bluuebunny/crossref_metadata_2025_split huggingface dataset:
Intrinsic neuromuscular defects in the neurogenic bladder: VIII. Effects of unilateral pelvic and pelvic plexus neurectomy on ultrastructure of the feline bladder base
Authors: Elbadawi Ahmad , Atta Mohamed A. , Hanno Ahmed G.‐E. 
Published: March 2007

AbstractIt has been shown previously that unilateral parasympathetic decentralization of the feline bladder by sacral ventral rhizotomy results in early degenerative and eventual regenerative ultrastructural neuromuscular changes in the bladder base. The present study was conducted to define the effects of unilateral parasympathetic decentralization by pelvic neurectomy and postganglionic “denervation” by pelvic plexus neurectomy on the neuromuscular ultrastructure of the feline bladder base. Eighteen sexually mature male cats were used. Three cats provided the control material; six cats underwent unilateral pelvic and nine unilateral pelvic plexus neurectomy. Bladders were collected for study 2, 3, and 10 weeks following the former and 1–4 days, 3 weeks, and 7–12 weeks following the latter procedure. Samples from both the neurectomized and the intact sides of each bladder were obtained for electron microscopic study. The ultrastructural neuromuscular changes observed after pelvic neurectomy were identical to those previously described following unilateral sacral ventral rhizotomy, except for early developing and persistent, widespread degeneration of myelinated axons in the former model. As in the rhizotomy model, there was cholinergic axonal regeneration, adrenergic hyperinnervation, and a prominent population of probable copeptidergic axons in long‐term samples of the bladder base following pelvic neurectomy. In contrast, pelvic plexus neurectomy (a postganglionic “denervation” procedure) resulted in early developing and persistent degeneration of all axons in the bladder base: i.e., myelinated, cholinergic and adrenergic, with long‐term hypoinnervation by both cholinergic and adrenergic neural elements. Our observations indicate that two forms of the experimentally induced lower‐motor neurogenic bladder can be distinguished ultrastructurally.
Intrinsic neuromuscular defects in the neurogenic bladder: IX. Effects of combined parasympathetic decentralization and hypogastric neurectomy on neuromuscular ultrastructure of the feline bladder base
Authors: Hanno Ahmed G.‐E. , Atta Mohamed A. , Elbadawi Ahmad 
Published: March 2007

AbstractPrevious studies have shown that unilateral decentralization of the feline bladder by sacral ventral rhizotomy results in ultrastructural neuromuscular changes in the bladder base. In the present study, the neuromuscular ultrastructure of the feline bladder base was studied in twenty sexually mature adult male cats 1–4 and 6–10 weeks following bilateral sacral rhizotomy, alone and combined with hypogastric neurectomy. The former procedure resulted in initial degeneration of cholinergic axons with loss of their neuroeffector junctions, but the adrenergic axons and neuroeffector junctions were preserved; within 6–10 weeks, the bladder base became re‐innervated by regenerated cholinergic, increased adrenergic, and abundant probable copeptidergic axons. In contrast, combined sacral rhizotomy and hypogastric neurectomy resulted in persistent (up to 10 weeks) degeneration of both cholinergic and adrenergic axons with loss of their neuroeffector junctions, and no adrenergic hyperinnervation, with only a modest increase in probable copeptidergic axons in long‐term samples. Our observations indicate that intact efferent sympathetic pathways are essential for eventual cholinergic re‐innervation and adrenergic hyperinnervation of the decentralized bladder and suggest that the latter is an important factor in the development of vesical hypertonicity in lower‐motor neuron lesions. On this basis, we introduce the concept that two functional types of the lower motor neurogenic bladder–i.e., the hypertonic with intact and the normotonic with injured efferent sympathetic pathways–may be distinguishable morphologically by ultrastructural study of the vesical muscularis.
Relation between bladder filling and anal sphincter reflexes
Authors: Petersen Thor , Schrøder Henrik D. 
Published: March 2007

