bluuebunny/crossref_metadata_2025_split huggingface dataset:
Urinary flow curve patterns and their prognostic value in males over the age of 50 years
Authors: Balslev Jørgensen J. , Klarskov P. , Thorup Andersen J. , Jensen K.M.‐E. , Mogensen P. 
Published: March 2007

AbstractFlow curves from two groups of men over the age of 50 years were compared. One group consisted of 112 initially asymptomatic men, controlled with history, uroflowmetry, and symptom score over a 7‐year period. The other group consisted of 85 men treated for benign prostatic hyperplasia. Five flow curve patterns were defined, and each flow curve was classified according to the definitions. A significant difference was found comparing untreated and treated males, as 78% of the flow curves in the untreated group were type 1 or 2 and 16% were type 3 or 4 compared to 56% and 37%, respectively, in the treated group. The risk of need of operation in the initially asymptomatic group as a whole was 17% over a 7‐year period versus 25% to 44% if the initial flow curve was type 3 or 5, i.e., severely abnormal. Analysis of the influence of age on flow curve pattern revealed a significant shift from “normal” to “abnormal” as age advanced.In conclusion, flow curve patterns, reflecting the voiding process, shifts from normal to abnormal even in subjectively normal men as age advances. At the same time the flow curve seems to be of some prognostic value as to need of operative treatment in voiding problems.
Prospective urodynamic evaluation of the efficacy of prostatic balloon dilatation
Authors: Ganabathi Kumaresan , Roskamp Deborah , Foote Jenelle , Zimmern Philippe E. , Leach Gary E. 
Published: March 2007

AbstractIn order to evaluate the ability of transurethral prostatie balloon dilatation (TUPBD) to effectively treat prostatic obstruction, 18 men (aged 53–77 years) with obstructive small prostate glands were evaluated with symptom scores and urodynamic studies before and 6 and 12 months after TUPBD utilizing the endoscopically placed Advanced Surgical Intervention 75F balloon.After TUPBD, 81% of men reported some improvement in their symptoms with statistical significance (P <.05) at 6 and 12 months after the procedure. The mean non‐invasive peak flow rate did not change significantly after TUPBD. Although the mean maximum voiding pressure (Pv max) and the maximum detrusor pressure at peak flow (Pq max) were reduced at 6 and 12 months postoperatively, the changes were found to be statistically insignificant (P >.05). In addition, the use of Abrams and Griffiths pressure‐flow nomogram revealed a “non‐obstructive” pressure‐flow study in only one patient at 6 and 12 after TUPBD.Although TUPBD results in some symptomatic improvement, on pressure‐flow analysis the majority of men remain obstructed at 6 and 12 months after the procedure.
Prevalence of hand‐washing urinary incontinence in healthy subjects in relation to stress and urge incontinence
Authors: Kondo A. , Saito M. , Yamada Y. , Kato T. , Hasegawa S. , Kato K. 
Published: March 2007

AbstractHand‐washing urinary incontinence is involuntary urine loss in response to washing hands, hearing the sound of running water, or exposing oneself to cold wind in the winter season. The prevalence of this incontinence in relation to stress and urge incontinence was studied in healthy community‐dwelling subjects of 1,636 females and 3,010 males. The afflication rate of both genders was 3% for those in their 50s and younger and 16% for those in their 60s and older, which was significantly different (P < 0.01). Females (10%) suffered more from this incontinence compared to males (5%) (P < 0.01). The prevalence of this incontinence was approximately the same as that of stress and urge incontinence in each gender except females' stress incontinence, which was 3 times more than the other two. Seventytwo percent of subjects with hand‐washing incontinence also had either urge incontinence, stress incontinence, or both.
Dopamine D‐1 receptor‐mediated inhibition of micturition reflex by central dopamine from the substantia nigra
Authors: Yoshimura Naoki , Yoshida Osamu , Sasa Masashi , Takaori Shuji 
Published: March 2007

