bluuebunny/crossref_metadata_2025_split huggingface dataset:
Detrusor‐myoplasty, innervated rectus muscle transposition study, and functional effect on the spinal cord injury rat model
Authors: Chancellor Michael B. , Rivas David A. , Acosta Rafael , Erhard Michael J. , Moore John , Salzman Steven K. 
Published: March 2007

AbstractThe purpose of this investigation was to determine the feasibility of striated muscular augmentation of the urinary bladder (detrusor‐myoplasty, DMP). Initial studies, transposition, and bladder wrap using several distinct muscle groups was attempted in laboratory rats, goats, and fresh human cadavers. The rectus abdominus muscle was found to be best suited to completely encompass the bladder with an intact neural and vascular supply. The technique was then applied in a rat model of spinal cord injury (SCI).Modified Tarlov ratings were employed to assess neurologic function 30 days after SCI. The median final neurological score of SCI rats with and without DMP was 4 and 5, respectively. Sham‐operated SCI (control) rats, with and without DMP, both had normal final Tarlov scores of 12 (P < 0.05). Muscle blood flow values for the flap and the contralateral undissected rectus muscles were not significantly different (97 ± 34 and 105 ± 40 ml/100 g tissue/min, respectively, P = 0.47). Postoperatively, no bowel or abdominal wall functional deficits were apparent. The rotated muscular flap remained innervated and vascularized.Analysis of 24 hr micturition patterns demonstrated no differences in oral fluid intake/24hr. voided volume/24hr, and ratio of number of micturitions during the night vs. day among the four groups: (1) control (neither SCI nor DMP), (2) DMP only, (3) SCI only, and (4) SCI with DMP. Spinal cord injured rats with and without detrusor‐myoplasty demonstrated a significant decrease in the number of micturitions/24hr, an increased volume per micturition, and greater largest and smallest micturition volumes (P < 0.05) when compared to controls. The micturition patterns among SCI rats with and without DMP were similar, as were non‐SCI animals with and without DMP.This is the first report of the principle and technique of detrusor‐myoplasty. Dissection of rats, goats, and human cadavers revealed that a vascularized and innervated rectus muscle flap can be rotated into the pelvis and wrapped around the bladder without tension. Significant loss of bladder capacity did not occur with skeletal muscle adaptation. Detrusor‐myoplasty may be applicable for patients with an areflexic detrusor and non‐intact sacral motor roots who are not candidates for sacral anterior root neurostimulation. © 1994 Wiley‐Liss, Inc.
Ultrasound diagnosis of bladder outlet obstruction in rabbits
Authors: Schoor Richard A. , Canning Douglas A. , Bella Richard D. , Broderick Gregory A. , Snyder Howard M. , Duckett John W. , Krasnapolski Lev , Wein Alan J. , Levin Robert M. 
Published: March 2007

AbstractOne of the primary characteristics of partial outlet obstruction secondary to BPH is an increase in bladder mass commonly referred to as bladder hypertrophy. This condition has been simulated in rabbits by the partial ligation of the catheterized urethra. Ultrasonography has been utilized in both adult and pediatric urology to visualize the bladder and diagnose specific bladder disorders. The aim of the present study is to determine if ultrasonography can visualize bladder wall hypertrophy induced by obstruction. Partial outlet obstructions were created in NZW rabbits using standard methodologies, and then 5 to 7 days later, sonography was performed. The films were read by both the principal investigator and blinded investigators instructed to determine bladder wall thickness and from this predict the bladder weight.Then results were correlated with cystometrograms (CMGs) and whole bladder weights. Both the principal investigator and the blinded investigators were consistently able to distinguish obstructed from control bladders based solely on sonographic depictions of relative bladder wall thickness. In addition, the investigators were able to distinguish between low (control), medium, and high bladder weights based on sonography.The accuracy of predicting the bladder weights increased when cystosonograms were correlated with CMC studies. Thus, the degree of bladder hypertrophy can be accurately estimated by the combination of cmg and ultrasonography. © 1994 Wiley‐Liss, Inc.
Contractility of the guinea pig bladder measured in situ and in vitro
Authors: Groen J. , Van Mastrigt R. , Bosch R. 
Published: March 2007