AbstractThe effect of bladder filling on the threshold of the perianally elicited anal reflex and the anal reflex elicited by peripheral stimulation of the lower limbs has been studied in seven patients with hyperactive bladder and detrusor‐sphincter dyssynergia and in seven normal controls. No changes were found in the perinally elicited reflex, while the minimal peripheral stimulus necessary for eliciting a reflex changed in both groups but in opposite directions. These observations show that the different anal reflexes use different spinal pathways and that the central control of the interaction between detrusor and sphincters is exerted on the pathway used by the peripheral reflex. These findings, moreover, call for a thorough standardization of the conditions of investigation.
Ambulatory urethro‐cysto‐rectometry: A new technique
Authors: Kulseng‐Hanssen S. , Klevmark B. 
Published: March 2007

AbstractIn some patients complaining of urinary incontinence a leakage is not found during sitting simultaneous urethrocystometry (SUCM). In these patients, who often exhibit marked urethral pressure variations, the closure pressure frequently falls close to zero due to a decrease in the maximum urethral pressure without simultaneous detrusor contraction. In order to see what happens to urethral, bladder, and rectal pressures when these patients leak urine in daily‐life situations, a new ambulatory urethro‐cysto‐rectometric technique (AUCRM) has been developed.Twenty‐six female patients who had urethral pressure variations of 20–100 cm H2O during SUCM were reinvestigated with this new technique.Urinary leakage was found significantly more often during AUCRM than during SUCM (21 patients of 26, vs. 13 of 26; P < 0.05).Twenty‐one of 26 patients complained of the symptom urge incontinence. In these patients urinary leakage was found to be highly significant more often during AUCRM than during SUCM (16 patients of 21, vs. 4 patients of 21; P < 0.001). Leakage was always due to a combination of urethral pressure decrease and detrusor pressure increase, as in normal micturition. The condition unstable urethra was not found.During SUCM 17 patients were found to have sensory and 4 motor urgency. Performing AUCRM in the same patients, 5 were found to have sensory and 16 motor urgency. By the use of AUCRM the condition sensory urgency has been shown to be less frequent than was previously believed.The new technique of AUCRM used in the present study is compared to supine and sitting SUCM, judged to be superior for detection of the leakage mechanism.
Correlation of bladder dysfunction and lumbosacral somatosensory evoked potential S‐wave abnormality in spinal‐cord‐injured patients
Authors: Berić Aleksandar , Light J. Keith 
Published: March 2007

AbstractThirty‐six patients with stable cervical and high thoracic spinal cord injury underwent urodynamic evaluation and lumbosacral somatosensory evoked potential testing. All these patients had a preserved peripheral sensory neuron (normal R‐wave). Fifteen of the 36 patients had either an abnormal or absent lumbosacral postsynaptic posterior horn potential (S‐wave). Correlation of the S‐wave abnormality and urodynamic evaluation in these patients showed a high incidence of abnormal detrusor contractility (87%). This supports an underlying neurogenic dysfunction for the abnormal detrusor behavior in spinal‐cordinjured patients.
The bladder neck in neurological degenerative disorders
Authors: Sotolongo Jose R. 
Published: March 2007

AbstractBladder neck incompetence occurs frequently in the Shy‐Drager syndrome. The behavior of the bladder neck in patients with multiple sclerosis and Parkinson's disease, however, has not been well defined.Complete urodynamic studies were performed on 48 patients with urgency incontinence and one of the following neurological diagnoses: Parkinson's disease (13 patients), Shy‐Drager syndrome (13 patients), and multiple sclerosis (22 patients). Complete studies were also performed on 73 patients with no neurological diagnoses and no incontinence. None of the patients had ever undergone prior transurethral surgery. All patients with a neurological diagnosis had detrusor hyperreflexia on cystometrogram. Bladder neck function was evaluated with fluoroscopy as well as with intraluminal‐pressure measurements utilizing a 10 French triple‐lumen catheter.Only 11 (22%) of the neurological patients had an incompetent bladder neck on fluoroscopy (6 with Shy‐Drager, 3 with Parkinson's, and 2 with multiple sclerosis). Mean bladder neck pressures of the 48 neurological patients were as follows: Parkinson's: 12 cm H2O, SE = 5; multiple sclerosis: 15 cm H2O, SE = 1.2; and Shy‐Drager: 7 cm H2O, SE = 2.Bladder neck incompetence, commonly seen in Shy‐Drager and strongly suggestive of sympathetic dysfunction, is uncommon in incontinent patients with other degenerative neurological disorders and detrusor hyperreflexia.
Use of a previously undescribed elastic lamina of the serosa to characterize connective tissue hypertrophy of the rabbit bladder wall following partial outlet obstruction
Authors: Monson Frederick C. , Goldschmidt M. H. , Zderic S. A. , Ruggieri M. R. , Levin R. M. , Wein A. J. 
Published: March 2007