AbstractWe examined the role of dopamine derived from the pars compacta of the substantia nigra (SN) in the micturition reflex using a‐chloralose anesthetized cats. Repetitive stimuli applied to the SN suppressed rhythmic contractions of the urinary bladder induced by continuous infusion of saline into the bladder. SN stimulation‐induced inhibition of rhythmic contractions of the urinary bladder was antagonized by intracerebroventricular administration of haloperidol, a non‐selective dopamine receptor antagonist, and SCH 23390, a dopamine D‐1 receptor antagonist. The intracerebroventricular administration of SCH 23390 alone increased the frequency of bladder contractions induced by its distension. In addition, rhythmic contractions of the urinary bladder induced by its distension were in hibited by intracerebroventricular administration of dopamine, a non‐selective dopamine receptor agonist, and SKF 38393, a dopamine D‐1 receptor agonist, but were not affected by quinpirole, a dopamine D‐2 receptor agonist. However, the bladder contraction induced by stimulation of the locus coeruleus, remained unaffected during SN stimulation. These findings suggest that central dopamine derived from the pars compacta of the SN inhibits the micturition reflex via dopamine D‐1 receptors probably in the afferent pathway form the sacral spinal cord to the locus coeruleus, although the possibility that it acts on the efferent pathways originating in areas other than locus coeruleus could not completely be excluded.
Energetics of detrusor contraction: Effects of outlet obstruction
Authors: Lin Alex Tong‐Long , Shiao Ming‐Shi , Chen Ching‐Ju , Chang Luke S. , Chen Ming‐Tsun , Yang Chin‐Hua , Levin Robert M. 
Published: March 2007

AbstractPrevious studies demonstrated that the ability of the urinary bladder to empty was impaired after mild outlet obstruction. One contributing factor may be the derangement of intracellular energy metabolism. The primary objective of the current study is to examine the energentics of detrusor contraction in normal and obstructed rabbit urinary bladders. Mild bladder outlet obstruction was induced in male rabbits; after 2 weeks of partial outlet obstruction, three muscle strips were isolated from the bladder body of each obstructed and control rabbit. One of these strips was frozen at unstimulated state, while the remaining two strips were stimulated with 500 m̈M bethanechol and frozen separately either at maximal phasic (peak) contraction or during plateau (tonic) contraction. Tissue content of adenine nucleotides (ATP, ADP, AMP), NAD (nicotinamide adenine dinucleotide), creatine, and creatine phosphate were determined using reverse phase high performance liquid chromatography (HPLC).The results can be summarized as follows: 1) The tissue content of creatine phosphate of the unstimulated control bladder was significantly higher than in the obstructed bladders. The tissue content of all other compounds were similar. 2) In the normal bladder strips, bethanechol stimulation induced a significant net decrease only in the tissue content of creatine phosphate during the plateau phase of contraction. 3) In the obstructed bladder strips, bethanechol stimulation induced a decrease in both ATP and creatine phosphate during the plateau phase of the response. The decrease in creatine phosphate was of a significantly greater magnitude than the decrease of creatine phosphate observed in normal strips. In addition, AMP content was significantly increased during both peak and plateau contraction.These observations show that mild bladder outlet obstruction results in changes in the energy metabolism of detrusor contraction, which indicates that the obstructed bladder is unable to maintain proper tissue levels of high energy phosphates which are necessary for adequate detrusor contraction.
Relationship of fluid intake to voluntary micturition and urinary incontinence in geriatric patients
Authors: Griffiths Derek J. , Mccracken Peter N. , Harrison Gloria M. , Ann Gormley E. 
Published: March 2007

AbstractThe aim of this study was to investigate, in a group of geriatric inpatients with established incontinence, the relationships among urine loss, voided volumes, frequency of voiding, and fluid intake. The investigated included 128 patients: 76 women and 52 men, with a median age of 79 years. One‐half had significant cognitive impairment. Patients underwent 24‐hr monitoring of fluid intake, urine loss, and voiding, as well as conventional videourodynamic testing. Diurnal and nocturnal voiding frequencies were significantly but relatively weakly related to fluid intake. Diurnal and nocturnal voided volumes were more closely related, however, to the fluid intake. There was a strong and easily interpretable relationship among nocturnal voided volume, nocturia, cystometric bladder capacity, and evening fluid intake. Sixty of 128 patients had urodynamically proven urge incontinence, and this group was studied separately. They were more cognitively impaired and had significantly greater urine loss and smaller fluid intake than was true of the other incontinent patients. Urine loss was significantly related to fluid intake in this group. Nocturnal urine loss increased by an average of 28 ml/dl of evening fluid intake and decreased by 17 ml/dl voided at night. These results suggest that nocturnal toileting and evening fluid restriction may reduce nocturnal urine loss by a small but useful amount in carefully selected older patients with severe urge incontinence. © 1993 Wiley‐Liss, Inc.
Time‐series analysis of urethral electrical conductance measurements in the assessment of unstable urethral pressure: Results in normal patients and in those with genuine stress incontinence
Authors: Ramsay Ian N. , Hilton Paul , Cox Trevor F. 
Published: March 2007