AbstractTo study the relative importance of neurogenic factors in detrusor contractility and to relate a total bladder in vitro contractility model to a previously described bladder wall strip model, active intravesical pressure values were compared in situ and in vitro in eight male guinea pigs. In situ, the active pressure was measured in spontaneous isometric and nonisometric micturition contractions. In vitro, the active pressure was measured in isometric contractions of the same bladders, developed in response to optimal electrical stimulation. The volume dependence of the active pressure generated by the bladder was measured in vitro in order to relate bladder capacity to the volume where the generated force is maximal and to determine the optimal volume at which to study detrusor contractility. The results indicated that in normal micturition the detrusor muscle was not fully stimulated: active pressure in isometric contractions in vivo was about 60% of the pressure values attained in vitro at the same bladder volume. Most micturitions occurred at a volume where the active pressure generated in vitro was about 80% of the maximal pressure. The active pressure‐bladder volume relationship complied with the sliding filament‐cross bridge theory. In whole bladder preparations active stress was about twice as high as in strips. © 1994 Wiley‐Liss, Inc.
Elastic wall properties and collagen content in the ureter: An experimental study in pigs
Authors: Knudsen L. , Gregersen H. , Eika B. , Frøkiær J. 
Published: March 2007

AbstractWe used an impedance planimetric method to look at elastic wall properties of ureter in ten anaesthetized pigs. A balloon was stepwise inflated and deflated in the ureteropelvine junction in the mid‐ureter and in the intramural part of the ureter at the ureterovesical junction with pressures up to 70 cmH2O, while the pressure and balloon cross‐sectional area (Bcsa) were measured simultaneously. The elastic wall parameters were calculated from these measurements. At sacrifice, tissue samples were collected for analysis of collagen content of the ureteral wall.A non‐linear clockwise relation (hysteresis loops) between Bcsa and balloon pressure was demonstrated. At maximal inflation of the balloon, the Bcsa, wall tension, and compliance were 35.28 ± 3.52. 38.44 ± 3.23, and 61.36 ± 8.09 mm2, 230.71 ± 12.82. 242.38 ± 10.49. and 302.17 ± 20.03 cmH2O × m, and 0.167 ± 0.047, 0.124 ± 0.002, and 0.182 ± 0.040 mm2 × cmH2O 1 in the intramural part of the ureter, middle part, and ureteropelvine junction, respectively. The collagen content was 0.3249 ± 0.0077, 0.3301 ± 0.0066. and 0.3457 ± 0.0060 mg × mg 1 dry defatted weight in the intramural part, in the middle, and in the ureteropelvine junction, respectively. The collagen content of the ureteropelvine junction was significantly higher than that of the middle of ureter (P < 0.02) and than that of the intramural part (P < 0.05). No significant correlations were found between the elastic parameters at maximal inflation of the balloon and the collagen content (P > 0.10)In conclusion the elastic wall properties were significantly different in the three ureteral segments and the collagen content of the ureteropelvine junction differed from that of the two distal locations. However, no relationship between the wall properties and the collagen content was found. © 1994 Wiley‐Liss, Inc.
Comparative studies on intracellular calcium and nadh fluorescence of the rabbit corpus cavernosum
Authors: Levin Robert M. , Hypolite Joseph , Broderick Gregory A. 
Published: March 2007