AbstractPartial outlet obstruction of the rabbit urinary bladder was induced in New Zealand rabbits through surgical introduction of a silk ligature distal to the urethrovesicular junction. The consequence of this intervention is acute overdistension followed by severe bladder wall hypertrophy. In conjunction with physiological experiments, two additional animals were generated for histological evaluation at each of three time intervals after partial obstruction (1, 7, and 14 days), as well as six sham‐operated and two normal subjects. Bladders were fixed in Bouin's fluid and processed routinely for paraffin embedment. Sections were stained with hematoxylin and eosin (H&E), periodic acid Schiff (PAS), and elastin stains, and Mallory's triple stain for connective tissue (CT). The results of this present study confirm and significantly expand previous reports of CT hypertrophy after partial outlet obstruction. After 14 days of partial obstruction the elastin stains showed a peculiar welldefined lamina of elastin buried in the wall of the bladder. In 7‐day animals, the lamina is either buried as in 14‐day bladders, covered with bands of collagenous CT, or associated with the serosa. The lamina is confined to serosa in normal and sham operated animals and in partially obstructed animals, 24 hr after surgery. In normal and sham‐operated animals the elastic lamina is always found to be uninterrupted. In 1‐, 7‐, and 14‐day obstructed animals, the lamina is typically observed to be broken. The elastic lamina is part of the serosa rather than part of the bladder, and it accompanies the mesothelium wherever it is found. Nonetheless, it is clear from these experiments that the serosa becomes involved in the response of the bladder to the obstructive insult, and a fibrotic reaction of the serosa contributes to the thickening of the wall of the hypertrophic bladder. By using this elastic lamina as a marker, CT hypertrophy can be classified as either intrinsic (that within the original bladder wall) or extrinsic (that within the serosal comartment). Although the precise sources of these additional materials are not known at present, hypotheses are suggested. These distinctions may be important in determining the specific cellular and tissue causes of decreased bladder function that are characteristic of certain bladder pathologies.
Urethral pressure recording—an alternative: Balloon‐covered microtransducer catheter detection
Authors: van Der Kooi J. B. , Kornelis J. A. , De Jonge M. C. , van Wanroy P. J. A. , De Pater L. 
Published: March 2007

AbstractIn order to remove artifacts due to side‐mounted sensor detection, while also retaining the unmatched frequency response of the microtransducer catheter (MTC), pressure detection in the urethra has been carried out by using a MTC with the sensor surrounded by a tiny, water‐filled balloon. In 14 women without stress incontinence, static and dynamic urethral pressures have been determined simultaneously with a balloon‐covered and a plain MTC coupled together.
Quantitative study in vitro of the spontaneous contractions of pig detrusor muscle and their frequency‐selective inhibition by drugs
Authors: Hak Jaap , Griffiths Derek J. , van Mastrigt Ron , Koopal Bouwe , Klück Paul 
Published: March 2007

AbstractThe amplitudes of the various frequency components present in the spontaneous contractions of pig detrusor muscle in vitro have been analysed and their responses to drugs examined. For strips taken from the ventral wall of the bladder the spontaneous contractions typically show one or both of two main frequency components near 0.02 Hz (1 per 50 s) and 0.05 Hz (1 per 20 s), respectively. The relative prominence of the two components differs from strip to strip. Spontaneous activity in strips showing mainly the lower frequency is strongly inhibited by oxyphenonium bromide (3 × 10−5 M). Activity in strips showing mainly the higher frequency is almost unaffected. Atropine sulphate (10−6 M) has no consistent effect on either of the two frequency components. Hexamethonium bromide (10−5) selectively inhibits the low‐frequency component. Histological examination shows that the strips contain ganglion cells and suggests that those with mainly low‐frequency activity contain many more such cells than those with higher‐frequency activity. This observation is consistent with the observed frequency‐selective effect of hexamethonium bromide.
Effect of urinary bladder outlet obstruction on the rabbit ureter
Authors: Ruzich Jeffery , Wein Alan J. , Keating Michael A. , Ruggieri Michael R. , Levin Robert M. 
Published: March 2007