AbstractIt is well established that urethral pressure variations occur in patients with or without urinary incontinence, but to what extent they contribute to a patient's symptoms remains unclear. Previous work has suggested that in stress incontinent patients, a rise in bladder neck electrical conductance (BNEC) occurs simultaneously with a fall in urethral pressure, and that this represents bladder neck opening. Six patients with genuine stress incontinence (gsi), and six normal controls underwent simultaneous urethral pressure and BNEC measurements, the results being subjected to time‐series analysis, to determine whether the previous finding could be confirmed statistically, and to establish whether a similar association was present in normal women. All six patients with gsi and five of the normal patients had unstable urethral pressure. Estimated cross‐correlation of differenced data for the two parameters showed a significant negative correlation at zero time lag in three patients with gsi and two of the control group. There was no significant correlation between the two parameters in the other seven patients. We conclude that the previous finding of a correlation between urethral pressure variation and BNEC, suggesting bladder neck opening occurs as urethral pressure falls in patients with gsi is confirmed, but appeared to be present in only 50% of patients; the finding is just as likely in normal patients, and therefore whilst it may be of relevance to the severity of symptoms, could not be held to have any aetiological significance. © 1993 Wiley‐Liss, Inc.
Role of adrenoceptors in the proximal urethral function of female and male rabbits using an in vivo model of isovolumetric pressure generation
Authors: Yamaguchi Takanori , Kitada Shinichiro , Osada Yukio 
Published: March 2007

AbstractThe role of alpha‐1 and alpha‐2 adrenoceptors in the contractile response of the proximal urethra to agonists and antagonists was studies in female and male New Zealand White rabbits. The response pattern for alpha‐1 agonists showed a sharp rise, while that for alpha‐2 agonists showed a gradual increase to a maximum pressure. The duration of the response of alpha‐2 agonists was significantly longer than that of alpha‐1 agonists. A difference in the response between alpha‐1 and alpha‐2 would be produced mainly through different receptor functions. The magnitude of the response of alpha‐1 adrenoceptors in the male rabbits was almost twice that of the female rabbits. In contrast, the response of alpha‐2 in the male rabbits was less than that of the female rabbits. Our experimental findings indicate that alpha‐2 stimulation mediates a slow and prolonged response that is essential for urinary continence in female rabbits. © 1993 Wiley‐Liss, Inc.
A model of the mechanics of smooth muscle reservoirs applied to the intestinal bladder
Authors: Coldinq‐Jørqensen Morten , Steven Kenneth 
Published: March 2007

AbstractA model of the mechanics of smooth muscle reservoirs was derived from the stress‐strain relation in smooth muscle strips. The model was applied to the intestinal bladder reservoir but may also be applied to natural reservoirs such as the bladder. The relation between reservoir volume and pressure was calculated at different values of smooth muscle tone and was found to accord with clinical results. The muscle tone of the bowel when measuring off the bowel to construct the reservoir was found to have a profound influence on its ultimate volume. Stiffening of a part of the reservoir wall as a result of edema or fibrosis will cause a substantial decrease in functional capacity, both directly as a result of a reduced expansion of the diseased part and indirectly by enhancing the stretching of the adjacent normal wall. The pressure rise produced by a slow peristaltic contraction was calculated to depend both upon the strength of contraction and on the degree of reservoir filling: Almost no pressure rise will occur in the near empty reservoir, while the highest pressure rise was calculated to occur at a volume of about 300 ml. If only a part of the reservoir contracts, more filling is needed before the pressure increases and the maximum pressure will be reached at a substantially higher volume. Localized contractions will stretch the resting reservoir wall and so activate stretch receptors, which may cause a desire to void, resulting in reduced functional capacity. © 1993 Wiley‐Liss, Inc.
Regulation of the bladder neck closure by lumbar splanchnic nerves at ejaculation in the dog
Authors: Ando Masao , Kihara Kazunori , Sato Kenji , Sato Tatsuo , Oshima Hiroyuki 
Published: March 2007

