bluuebunny/crossref_metadata_2025_split huggingface dataset:
Effect of partial outlet obstruction on contractility: Comparison between severe and mild obstruction
Authors: Saito Masahiko , Wein Alan J. , Levin Robert M. 
Published: March 2007

AbstractDetrusor dysfunction is one of the most common problems in patients with outflow obstruction secondary to benign prostatic hyperplasia. These patients complain of various symptoms, including urinary frequency, urge incontinence, difficulty in voiding, and retention. The severity of the symptoms is dependent on the stage of disease and/or severity of the obstruction. We compared the changes in the rat detrusor function following both mild and severe models of partial outlet obstruction in the rat. Outflow obstructions were created by ligation of the urethra over which a catheter was placed. The size of the catheter determined whether the severity of obstruction was mild or severe (1.70 mm for mild obstruction and 1.09 mm for severe obstruction). Changes in the bladder weight, length‐tension relationships, and the contractile response to field stimulation, pharmacologic agonists, and KCl were studied in bladders isolated from 1 and 2 week obstructed rats.Bladder weights of all obstructed rats increased significantly. The weight of the severe obstructed rats were significantly greater than rats subjected to mild obstruction. In general, passive length‐tension curves of obstructed rats were shifted to right. The magnitude of the active tension induced by high KCl was higher in the mild obstruction and lower in the severe obstruction. The maximum response to KCl of mild obstruction was generated at greater lengths than for the other groups.In general, the contractile responses of the mild obstructed bladder body to field stimulation, bethanechol, KCl, and ATP, and of the bladder base to field stimulation, KCl, and methoxamine, were significantly increased when compared to the responses of the control bladder body and base. However in the severe obstructed bladder, the responses to field stimulation, KCl, ATP, and methoxamine were significantly reduced from the responses of the control strips; the response to bethanechol was similar for control and the severe obstructed groups.In conclusion, the severity of outlet obstruction significantly altered the contractile response of the bladder. Mild obstruction induced a mild increase in bladder mass, which was associated with significant increases to all forms of stimulation. Severe outflow obstruction induced a substantial increase in bladder mass and a significantly greater reduction in the response to field stimulation than the response to bethanechol (which was unchanged).
Interconnections of the upper ventral rami of the human sacral plexus: A reappraisal for dorsal rhizotomy in neurostimulation operations
Authors: Marani Enrico , Fiji Milan E. J. , Kraan Maarten C. , Lycklama à Nijeholt Gus A. B. , Videleer André C. 
Published: March 2007

AbstractThe extension of a dorsal rhizotomy in bladder stimulation patients is partly determined by connections between the ventral rami of the second, third, and fourth sacral spinal nerves. The literature is inconclusive on interconnections of these ventral rami in the human sacral plexus. The sacral plexuses of ten human cadavers were dissected in this gross anatomy study. In nine cases a branch connecting the ventral rami of the second and third sacral spinal nerves was found. Electron microscopy demonstrated the presence of thick myelinated fibers in this branch. In the male plexuses this branch formed the only link between the second sacral spinal segment and the pelvic plexus. The ventral ramus of the second sacral nerve always contributed to the pudendal nerve, whereas involvement of the ventral rami of the first and third sacral nerves differed individually and intersexually.
Effect of terazosin on urine storage and voiding in the aging male with prostatism
Authors: Gleason D. M. , Bottaccini M. R. 
Published: March 2007

AbstractPatients in a private practice. evaluated for prostatism due to benign prostatic hypertrophy were offered the options of medical treatment with the alpha blocker terazosin, surgical treatment, or continued observation. Nineteen men accepted terazosin treatment and are the subjects of the present series. They were treated over a mean period of 8 months, the longest treatment lasting over 22 months. Dosage was started at 1 mg/d and increased as tolerated to 2.5, and 10 mg/d over the test period. Extensive testing including invasive urodynamics, multiple voiding diaries, and symptoms scores at each dosage level was carried out. We found that flow rales increased moderately from baseline in a dose dependent fashion. At the 10 mg/d dosage some patients achieved flow rates in the low normal range. Patients on treatment documented a decrease in the number of voidings per day, a decrease in nocturia, an increase in bladder capacity and the volume of each voiding. On the other hand, patients frequently did not appreciate changes in their voiding patterns, as reflected in their responses to the symptom questionnaires. We could not demonstrate significant changes in bladder pressures on cystometry either during filling or voiding. Our data suggested that terazosin may well have a direct effect on the fundus of the aging bladder to increase capacity, and, through the well‐known relationship between voided volume and flow rate, increase urinary flow rate. © 1994 Wiley‐Liss, Inc.
Urodynamic parameters in patients with slight and severe genuine stress incontinence: Is the stress profile useful?
Authors: Meyer S. , De Grandi P. , Schmidt N. , Sanzeni W. , Spinosa J. P. 
Published: March 2007

