bluuebunny/crossref_metadata_2025_split huggingface dataset:
Experimental models of urinary bladder outlet obstruction
Authors: Levin Robert M. , Wein Alan J. 
Published: March 2007

AbstractUrinary bladder obstruction has been the subject of numerous clinical and experimental studies. The most common experimental model for outlet obstruction requires the surgical creation of a bladder outlet obstruction and then determining the effects after specific periods of time. These studies have demonstrated that the bladder responds to obstruction with rapid and significant changes in bladder structure and function. Although much important information comes from experimental surgical obstruction, this model is not appropriate for the study of the initial effects of outlet obstruction. The in‐vitro whole bladder model (rabbit) can be utilized to study the initial effects of outlet obstruction on the physical characteristics of bladder emptying. This model has the advantage of one being able to have complete control of the type and magnitude of obstruction.
Direct static measurement of obstruction
Authors: Regnier Claude H. 
Published: March 2007

AbstractThe measurement of related values of pressure and cross‐sectional area along the urethra provides, on theoretical grounds, the means to detect local areas of obstruction. A probe was developed to make such measurements and was used in a preliminary study on tubes of known mechanical properties; it enabled the differentiation of elastic from nonelastic tubes, based on values of the “hydrostatic compliance.” The results obtained are discussed and compared to alternative techniques used for the measurement of urethral compliance that have been developed for and applied clinically on females.
Effect of varying size of urethral catheters upon flow and resistance measurements
Authors: Reid R. E. , Chandrasekar D. , Pugach R. , Laor E. , Tolia B. M. , Freed S. Z. 
Published: March 2007

AbstractThe effect of urethral catheters upon voiding parameters has been studied in eight patients. Each patient was studied sequentially with catheter sizes 3 1/2, 5, 8, and 10 F. Catheter free flow measurements are done before and after instrumentation. No significant changes were seen with varying catheter sizes if there was no clinical obstruction (two patients). In six patients with bladder outlet obstruction, flow diminished and resistance measurements increased with increasingly larger catheters.
Videourodynamics and differential pressures in the evaluation of infravesical obstruction
Authors: Lockhart J. L. , Weinstein D. A. , Hamady G. 
Published: March 2007

AbstractTwenty‐five patients were investigated for infravesical obstruction using videourodynamics and a modified differential pressure technique. Clinical symptoms correlated 86%, 71%, and 56% with urethral resistance, differential pressures, and fluoroscopy, respectively. We believe that differential bladder‐posterior urethral pressure (Pves‐Pura) recorded in erect position and with a fixed catheter is a valuable technique to investigate males suspected to have bladder neck‐prostatic obstruction.
Endourodynamics: Another valuable dimension in clinical urodynamics
Authors: Loughlin Kevin R. , Yalla Subbarao V. 
Published: March 2007

AbstractUsing a custom‐made (10.5‐F) fiberoptic endoscope, we have carried out endoscopy‐aided urodynamic studies in several male and female patients. Our preliminary observations in more than 25 subjects have suggested that additional endoscopic observations during urodynamic studies can help in determining the accuracy of the urethral locations, especially the bladder neck and prostatic urethra, where pressures are being monitored during voiding. Fluid bridge tests, micturitional total urethral pressure determinations without yaw, and voiding cystourethroscopy can be performed with this clinical investigational tool. Although we understand its usefulness, we have also described its limitations.
Management of striated sphincter dyssynergia
Authors: Madersbacher H. 
Published: March 2007