AbstractTo clarify the role of canine thoracolumbar splanchnic nerves for bladder neck closure during ejaculation, these nerves of adult male mongrel dogs were exposed under anesthesia using ketamine hydrochloride and pentobarbital, and electrical stimulation and anatomical dissection studies were performed. Bladder neck closure by the stimulation of each sympathetic nerve was monitored with a 10 Fr silicon catheter equipped with pressure‐sensitive rubber balloon placed at the bladder neck. The dissection study revealed that canine thoracolumbar splanchnic nerves consisted of two nerve groups: one branching from the sympathetic trunks at thoracic and L1 ganglia, reaching caudal mesenteric plexus (CMP) through the anterior wall of the aorta, the other branching from the sympathetic trunks at level L2–L5 ganglia, reaching CMP through the posterior side of the bilateral spermatic arteries. The former were designated intermesenteric splanchnic nerves, the latter lumbar splanchnic nerves. No bladder neck closure was observed by electrical stimulation of the distal end of severed intermesenteric splanchnic nerves or of the sympathetic trunks at the lumbopelvic level among 10 dogs examined. At least one lumbar splanchnic nerve generated the closure in all 10 dogs and generally, a few lumbar splanchnic nerves, generated the closure. The results indicate that bladder neck closure during ejaculation is generated by lumbar splanchnic nerves regardless of their branching levels from lumbar sympathetic ganglia, but not by either intermesenteric splanchnic nerves or pelvic sympathetic trunks. © 1993 Wiley‐Liss, Inc.
Reproducibility of pressure transmission ratios in stress incontinent women
Authors: Richardson David A. , Ramahi Alfida 
Published: March 2007

AbstractPressure transmission ratios (PTR) are obtained during cough pressure profiles (Δ urethral pressure/Δ bladder pressure × 100) and have been extensively used in pre and post operative evaluation of patients with stress urinary incontinence. Sixteen patients with genuine stress were studied to assess the magnitude of PTR variance in incontinent women and how changes in bladder pressure impact on PTR. A marked variation in PTR was seen in individual patients with the coefficient of variation averaging 19.8%. Using linear regression analysis, 5 patients demonstrated a statistically significant relationship between bladder pressure and PTR. Only one of the five patients showed a decrease in pressure transmission with increased cough strength. The differences seen in PTR within individual patients make comparisons of single recordings at different times difficult to interpret.
Complications of teflon injection for stress urinary incontinence
Authors: Kiilholma Pentti J. , Chancellor Michael B. , Makinen Juha , Hirsch Irvin H. , Klemi Pekka J. 
Published: March 2007

AbstractFour significant complications of Teflon injections for stress urinary incontinence are reported in 22 women and eight men. Three of the complications included periurethral abscess, urethral diverticulum, and periurethral Teflon granuloma with urethral wall prolapse occurred in women. These complications needed surgical excision and further surgery for stress incontinence, in two patients the outcome was good. Among the female patients the cure rate for stress incontinence with Teflon injection was only 18% in the 5‐year follow‐up. One other complication, a Teflon cyst, occurred in a male who had previously undergone radical retropubic prostatectomy. Only two of the eight men (25%) who received Teflon injections had maintained improvement after 1 year.
The dynamic urethral sphincter function in healthy females assessed by rapid dilatations in the resting state: Evaluation of reproducibility
Authors: Thind Peter , Lose Gunnar , Colstrup Hans , Kristensen Jøgen Kvist 
Published: March 2007