AbstractErectile function (erection and detumescence) involves the complex interaction of direct neuronal stimulation of corporal smooth muscle, neurohumoral release of specific endothelial contractile and relaxant factors, and secondary modulation by a variety of putative neuropeptides and vasoactive modulators. Using surface spectrofluorometry, we have correlated spontaneous contractile activity and the contractile response to field and pharmacological agents with intracellular calcium and NADH metabolism.The results demonstrate that the corpus cavernosal tissue has very unusual properties. Spontaneous contractile activity is correlated with a phasic increase in intracellular calcium. However, spontaneous contractile activity is most often correlated with a bi‐phasic effect on the ratio of NADH/NAD. At the start of the spontaneous contraction, there is a sharp phasic increase in NADH/NAD; peak contractile force occurs simultaneous with a phasic decrease in this ratio showing that at peak force generation, there is a decrease in the level of intracellular energy. Phenylephrine stimulation results in an increase in intracellular calcium in proportion to the increase in tension; however, phenylephrine stimulation at low concentrations results in a net increase in the NADH/NAD ratio whereas high concentrations of phenylephrine result in a net decrease in the NADH/NAD ratio. In general, field stimulation results in a decrease in tension at low frequencies, a biphasic response at midfrequencies, and a contraction at high frequencies. These contractile responses are directly related to alterations in the intracellular concentration of calcium. That is, a decrease in tension is preceded by a decrease in intracellular calcium while an increase in tension is preceded by an increase in intracellular free calcium. Field stimulation results in a rapid and phasic alteration in the NADH/NAD ratio; however, the NADH/NAD response can be either an increase, decrease, or biphasic response. There does not appear to be a consistent relationship between the contractile/relaxant response to field stimulation and altered NADH/NAD ratio. Finally, ATP, bethanechol, and nitroprusside induce a decrease in the basal tension of the corpus cavernosal strips which corresponds with a decrease in the NADH/NAD ratio. However, whereas nitroprusside relaxation is correlated with a decreased intracellular calcium level, both ATP and bethanechol stimulate an increase in intracellular free calcium.These studies indicate that the response of the corpus cavernosal tissue to both field stimulation and pharmacological agents is complex and may involve both direct and indirect actions of a variety of cellular mediators on the corporal smooth muscle. © 1994 Wiley‐Liss, Inc.
Enterocystoplasty in the neuropathic bladder
Authors: Singh Gurpreet , Thomas David G. 
Published: March 2007

AbstractPatients with neuropathic bladders who have intractable hyperreflexia often require cystoplasty and in patients adequately motivated and counselled, continence rates in excess of 90% can be achieved.Seventy‐eight patients with neurological disease have undergone enterocystoplasty and are presented. Twenty‐two patients had acquired cord lesions of which 17 were traumatic. Of the 56 patients with congenital myelodysplasia. 49 were meningomyelocele, 5 had sacral agenesis, and 2 lipoina of cauda equina. The mean age was 26 (range 13–61) years with 48 male and 30 females. Pre‐operative video urodynamics showed sphincter weakness in 54 patients, all patients had intermediate type bladders; hyperreflexia in 52, reduced compliance in 17. and in 7 a combination of both. Forty‐seven patients had ileal, 20 had sigrnoid, and I I had ileocaecal cystoplasty. Fifty‐two patients had an artificial urinary sphincter inserted, 9 had a colposuspension. and I had both tor concurrent sphincter weakness incontinence.Acceptable continence has been achieved in 73 (93.6%) patients, 65 claiming complete continence with no pads or incontinence episodes and the 8 others needing pharmacotherapy or pads. Two of our 5 failures have been converted to an ileal loop, 2 are awaiting further surgery, and 1 is wet despite normal urodynamics. Our threshold for initiating intermittent catheterisation is low and 63 (81%) of our patients catheterise. Complications in these patients are few and the only one of note is persistent bowel problems in 30% of our patients.Cystoplasty is recommended as safe and reliable in the treatment of neurogenic detrusor over activity with a continence rate of 93% being achieved. All our patients need to demonstrate competence in performing intermittent self‐catheterisation before surgery is offered. © 1995 Wiley‐Liss, Inc.
External urethral sphincterotomy: Long‐term follow‐up
Authors: Yang Claire C. , Mayo Michael E. 
Published: March 2007

AbstractWe retrospectively reviewed the charts of 37 male spinal cord injury patients who underwent sphincterotomy from 1986–1993 to evaluate the long‐term results of this procedure.Patients were selected for the operation based on urodynamic criteria and all had some detrusor activity or were able to void by Valsalva's maneuver. There were 26 cervical injuries and 11 thoracic injuries. The operation was judged a failure if the following were present postoperatively: the presence of large post void residual volumes associated with urinary tract infections, autonomic dysreflexia symptoms associated with bladder overdistension or high voiding pressures, and/or progressive upper tract deterioration due to persistent vesicoureteral reflux or poor bladder emptying.Eighteen' operations were failures and 19 operations were successful. Causes for sphincterotomy failure included recurrent detrusor sphincter dyssynergy (6), detrusor hypocontractility (6), bladder neck contracture (3), stricture at the external sphincter (1), incomplete sphincterotomy (1), and unknown etiology (1). The reoperation rate was 32%. The mean follow‐up time was 49 months for the failure group (range 2–81) and 26 months (range 2–54) for the successes. The longer mean follow‐up period in the former group suggests that the number of failures increased with time. There was no predictor of failure among any of the following parameters: age at operation, level of injury, previous bladder neck/sphincter operations, preoperative maximum detrusor contraction pressures, or rise time to maximum pressure.In conclusion: (1) the external urethral sphincterotomy, even in appropriately selected patients, can have a high failure rate over time, and (2) we could not identify any variables to predict an unsuccessful operation using our present selection criteria. © 1995 Wiley‐Liss, Inc.
Long‐term follow‐up of sphincterotomy in the treatment of autonomic dysreflexia
Authors: Ricottone Anthony R. , Pranikoff Kevin , Steinmetz James R. , Constantino Georgeann 
Published: March 2007