AbstractThis study evaluates the usefulness of the urethral pressure profile (UPP) parameters in assessing the severity of genuine stress incontinence (GSI). Functional length (FL), maximum urethral closure pressure (MUCP), pressure transmission ratio (PTR), residual area at stress (RAS), number of patients with incontinent spikes (IS), and distribution of IS on UPP were determined in supine and standing position for 54 patients (group I) with a 1 ‐hour pad test < 2 g and compared with the values of 63 patients (group 2) with a 1 ‐hour pad test > 2 g. The results were similar: FL (supine: 24 mm ± 6/26 mm ± 7 [P:0.2]; standing: 26 mm ± 8/24 mm ± 11 [P:0.5]); MUCP (supine: 51 cm H2O ± 23/47 cm H2O ± 20 [P:0.3]; standing: 45 cm H2O ± 21/38 cm H2O ± 18 [P:0.1]); and PTR (supine: 83% ± 27/84% ± 31 [P:0.9]; standing: 81% ± 25 and 88% ± 27 [P:0.3]). But the RAS was lower (supine: 502 mm2 ± 497/246 mm2 ± 268 [P < 0.009]; standing: 500 mm2 ± 534/271 mm2 ± 306 [P < 0.05]) in group 2. If the percentage of patients with IS was higher (supine: 57/93% [P < 0.001 ]; standing: 54/84% [P] < 0.011) in group 2, the distribution of IS over the entire FL demonstrated no differences between group 1 and 2. In conclusion, except for the RAS, standard UPP parameters cannot be considered determinant in assessing the severity of GSI. © 1994 Wiley‐Liss, Inc.
Improved method for needle electromyography of the urethral sphincter in women
Authors: Lowe Eithne M. , Fowler Clare J. , Osborne J. L. , Delancey J. O. L. 
Published: March 2007

AbstractNeedle electromyography (EMG) of the urethral sphincter using the periurethral approach is a procedure which most women find painful and their discomfort can restrict the use fulness of the test. A new technique has been devised using a transvaginal approach. The patient lies in the left lateral position and using a Sims speculum the posterior vaginal wall is retracted. The urethral sphincter can be easily seen and palpated, assisting correct electrode placement. This new technique is much less uncomfortable and highly satisfactory EMG recordings are obtained. © 1994 Wiley‐Liss, Inc.
One month maximal electrostimulation for genuine stress incontinence in women
Authors: Schiøotz Hjalmar A. 
Published: March 2007

AbstractWhile awaiting surgery for genuine urinary stress incontinence, 51 women with were treated at home for 1 month with vaginal maximal electrostimulation. They were evaluated subjectively, urodynamically, and with two different pad tests. Six patients (12%) were cured and 17 (33%) were much improved, subjectively and objectively. Statistically significant improvement was observed for both pad tests. Successful treatment was significantly more likely in women with milder degrees of incontinence but was unrelated to age or urethral pressure. Patient acceptance was excellent and apart from some vaginal soreness no complications were seen.Sixteen patients (31%) elected not to be operated on. These 16 patients were reevaluated after 1 year and 13 (81%) had maintained their improvement. Three had disimproved but were still better than before treatment; 2 again refused surgery and 1 opted for surgery. Therefore, 15 of 51 (29%) operations were saved after 1 year. This conservative treatment for stress incontinence is safe, simple, inexpensive, and reasonably successful. © 1994 Wiley‐Liss, Inc.
Stimulation of dna synthesis in rabbit bladder wall after partial outlet obstruction and acute overdistension
Authors: Monson F. C. , Wein A. J. , Eika B. , Murphy M. , Levin R. M. 
Published: March 2007