AbstractTherapy of striated sphincter dyssynergia becomes mandatory as soon as the increase of outflow‐resistance causes high detrusor voiding pressure, noncompensated bladder emptying, vesico‐uretero‐renal reflux, or reflux into the male adnexa. Pharmacotherapy of striated sphincter dyssynergia so far is disappointing, the local approach for relieving sphincter spasticity by neurectomy of the pudendal nerve was abandoned at least in men because of an over 50% rate of erectile impotence. The concept of a “reversible sphincterotomy” is fascinating but not yet ready for clinical use. Nowadays, two methods are common for managing striated sphincter dyssynergia: intermittent catheterization (IC) and transurethral sphincterotomy. IC is the method of choice if a poorly sustained and lowpressure detrusor is present and if the patient stays dry in between, with or without anticholinergic medication. Otherwise, transurethral sphincterotomy by means of an anteromedian incision is the alternative. Both methods are not ideal and have definite disadvantages: IC needs instrumentation; sphincterotomy is destructive. Therefore, especially in females, a trial to empty the bladder by anal stretch is advisable and should be undertaken before other therapeutic measures are considered. A new way to achieve compensated bladder emptying is the implantation of an anterior sacral root stimulator, which also provides continence, if the relevant posterior sacral roots are out. The results so far are excellent, but further observation is necessary to prove its long‐term effects.The optimal therapy for clinically relevant striated sphincter dyssynergia can only chosen on the basis of a careful workup and with regards to the patient's personal and social situation.
Clinical characteristics of Pseudo‐dyssynergia
Authors: Siroky Mike B. 
Published: March 2007

AbstractPseudo‐dyssynergia is distinguished from true vesico‐sphincter dyssynergia by the voluntary, as opposed to reflex, nature of the sphincteric contraction. Pseudo‐ dyssynergia (PSD) occurs clinically in association with functional voiding disorders, neurologic disorders and local disorders of the bladder. The diagnosis of PSD depends on the demonstration that dyssynergic contractions of the pelvic floor occur during micturition and that these contractions can be voluntarily suppressed by the patient. Treatment of PSD is based on a combination of pharmacologic, psychologic and educative techniques which are individually discussed.
Voiding patterns and urinary control after repair of giant vesicovaginal and vesicourethrovaginal fistulas and neourethral construction
Authors: Bissada Nabil K. , Morcos Rafik R. 
Published: March 2007

AbstractTwenty‐six patients, 10 with giant vesicovaginal fistulas and 16 with vesicourethrovaginal fistulas, who underwent fistula repair (12) or fistula repair and neourethral construction (14) were evaluated 1 to 6 months postoperatively for adequacy of their urinary storage and evacuation.The ten patients with giant vesicovaginal fistulas and two patients with giant vesicourethrovaginal fistulas, in whom the urethral involvement was minimal, were managed solely by repair of their fistulas. Eleven of these 12 patients (92%) are continent and one has mild stress urinary incontinence. Of the 11 continent patients, nine have normal voiding and two void by straining. Five patients with extensive urethral involvement were managed initially by fistula repair that did not alleviate their incontinence. Fourteen patients with vesicourethrovaginal fistula and extensive urethral involvement were managed by simultaneous or nonsimultaneous fistula repair and neourethral construction. Ten of these patients (71 %) became continent. Continence rate was better in those who had no suprapublic operations prior to neourethral construction. In spite of attainment of continence in the majority of these patients, those with extensive urethral involvement did not regain normal evacuation function.
Bladder neck obstruction in women
Authors: Diokno Ananias C. 
Published: March 2007

AbstractBladder neck obstruction in women is uncommon. It should be suspected in patients with chronic symptoms of obstruction and irritation, and with signs including bladder trabeculation, diverticula, and vesicoureteric reflux. Accurate diagnosis can be established using the simultaneous pressure‐flow fluoroscopy study. A specific surgical approach to correct the bladder neck obstruction may be justified with proper urodynamic documentation.
Sacral stimulation for neurogenic bladder outlet obstruction
Authors: Talalla Andrew , Bloom Joseph W. 
Published: March 2007

AbstractThere are four anatomical sites at which functional electrical stimulation may be applied to the sacral neural outflow to achieve voiding of urine in patients with neurogenic bladder dysfunction: the micturition centres of the conus medullaris; the sacral anterior nerve roots; the mixed sacral nerves in their intraspinal, extradural course; and the pelvic nerves. This paper reviews the surgical and physiological advantages and disadvantages of each of these stimulation sites.
Detrusor inhibition induced by stimulation of pudendal nerve afferents
Authors: Vodusek David B. , Light J. Keith , Libby James M. 
Published: March 2007