AbstractAutonomic dysreflexia (AD) is a syndrome affecting a majority of patients with high spinal cord lesions. An association between AD and detrusor‐sphineter dyssynergia (DSD) is often seen. Between 1980 and 1988 we performed 51 transurethral sphincterotomies in 38 patients. Twelve of these patients underwent procedures primarily for the prevention of AD related to bladder distension. This study presents their long‐term follow‐up.One patient was lost to follow‐up secondary to unrelated death; the remaining 11 patients were followed on average 117.5 months (94–154) after the initial operative procedure. Repeat sphincterotomy was required in 9 of 11 patients (82%) Six (66% ) of these were performed within 24 months. One patient (11%) required delayed sphincterotomy greater than 100 months from the initial procedure. Overall, sphincterotomy was successful in controlling symptoms of AD in 10 of 11 (91%) patients. No major complications were recorded. Sphincterotomy is a sate and effective treatment for AD associated with DSD, however long‐term urologic follow‐up and management are necessary. © 1995 Wiley‐Liss, Inc.
Non‐operative management of the urinary tract in spinal cord injury
Authors: Dmochowski Roger R. , Ganabathi Kumaresan , Leach Gary E. 
Published: March 2007

AbstractVarious options exist for the management of the lower urinary tract in chronic spinal cord injury. These options include chronic indwelling catheterization, urethral sphincterotomy, and intermittent catheterization supplemented with anticholinergic agents.Sixty‐four spinal cord injured patients, treated with intermittent catheterization and anticholinergic therapy, were evaluated for long‐term efficacy in maintaining upper tract status and preservation or improvement in continence. Complications of therapy were also evaluated. Therapy was based upon initial urodynamic evaluation followed by limited subsequent evaluation of the urinary tract.Mean follow‐up was 54 months. Only I patient developed hydronephrosis. Fifty‐nine patients either became continent or experienced improved continence on therapy Eight patients required surgical procedures either to increase outlet resistance (2) or to decrease intravesical pressures (6).The most common complication of therapy was urinary tract infection. Thirty‐nine infections occurred in 23 patients, 16 of which were febrile. Fifteen patients were non‐compliant with treatment recommendations. The only factor related to therapeutic complications which reached statistical significance was non‐compliance with therapy.The combined use of intermittent catheterization and anticholinergic agents provides an effective means to prevent hydronephrosis and establish continence in chronic spinal injury. © 1995 Wiley‐Liss, Inc.
Fate of the upper urinary tract in multiple sclerosis
Authors: Kasabian Nabet G. , Krause Ira , Brown Wendy E. , Khan Zafar , Nagler Harris M. 
Published: March 2007

AbstractUrologic problems arc a major source of morbidity for patients with multiple sclerosis (MS). Fifty‐four to 78% of patients experience bladder symptoms which are due to spinal lesions interrupting neural pathways that control micturition. MS patients could have upper or lower motor neuron lesion type bladders. Both obstructive and irritative symptoms may be present. Although lower urinary tract dysfunction has been well described in MS, few studies have investigated the fate of the upper urinary tract.Thirty‐two patients with MS were referred for urodynamic evaluation. Twenty‐six of the 32 patients had upper urinary tract studies performed. Only I of the 26 patients had evidence of upper urinary tract deterioration It is our impression that upper tract deterioration occurs infrequently in these patients. We discuss clinical clues that may predict deterioration. © 1995 Wiley‐Liss, Inc.
Location and concentration of estrogen, progesterone, and androgen receptors in the bladder and urethra of the rabbit
Authors: Rosenzweig Bruce A. , Bolina Parminder S. , Birch Lynn , Moran Catherine , Marcovici Iacob , Prins Gail S. 
Published: March 2007