AbstractUreters of mature New Zealand white male rabbits were studied at 7 and 14 days following partial bladder outlet obstruction. Muscarinic receptor density; intracellular concentrations of DNA, RNA, lipid, and hydroxyproline; and functional characteristics of the whole ureter were assessed as a means of characterizing the ureteral secondary response to partial bladder obstruction.Wet weight increased 2‐fold by day 7 and almost to 3‐fold by day 14. Ureteral length increased 15% by day 7 and 29% by day 14. DNA concentration varied only slightly from controls while RNA increased by 68% by day 7 but returned to near normal range by day 14. Total hydroxyproline content increased, although hydroxyproline concentration per mg tissue decreased. Total lipids increased by 73% over the first 7 days but subsequently decreased to 27% above control levels by day 14. After 1 week of obstruction, muscarinic receptor density was 35.5% of controls, and after 2 weeks of obstruction, muscarinic density was 52.5% of controls. Although muscarinic receptor density decreased significantly, the number of receptors per ureter did not substantially change. Flow studies demonstrated increased opening pressures at 7 days and decreased opening pressures by day 14. Flow as a function of constant pressure was not significantly changed by the 7th day but increased 24% by the 14th day. Bethanechol (muscarinic agonist) caused similar decreases in flow in control and 1‐ and 2‐week obstructed ureters.These studies indicate that 1 week following partial outlet obstruction, ureters demonstrate increased protein synthesis and lipid deposition resulting in increased weight and length. By the 2nd week, protein synthesis and lipid content begin to return to normal. Weight and length remain significantly increased and the capacity for flow through the ureter improves.
Detrusor hyporeflexia after anterior sciatic syndrome. Effect of short‐term maximal electrostimulation
Authors: Eriksen B. C. , Sand T. , Sjaastad O. 
Published: March 2007

AbstractA 63‐year‐old woman with persisting detrusor hyporeflexia and lack of bladder sensibility 6 weeks after the occurrence of an acute anterior sciatic syndrome was treated with maximal electrical stimulation of the pelvic floor. An immediate improvement of bladder sensibility was observed. A complete normalization of the micturition reflex was obtained after five sessions of maximal stimulation during a period of 8 days. Electrostimulation therapy may restore normal function in the lower urinary tract in selected patients with neurogenic bladder dysfunction.
Urethrometry: Considerations of static, dynamic, and stability characteristics of the female urethra
Authors: Constantinou C. E. 
Published: March 2007

AbstractMeasurements of resting anterior/posterior urethral pressures and detrusor function are considered with respect to clinical observations made during the physical examination of patients complaining of urinary incontinence. Observations made on a large number of consecutive unselected patients show that the extent of incontinence is much larger than can be determined by the physical examination alone. Urethral profilometry shows that there are statistically significant differences in the anterior and posterior maximum urethral closure pressure between stress‐ and non‐stress‐incontinent patients regardless of age and detrusor function. The measurement of posterior resting urethral closure pressure correlates best with the physical demonstrability of stress incontinence among patients with a stable detrusor function. The age‐related rate of decrease in the maximum resting urethral pressure is approximately the same for both anterior and posterior urethra in the continent patient. Demonstrably incontinent patients show a rate of posterior urethral pressure decrease with age double that of those with no evidence of incontinence on physical examination. The differences between anterior, posterior, and lateral closure pressures are discussed in terms of their correlative anatomical periurethral structures and are graphically represented in a threedimensional perspective schema.The direction of occlusive forces in the proximal healthy female urethra is critically examined at rest and also during dynamic events such as holding and coughing. The results show that compressive forces in the proximal urethra are asymmetrically distributed with respect to the anterior/posterior plane and are symmetrical in the lateral plane. Resting urethral pressure profiles show that the absolute value of the maximum urethral closure pressure is equal in the anterior/posterior and lateral aspects of the urethra. Dynamic measurement at the proximal urethra in controls shows that holding or coughing produces directional closure from posterior to anterior. The directional forces acting at the proximal urethra are observed in the region coincident with the position of the vaginal attachments to the pelvic diaphragm. Based on resting and dynamic urethral pressure measurements, evidence is presented to indicate that the microtip transducer with sensors oriented in the anterior/posterior plane provides a significant advantage in identifying urethral closure mechanisms and has contributed towards localization of anatomical structures involved in the continence mechanisms. Finally, consideration is made of urethral stability and local pressure variations detected in the absence of external periurethral influences possible interplay between the stability of the urethra on the one hand and the detrusor on the other are discussed with particular emphasis on establishing a link between them.
Applications of neurostimulation in urology
Authors: Schmidt Richard A. 
Published: March 2007