AbstractPartial outlet obstruction of the rabbit urethrovesical junction (UVJ) has been used to induce pathology in the urinary bladder characteristic of obstructive damage observed in humans. The purpose of the experiments reported here was to compare the 3H‐thymidine (3H‐TdR) labelling of DNA in urinary bladders of male New Zealand White (NZW) rabbits subjected to partial outlet obstruction or overdistension. A total of 18 animals was used. Two normal controls, and 12 partially obstructed animals (at I day [D], 3D, 5D, 7D, 14D, and 2ID) were injected (i.v.) with 3H‐TdR at a dose of 0.5 μ‐Ci/g body weight. An additional 4 were overdistended to volumes 120% of maximum intravesical pressure, immediately emptied via the catheter, and injected with 3H‐TdR 24 hr (ID) later. All animals were sacrificed up to 3.5 hr after injection of the label.DNA‐associated radioactivity reached a peak at 3D after obstruction and was reduced substantially by 5D, although the level of incorporation remained well above control levels out to 2ID. Levels of 3H‐TdR incorporation ID after overdistension bladders were about half of that found ID following partial obstruction.The distribution of 3H‐TdR labelled DNA in tissues was demonstrated by radioautography of histologic sections. One day following obstruction, 3H‐Tdr incorporation was localized in the urothelium. Labelling of urothelium subsequent to ID was reduced but remained above control levels until 2ID. Labelled smooth muscle nuclei were observed only in control and 3D bladders, and they were measured at similar frequencies. Labelling of both intrinsic connective tissue (ICT) (mucosal, submucosal, and mural) and extrinsic connective tissue (ECT) (serosal) peaked at 3D after obstruction and declined thereafter but not to control levels. Labelling of ECT was, of course, limited to those bladders in which ECT was present (i.e., 3‐2ID). While the distribution of labelled cells in radioautograms was more variable ID after obstruction than ID after overdistension, the general cellular and biochemical responses to overdistension, as measured by DNA synthesis, are similar to those observed after partial outlet obstruction. Since the first sequela of obstruction is acute distension, these data support the assertion that the initial overdistension of the bladder initiates the cellular response to obstruction. © 1994 Wiley‐Liss, Inc.
Rat: Overview and innervation
Authors: Steers William D. 
Published: March 2007

AbstractDespite the development of molecular and cellular methods for examining physiological processes, the use of the whole animal model remains essential to advance knowledge regarding the integration and coordination of events associated with urinary tract function. The rat offers an inexpensive and versatile species to investigate bladder and urethral responses to drugs or pathology. Models for many disorders have been developed in rodents including diabetes, multiple sclerosis, spinal cord injury, Parkinson's disease, bladder outlet obstruction, pain, and aging. This review examines methodologies to evaluate lower urinary tract function and manipulations used to create pathological models in rodents. © 1994 Wiley‐Liss, Inc.
Rabbit as a model of urinary bladder function
Authors: Levin Robert M. , Monson Frederick C. , Longhurst Penelope A. , Wein Alan J. 
Published: March 2007

AbstractMicturition is a complex neuromuscular process. Although control mechanisms have been identified at several levels of the central nervous system and spinal cord, the final pathway in the control of micturition is the autonomic innervation of the urinary bladder and related structures. Following this line of reasoning further, micturition is ultimately dependent on the ability of the urinary bladder to both contract and generate intravesical pressure, and to modify its shape in such a way as to efficiently expel its contents without leaving a high residual volume.In order to understand the various elements of micturition, a wide variety of both in vivo and in vitro animal models has been developed. In many cases, animal models have been utilized to describe the effect of specific experimental pathologies on the lower urinary tract. The current review of the use of the rabbit in urological research is not meant to be a comprehensive treatise on the topic, but should provide a rational description of the how this species can be utilized to study both normal and pathological function. © 1994 Wiley‐Liss, Inc.
Guinea pig as an animal model for the study of urinary bladder function in the normal and obstructed state
Authors: Mostwin Jacek L. , Karim Omer M. A. , Van Koeveringe Gommert , Seki Narihito 
Published: March 2007

