.
A study of the myelinated fibres in the branches of the pelvic plexus
Authors: Donker P. J. 
Published: March 2007

AbstractIn a 20‐year‐old human female specimen the nerves to the pelvic organs were dissected and analysed. The gross anatomy of the branches of the pelvic plexus was described. The composition of these nerves was studied and the sizes and distribution of the diameter of a great part of the myelinated nerve fibres were measured and analysed. It was confirmed that the ventral roots S2 and S3 contain many nonmyelinated nerve fibres. There are direct connections between the sacral sympathetic chain and the pelvic plexus. They contain myelinated fibres with sizes as large as 11 μm. There are two different groups of fibres which supply the bladder, one on the dorsal side, mainly nonmyelinated (postganglic sympathetic?), and another group to the lateral side which contains many thin myelinated fibres (parasympathetic preganglionic?). The pelvic plexus and its branches are fixed to the vagina and the rectum. Surgical interventions in this area and perhaps also childbirth can damage the nerve supply to the bladder and the urethra. The functional disturbances of the bladder after such interventions can depend on what group of nerve fibres is most seriously damaged. The large number of thick myelinated fibres which reach the ventro lateral side of the urethra makes it highly probable that these fibres innervate the intrinsic striated urethral musculature. The large number of nonmyelinated nerve fibres in the nerves to the m. levator ani probably innervate smooth muscle tissue which is found in the fasciae of the pelvic floor.
Effect of naloxone on detrusor‐sphincter dyssynergia in the chronic spinal cat
Authors: Galeano César , Jubelin Bruno , Biron Linda , Guenette Lilianne 
Published: March 2007

AbstractNaloxone, an opioid peptide antagonist, has been reported to facilitate voiding in neurologic bladder disorders, but its effects on the neural micturition reflex arc are poorly understood. We studied the effect of naloxone in 34 male adult cats, spinalized at C5‐C6 level 7 to 119 days previously. Each cat served as its own control.The following tests were performed: Urethral pressure profiles, cystosphincterograms with the urethro‐vesical junction opened and closed and mechanograms of the detrusor, and the circular and longitudinal urethral muscles. The study included (1) the effects of anesthesia of the bladder and pelvic nerve, as well as that of the urethral and pudendal nerves; (2) the action of naloxone; and (3) the action of oxymorphone.Our results demonstrated that naloxone (1) increased somatic (osteotendinous and nociceptive) reflexes and aggravated spasticity; (2) increased vegetative micturitional and sexual reflexes, in particular the urethra‐urethral contraction reflex, aggravating the spasmodic contractions of the external sphincter; and (3) increased the frequency and intensity of the mass reflex. In consequence, we suggest that naloxone is contraindicated in cases of spinal cord lesions with detrusor‐sphincter dyssynergia syndrome.
Is sympathetic control of the urethra mediated through vasomotor action?
Authors: Downie John W. , Lautt W. Wayne 
Published: March 2007

AbstractThe suggestion that the sympathetic nervous influence on urethral smooth muscle activity is mediated through vasomotor control was tested directly by using an arterial long circuit in pentobarbital‐anesthetized cats. Hypogastric nerve stimulation produced a frequency‐dependent contraction of the bladder and constriction of the urethra but had no influence on the resistance of the isolated vascular circuit. Altering the speed of the pump that controlled circuit flow to either increase or decrease vascular circuit pressure had no influence on urethral perfusion pressure. It was concluded that the hypogastric nerve induces urethral constriction directly and not by vasomotor action. Furthermore, short‐term alterations in vascular status are not reflected in changes in urethral tension.