AbstractA critical analysis of therapeutic vesicoinhibitory electrical stimulation is presented based on a study of ten patients with suprasacral spinal cord lesions and detrusor hyperreflexia. The detrusor contraction was either completely abolished, or the threshold of the contraction significantly increased, with electrical stimulation delivered to the dorsal nerves of penis (or clitoris) via surface electrodes. A current strength of 0.09 to 3.5 times the bulbocavernosus reflex threshold was used.
Treatment of micturitional disorders in the Shy‐Drager syndrome with oxybutynin chloride and self intermittent catheterization
Authors: Politi P. , Sandri S. D. , Marino V. , Fanciullacci F. , Catanzaro F. , Zanollo A. 
Published: March 2007

AbstractPatients with Shy‐Drager syndrome complain of frequency, urgency, and urge incontinence associated with urinary retention. We report our experience with three cases. Urodynamic evaluation showed detrusor hyperreflexia with low amplitude detrusor contractions. Symptoms have been well controlled by means of oxybutynin chloride and intermittent self catheterization.
Effect of opiate dependence on erectile function in primates
Authors: Levin Robert M. , Strong George , Brenman Henry , Hayes Lynn , Memberg William , O'Brien C. P. , Ternes Joe W. , Wein Alan 
Published: March 2007

AbstractThirteen nonhuman primates (Macaca mulatta and Madada fascicularis) were placed and maintained on opiates (six on morphine, seven on hydromorphone). Eight nondependent opiate naive primates were used as controls. Noninvasive transrectal electronic stimulation using a Biosonics MEGSRegistered trademark and devices by Biosonics, Inc. Philadelphia, Patents pending.
unit was employed to produce erection in all primates. This device has been previously demonstrated to produce consistant, full erections in the species of monkeys employed in these studies. The opiate‐dependent monkeys were tested both after being maintained on the opiates for 150 days, and following a 30‐day washout period (opiate free).The results clearly demonstrate that opiate dependence did not alter the erectile response to rectal stimulation, thus the dependence did not negatively affect the neural or cardiovascular components of the erectile system. Analysis of the results demonstrated although there were no difference between species, there was a significant acquisition effect for the transrectal stimulation procedure.
The effect of tonic immobility on urethral pressure and vesical capacity
Authors: Germain L. , Galeano C. , Elhilali M. M. 
Published: March 2007

AbstractTonic immobility (TI) is a behavioral response to a sudden constraint and inversion in the rabbit. TI is characterized by a long‐lasting immobilization, abolition of righting reflex, leg tremors, and waxy flexibility of the extremities. However, during TI autonomic functions do not seem significantly altered. We have used TI as a method to obviate the effect of anesthesia when recording urodynamic parameters during filling of the bladder. Our results suggest that, indeed, autonomic functions related to the filling phase of the micturition cycle are not altered by TI.
An integrated software package for urodynamic research and clinical applications
Authors: Saini Vasant D. , Thiede Henry A. 
Published: March 2007

AbstractA software package running on popular microcomputers (such as the IBM‐PC) has been developed to support computerized urodynamics studies. It lends itself to research as well as to clinical applications. Specifically, it provides: (1) recording and storage of urodynamics and EMG waveforms directly from the instrumentation into a microcomputer; (2) archiving and cataloging of these waveforms along with episodes and events; (3) display and analysis of raw and processed waveforms and data by means of an interactive graphics system; and (4) relational data base management for entry, management, storage, statistical analysis, and report generation of clinical data and other information along with urodynamic results. These four software modules are fully integrated, ie, results produced by one module can be automatically incorporated into others. Specifically, the relational data base manager organizes urodynamic results as well as a wide variety of other clinical information into a single integrated data base for purposes such as query, report generation, and statistical analysis. This package has been found to greatly simplify the handling and processing of the voluminous data typically generated in urodynamics work‐ups, as well as provide for clinical and research‐oriented analysis and report generation in a flexible and accurate manner.
Detrusor properties related to prostatism
Authors: Coolsaet Bo , Blok Cees 
Published: March 2007