AbstractRecording the pressure response to rapid dilatations enables one to assess urethral sphincter function. The rapid dilatations of the urethra experimentally simulate the ingression of urine. A method that enables standardized dilatations of 2‐mm long urethral segments was used, and the subsequent pressure response was measured. The reproducibility of the urethral pressure response to rapid and standardized dilatations was evaluated by repeating the measurements after 1 week in 10 healthy females. The pressure response showed an acceptable reproducibility. The urethral pressure increase as a response to dilatation is considered to rely on stretching of intra‐ and periurethral fibers. Calculations of strain (change in length divided by the original length) of circularly arranged fibers when the urethra is dilated indicate that the tension (and pressure) bearing layers must be located outside a circular zone with a radius of 4 mm perpendicular to the longitudinal axis of the urethra.
Voiding dysfunction in patients with spastic paraplegia: Urodynamic evaluation and response to continuous intrathecal baclofen
Authors: Bushman Wade , Steers William D. , Meythaler Jay M. 
Published: March 2007

AbstractPatients with hereditary spastic paraplegia (HSP), a degenerative central nervous system disorder characterized by progressive lower extremity spasticity, frequently experience symptoms of voiding dysfunction. Urodynamic evaluation of patients with HSP has not been reported, and the etiology of voiding dysfunction remains unexplained. We present our evaluation of three men (ages 42–62 years) with this rare syndrome.Urgency of urination was a uniform and dominant complaint, and two patients regularly experienced urge incontinence. Other symptoms included frequency (n = 3), nocturia (n = 3), and diminished force of stream (n = 1). Postvoid residual volumes were less than 25 ml in all patients. On urodynamic evaluation the two patients with urge incontinence displayed cystometric evidence of involuntary detrusor contractions. Pelvic floor EMG recordings suggested detrusor‐sphincter dyssynergia (DSD). In addition, one patient exhibited markedly diminished bladder compliance (1.0 ml/cm H2O) and capacity (50 ml). AH patients reported marked symptomatic improvement when treated with continuous intrathecal baclofen. Evaluation during baclofen treatment revealed increases in bladder compliance and capacity, with apparent resolution of DSD in one patient. Voiding symptoms in these patients most likely arise from a neurogenic etiology; however, a contributory role for chronic outlet obstruction from striated muscle spasticity may also exist.
Bladder instability in women: A premature activation of the micturition reflex
Authors: Papa Petros P. E. , Ulmsten U. 
Published: March 2007

AbstractUrethrocystometry was performed during a provocative hand washing test in 163 patients, 115 of whom had a prior history of urge incontinence. Almost invariably, a rise in detrusor pressure, when present, followed a fall in urethral pressure, and both were preceded by urge symptoms. This pattern appears to conform to the concept of “urethral instability”, “detrusor instability” and urge incontinence being different manifestations of a prematurely activated micturition reflex.
Effect of partial outlet obstruction on choline acetyltransferase activity in the rat and rabbit
Authors: Levin Robert M. , Saito Masahiko , Wein Alan J. , Packard David , Cohen Adam , Haugaard Niels 
Published: March 2007

AbstractPartial outlet obstruction of the rabbit bladder induces a rapid and significant increase in bladder mass. This increase in mass is associated with a variety of specific contractile dysfunctions, characterized by a marked decrease in the response to field stimulation (acting through the release of neurogenic transmitters). There is histological evidence indicating that the decrease in the contractile response of isolated strips of rabbit urinary bladder to field stimulation is associated with a degeneration of synaptic membranes within the bladder detrusor (neuropathy). In the current experiments, the effect of partial outlet obstruction in rabbit and rat urinary bladders on choline acetyltransferase activity (ChAT) were determined and correlated with both the level of bladder hypertrophy (increase in mass) and the contractile response to field stimulation. The results can be summarized as follows: In the rabbit, partial outlet obstruction induced a rapid 5‐fold increase in bladder mass over the 7 day period of study. This increase in mass was associated with a decrease in the contractile response of isolated strips of bladder body and base to field stimulation and a decrease in ChAT activity. Interestingly, the rabbit bladder base showed a significantly higher ChAT activity than the bladder body, although the contractile response to muscarinic stimulation was significantly greater in the bladder body than in the base. In the rat, partial outlet obstruction induced a mild 2‐fold increase in bladder mass. No change in ChAT activity was observed in the obstructed bladder. Consistent with this finding, there was no dysfunction in the response to field stimulation in the obstructed rat bladder.