AbstractThe guinea pig has become an excellent model for the study of mechanical and electrical mechanisms regulating bladder function in the normal and obstructed state. Much preliminary work has been done on the in vitro behavior of the detrusor smooth muscle. The tissue has permitted electrophysiological studies by sucrose gap. microelectrode. and patch clamp technique. Excellent urodynamic studies can be performed under anesthesia. A recent model of bladder obstruction has resulted in a source of tissue which is suitable for electrophysiological analysis of the muscle. Low‐cost and simple animal care requirements permit large‐scale studies correlating urodynamic, structural, biochemical, contractile, and electrophysiological changes in response to obstruction. © 1994 Wiley‐Liss, Inc.
Dog as an animal model for neurostimulation
Authors: Hassouna M. , Li J. S. , Elhilali M. 
Published: March 2007

AbstractThe dog provides an important model to study the effect of neural stimulation of different parts of the central and peripheral nervous systems. A multitude of experiments on neurostimulation and neuromodulation to ensure bladder evacuation have been conducted on dogs. The present article reviews the most prominent contributions in the English literature related to neurostimulation using the dog as an experimental model. The various modes of stimulation using dogs as a model and the rationale for their use as well as their shortcomings will be examined. The prominent anatomic features in the neural control of the bladder and the technical aspects involved in neurostimulation of the canine bladder will be reviewed. © 1994 Wiley‐Liss, Inc.
Cat and dog: Higher center of micturition
Authors: Nishizawa Osamu , Sugaya Kimio 
Published: March 2007

AbstractThe nervous control of micturition in the pontine level was studied using cats and dogs as research specimens. Two techniques for this purpose were employed: (1) electrical and chemical stimulations research and (2) nerve tracing research. This investigation suggests that two distinct pontine centers exist, the commonly known pontine micturition center (PMC) which is responsible for urine emptying, and a second, very important pontine center which functions as the urine storage facilitator (PUSFC). The PMC, which triggers bladder contractions and micturition, is located in the nucleus locus coerleus alpha (LCa). The second center (PUSFC) is located in the nucleus locus subcoerleus (LSC). Micturition is controlled by close coordinate operation of both centers in the pontine level. © 1994 Wiley‐Liss, Inc.
Pelvic fascia strength in women with stress urinary incontinence in comparison with those who are continent
Authors: Kondo A. , Narushima M. , Yoshikawa Y. , Hayashi H. 
Published: March 2007

AbstractBiophysical properties of the anterior vaginal wall as well as the rectus fascia were evaluated in vivo by penetrating the Stamey needle into these tissues of 26 female patients with stress incontinence in comparison with those of 21 continent subjects. The results demonstrated that shear strength of the anterior vaginal wall was lower in incontinent patients than in continent subjects (P < 0.01). Shear strength of the rectus fascia in the patients, which was not supposed to be related to urinary incontinence and should have had the same strength as the control subjects, was also found to be lower than the control (P < 0.01). Shear strength of the vaginal wall was not correlated with age irrespective of their continence status (P > 0.05). Based on our findings it is concluded that some women suffering from stress incontinence may have a hereditary disorder of biophysical properties of the tissues. © 1994 Wiley‐Liss, Inc.
Abnormal sensitivity to intravesical potassium in interstitial cystitis and radiation cystitis
Authors: Parsons C. Lowell , Stein Paul C. , Bidair Mohamed , Lebow Diana 
Published: March 2007