AbstractUrodynamic testing of 211 patients with prostatism symptoms showed that symptoms were related to detrusor instability, low detrusor strength, or low detrusor speed in the absence of obstruction in 72 patients and in combination with outlet obstruction in 139 patients. Detrusor instability is not related to the degree of outlet obstruction; detrusor strength does not increase with increasing outlet resistance; and detrusor speed is decreased in the obstructed group. BPH, as an obstructive entity, is overdiagnosed.
Intrinsic neuromuscular defects in the neurogenic bladder. VI. Myofiber ultrastructure in the somatically denervated male feline rhabdosphincter
Authors: Elbadawi Ahmad , Atta Mohamed A. 
Published: March 2007

AbstractOrdinary somatic striated muscle with purely somatomotor innervation undergoes atrophy with fibrosis when completely denervated. On this basis, it has been suggested that vesical outlet “obstruction” in voiding dysfunction resulting from lower‐motor neural lesions is due to fibrosis of a denervated rhabdosphincter. We have shown previously that: (1) this sphincter has natural triple somatomotor/autonomic, cholinergic/autonomic adrenergic innervation of its myofibers; and (2) following its somatomotor denervation by bilateral sacral ventral rhizotomy, its myofibers lose somatomotor innervation and eventually acquires a purely autonomic innervation that includes autonomic re‐innervation of their sole plates. The present study was conducted in 16 adult male cats to define the structural changes in myofibers of the somatically denervated rhabdosphincter. Samples of the sphincter, obtained 1, 2, 4, 6, and 10 weeks after bilaterial sacral ventral rhizotomy, were processed and studied by electron microscopy. In all samples, there was a combination of ultrastructurally normal, degenerative, and regenerative myofiber profiles. Degenerative profiles were most frequent in the 1‐week, and regenerative profiles in the 6–10 weeks samples. No atrophic myofibers or interstitial fibrosis were observed in any sample. It is concluded that the somatically denervated male feline rhabdosphincter, unlike ordinary somatic striated muscle, maintains its structural integrity through myofiber regeneration and by not undergoing fibrosis. The somatically denervated rhabdosphincter, with its eventual purely autonomic re‐innervation, therefore, can play an important role in lowermotor neurogenic dysfunctions that needs further investigation.
Urodynamic action of clonidine in the chronic spinal cat
Authors: Galeano César , Jubelin Bruno , Carmel Michel , Ghazal Georges 
Published: March 2007

AbstractSpinalization produces a central micturition dysreflexia characterized by weak vesical contraction reflexes and by an exaggerated urethro‐urethral contraction reflex, causing the peripheral syndromes of underactive detrusor and detrusor‐sphincter dys‐synergia. We explored the action of catecholaminergic drugs of central action on these micturitional dysfunctions.Twenty‐four male cats were spinalized by transection of the spinal cord at C5–C6 level and studied 1–18 weeks later. Cystosphincterograms were performed without using anesthetic drugs. Pves, Pura, the EMG of the external sphincter, the EMG of the extensor hindleg muscles, and urine emission were studied. The responses of the spinal vesicovesical contraction, urethro‐vesical contraction, and urethro‐urethral contraction reflexes were explored. Clonidine (0.02–0.06 mg/kg intravenously [IV], intraperitoneally [IP], or per os), phentolamine (0.7–1 mg/kg, IV), and yohimbine (0.4–1 mg/kg, IV) were administered.Clonidine, at doses of 0.02 mg/kg, IV or IP, or higher, produced the following effects: (1) it significantly increased the intensity and duration of Pves waves; (2) it inhibited the spasms of the external sphincter; (3) it induced voiding; (4) it reduced spasticity; (5) it reinforced the vesico‐vesical contraction reflex; (6) it antagonized the exaggeration of the urethro‐urethral contraction reflex; (7) it corrected totally or partially the underactive detrusor and detrusor‐sphincter dys‐synergia. Taken orally (0.02–0.03 mg/kg) the urodynamic effect of clonidine was not significant; higher doses produced vomiting and other adverse effects. The action of clonidine was blocked by yohimbine but not by phentolamine.These results suggest that the absence of the descending noradrenergic pathways plays a role in the physiopathology of neurogenic bladder dysfunctions in chronic spinalized cats.
Changes in ureteral peristaltic activity induced by various stimuli
Authors: Theobald Robert J. 
Published: March 2007