AbstractElectrical stimulation of nerves and muscle is a time honored approach to the treatment of urinary incontinence. The use of implantable neuroprosthetics in the field of urology remains a new frontier. This report presents a summary of seven years experience with neuroprosthetic devices in the treatment of symptomatic voiding dysfunction. The techniques devised to study and evaluate patients for treatment via neurostimulation are described.The majority of patients were not paraplegic and were significantly incapacitated by dysfunctional voiding patterns. The rationale in using neurostimulation were two: (1) most voiding dysfunctions result from, or are associated with hyperactive striated muscle behavior; (2) neurostimulation has an intrinsic inhibitory effect on this spastic behavior of striated muscle. Very favorable results were obtained. Neurostimulation would appear to be a valuable asset to the urologist from both an investigational as well as a therapeutic viewpoint.
Permanent retention following radical hysterectomy
Authors: Kadar Nicholas 
Published: March 2007

AbstractUrodynamic findings associated with permanent retention after radical hysterectomy are presented and discussed in the light of previous observations made in women rendered severely incontinent by the operation. These findings suggest that if the operation ablates the micturition reflex, some reduction in urethral pressure is required to achieve balanced bladder function. They also demonstrate that opposite extremes of proximal urethral pressure can occur after a radical hysterectomy and that they are associated with diametrically opposite types of urinary dysfunction even if detrusor function is identical. It is difficult to reconcile these observations with histochemical data which suggest a purely cholinergic efferent nerve supply to the proximal urethra.
Quantification of urethral resistance and bladder function during voiding, with special reference to the effects of prostate size reduction on urethral obstruction due to benign prostatic hyperplasia
Authors: Griffiths Derek , van Mastrigt Ron , Bosch Ruud 
Published: March 2007

AbstractIn pressure/flow studies of adult voiding the behaviour of the urethra can be distinguished from that of the bladder, and quantified separately, as follows. Different degrees of urethral obstruction can be quantified and ranked using a group‐specific resistance factor (URA) that is based empirically on the pressure/flow plots obtained in a large number of voidings of adult patients. Different detrusor contractions can be similarly quantified using a physiologically based measure (WF, abbreviated from power [W] factor) of the contraction strength. Both URA and WF can be calculated by computer from measurements of detrusor pressure, voiding flow rate, and the residual volume in the bladder after voiding. For other groups of patients, e.g., children, different group‐specific resistance factors are appropriate.In men with obstructed voiding due to benign prostatic hyperplasia (BPH), “chemical castration” with cyproterone acetate or buserelin caused a substantial, reversible reduction in the size of the prostate. The effect on the degree of urethral obstruction and the voiding bladder contraction has been studied using the above‐mentioned methods. There was an increase in peak urinary flow rate, a reduction in residual urine, and a decrease in daytime voiding frequency. Surprisingly, however, there was on average no decrease in urethral resistance but only an increase in the average detrusor contraction strength. In individual patients large increases and decreases of urethral resistance and detrusor contraction strength occurred, which largely cancelled each other out. These large changes masked the relatively modest urethral resistance decrease caused directly by prostate size reduction.