AbstractThe urgency‐frequency syndrome (UFS) (non‐bacterial cystitis, interstitial cystitis) may well represent a heterogenous group with several etiologies. This study was based on the hypothesis that one subset of UFS patients has a leaky (to solutes) epithelium and cations such as potassium could thereby diffuse subepithelially and provoke symptoms. It was also hypothesized that normal impermeable transitional epithelium would not allow cations to diffuse across the cells during the K + provocation test and no symptoms would be experienced. If the epithelium was permeable (“leaky”), diffusion would occur and provoke symptoms. Water or 0.4 M KCl was placed intravesically into normal volunteers and interstitial cystitis (IC) patients. Water did not provoke symptoms in either group but KCl provoked 45% of normals and 70% of IC patients. Differences were significant (P < 0.0001). This test provides a valuable diagnostic tool for UFS and a valuable research tool to separate epithelial permeability problems from other subsets of patients. A third group, consisting of 11 IC patients in remission on heparinoid therapy, was also tested and only 18% were provoked by KCl. Four patients with radiation cystitis were also examined and all four (100%) were provoked by the potassium. © 1994 Wiley‐Liss, Inc.
Correlation of the AUA symptom index with urodynamics in patients with suspected benign prostatic hyperplasia
Authors: Nitti Victor W. , Kim Young , Combs Andrew J. 
Published: March 2007

AbstractThe AUA symptom index is widely used to access patients with suspected benign prostatic hyperplasia (BPH). In order to determine how well symptoms as assessed by this index correlate with urodynamic findings, we evaluated 83 patients referred to our urology clinics with symptoms of BPH. All patients completed the AUA symptom index and then underwent a multichannel urodynamic evaluation. Patients were classified as obstructed, unobstructed, or equivocal according to the Abrams Griffiths nomogram. The AUA symptom index was recorded as the total score and, for purposes of symptom classification, further subdivided into an obstructive score (questions 3, 5, and 6) and an irritative score (questions 1, 2, 4, and 7).The mean age of the 83 patients was 67 (45–84). The mean total AUA symptom score was 16.6 (6–34), mean obstructive score was 6.1 (0–15), and the mean irritative score 10.4 (3–20). Pressure flow analysis using the Abrams‐Griffiths nomogram classified 28 patients (34%) as obstructed, 17 (20%) as unobstructed, and 38 (46%) as equivocal. Using the analysis of variance procedure (ANOVA) there was no statistically significant difference in the mean total (P = 0.446), obstructive (P = 0.979), or irritative (P = 0.136) scores. Detrusor instability was present in 45 patients (54%). While total and obstructive scores were not significantly different in patients with detrusor instability vs. those with stable bladders, irritative scores were higher in patients with instability (P = 0.028) using the T‐test procedure. Using ANOVA, the difference in post void residual (PVR) between the groups was not quite statistically significant (P = 0.057).The AUA symptom score does not appear to correlate with urodynamic obstruction. However, higher irritative symptom scores are associated with detrusor instability. It is likely that in many men with “BPH,” symptoms are not caused by outlet obstruction and may be related to changes in the aging bladder. © 1994 Wiley‐Liss, Inc.
Basis of severity grade in detrusor hyperreflexia
Authors: Bonney William W. 
Published: March 2007

AbstractFor both treatment and research it is useful to classify detrusor hyperreflexia/instability according to degree of severity, because it relates to symptomatic impact. However, there has been no systematic evaluation of criteria for severity assignment. This report compares patient classification by urodynamic data according to 3 methods: arbitrary criteria, a severity index, and an empirical cluster analysis. Within the primary urodynamic data there were no natural groupings as a basis for division into discrete patient groups. By all three methods, however, severity level did relate to symptoms. © 1994 Wiley‐Liss, Inc.
Functional obstruction of the female urethra: Relevance to refractory bed wetting and recurrent urinary tract infection
Authors: Kondo Atsuo , Kapoor Rakesh , Ohmura Masaharu , Saito Masahiko 
Published: March 2007

AbstractA 20‐year‐old woman and 3 girls were referred to our urodynamic unit because of refractory bed wetting, recurrent urinary tract infection, and/or weak stream. All patients required extremely high detrusor pressure to evacuate urine, a mean of 116 cm of water. Urethral configuration was either a ballooning or a spinning‐top shape. Organic stenosis of the urethra was not detected by bougie a boule. Urodynamically, functional obstruction at the distal urethra was found to be an etiology of these symptoms. When the urethra was dilated with the Otis urethrotome, all patients were greatly benefitted both symptomatically and urodynamically without an adverse effect of urinary incontinence. We stress clinical importance of pressure flow study and fluoroscopic monitoring of the bladder and urethra when one encounters female patients with long histories of above symptoms. © 1994 Wiley‐Liss, Inc.