AbstractThe objective of this study was to determine location and concentration of estrogen, androgen and progesterone receptors in the bladder and urethra of the rabbit. Two urethral and two bladder specimens were obtained from four 12‐week‐old female New Zealand white rabbits. Rat monoclonal antibody (AN 1–15) to human androgcn receptor and (H222) to human estrogen receptor and mouse monoclonal antibody (PR6) to chicken progesterone receptor were used. Immunocytochemical staining was performed and specimens were evaluated lor presence and location of steroid receptors. Androgen receptors were found in the highest concentrations in urethral and bladder epithelium. Low to low/moderate concentration were found in smooth muscle. Estrogen receptors were found in moderate to moderate/high concentrations in urethral epithelium and bladder and urethral smooth muscle. Progesterone receptors were not found in appreciable concentrations from any location, though the animals were not pretreated with estrogen. The rabbit model suggests a mechanism by which estrogen therapy can be effective in treating postmenopausal lower urinary tract symptoms. Progesterone receptors were not found in appreciable concentrations, suggesting progesterone therapy may not diminish the effectiveness of estrogen therapy by acting on urethral progesterone receptors. The effect of androgcns on the lower urinary tract needs further investigation to determine if androgen therapy can alleviate lower urinary tract symptoms. © 1995 Wiley‐Liss, Inc.
Passive urethral resistance to dilation in healthy women: An experimental simulation of urine ingression in the resting urethra
Authors: Bagi Per , Thind Peter , Nordsten Merete 
Published: March 2007

AbstractThe dynamic urethral pressure response to a simulated urine ingression was studied at the bladder neck, in the high pressure zone, and in the distal urethra in 10 healthy female volunteers. The pressure response was characterised by a steep pressure increase simulataneous with the urethral dilation, followed by a decay during the next seconds until a new equilibrium pressure was reached. The pressure decay could be described by a double exponential function in the form Pt = Pequ + Pαe‐t/τα + Pβct/τβ, where Pt represents the pressure at the time t, Pequ represents the pressure at equilibrium, Pα and Pβ express the decline in pressure, and τα and τβ are time constants. The size of the pressure response proved highly dependent on velocity and size of dilation as well as urethral site of measurement, with the maximum values in the high pressure zone. The time constants, on the other hand, were uninfluenced by these factors.The pressure response represents an integrated stress response from the surrounding tissues which may reflect the visco‐elastic properties of the structures involved. The findings indicate that striated muscle fibres are of dominating significance for the pressure response, and the varying size of the response along the urethra is in accordance with the localization of the horseshoe‐shaped rhabdosphincter, which quantitatively is the dominating circularly arranged structure around the female urethra.Functionally, the stress response will oppose any dilation, and increasingly with rising size or velocity of dilation. But even though this reaction seems to represent a forceful mechanism prepared instantaneously to assist in securing continence, it is not energy consuming, and consequently is a very economic additive to the urethral closure mechanism. © 1995 Wiley‐Liss, Inc.
Exercise pad testing in continent exercisers: Reproducibility and correlation with voided volume, pyridium staining, and type of exercise
Authors: Nygaard Ingrid , Zmolek Gwen 
Published: March 2007

AbstractThis study was undertaken to determine normal values for a modified pad test to be used for testing outcomes of studies addressing therapy for exercise incontinence. Fourteen asymptomatic volunteers who were continent by history completed three similar exercise sessions wearing pre‐weighed pads after ingesting phenazopyridine hydrochloride (Pyridium, Parke‐Davis, Sandy. UT). The mean pad weight gain for all exercise sessions combined was 3.19 ± 3.16 g (range 0.1–12.4). The mean area of pyridium staining was 2.66 ± 3.14 mm. Mean volume voided after the exercise sessions was 193 ± 108 cc (range 10–625). The Kendall coefficient of concordance used to test the intertest reliability was 0.96 for pad weight gain, 0.76 for area of stain, and 0.60 for volume voided. All but one of the subjects had at least one spot of pyridium stain on at least one of the three pads. The increase in pad weight attributable to sweat and vaginal moisture is reproducible in a given individual performing the same exercise routine, but due to the large variation between subjccts, we were unable to establish a cut‐off value separating continence from incontinence. Adding pyridium did not improve the specificity o f the test, despite instructing subjects to milk the urethra and blot before applying the pad. © 1995 Wiley‐Liss, Inc.