AbstractThe interaction between the urinary bladder, the kidneys, and ureters is an area of interest to many investigators. Several investigators have suggested the existence of a feedback control system which would regulate urine production by the kidney and urine transport by the upper tract system. In certain conditions, such as urinary bladder outlet obstruction, this system would adjust the production and flow of urine as the situation dictates. The present study was designed to investigate the effects of changes in detrusor pressure, electrical stimulation of the pelvic nerves and the hypogastric nerves, and drugs on ureteral peristaltic activity and on renal nerve electricial activity. Cats anesthetized with alpha chloralose were monitored for changes in ureteral peristaltic frequency or spontaneous firing in renal nerves during changes in detrusor pressure, pelvic and hypogastric nerve stimulation, or drug administration.Increases in detrusor pressure decreased ureteral activity, while pelvic nerve and hypogastric nerve stimulation had little effect on renal nerve firing or ureteral peristaltic activity. Attempts were made to elicit changes in ureteral activity by the administration of acetylcholine, adenosine, adenosine nucleotides, and substance P. Acetylcholine increased and the purines decreased ureteral peristaltic frequency. Atropine and theopylline were used to antagonize the effects of drugs on ureteral peristaltic frequency. Theophylline antagonized only the adenosine responses.This study indicates that there is some interaction between the organs of the cat urinary tract. The results suggest the existence of a vesicoureteral reflex. However, the actual neural pathway for this reflex is still unproven. In addition, the evidence indicates the involvement of purines as neurotransmitters or neuromodulators in this reflex.
Adrenergic influences on the voiding cycle in the decerebrated dog
Authors: Nishizawa Osamu , Fukuda Takashi , Matsuzaki Akira , Moriya Itaru , Satoh Sadamoto , Tsuchida Seigi 
Published: March 2007

AbstractAdrenergic influences on the voiding cycle were clarified by the modern urodynamic technique of pressure flow electromyogram study in 20 decerebrated dogs. A series of experiments were performed before and after hypogastric nerve transection. Similar experiments were done before and after pharmacologic blockade of α‐ and β‐adrenergic receptors. In the control condition, reflex micturition occurred when a critical degree of filling was reached. After hypogastric nerve transection or administration of phentolamine or propranolol, reflex micturition still occurred. However, hypogastric nerve transection, phentolamine, and propranolot produced significant changes in the values of some urodynamic parameters. It appears that adrenergic function plays a definite role in the voiding cycle of the decerebrated dog by regulation of bladder and ureihral smooth muscle activity.
Glycosaminoglycans on the surface of the human urothelium: A preliminary report
Authors: Holm‐Bentzen Merete , Ammitzbøll Thorkil , Hald Tage 
Published: March 2007

AbstractGlycosaminoglycans (GAGs) are thought to be present in the mucous surface coat of the human urinary bladder and to play a role in the environmental adaptation of the bladder urothelium. A defective mucous surface coat might be involved in the pathogenesis of painful bladder disease (interstitial cystitis) of unknown etiology. By a new cystoscopic scraping method for obtaining the mucous surface coat of the bladder, we investigated four painful bladder patients and three controls (prostatic hypertrophy). Electrophoretic analysis of the surface coat revealed differences in the biochemical GAG‐composition of the surface coat between patients and controls. This preliminary study suggests the existence of GAGs in the mucous surface coat of the bladder and suggests that qualitative differences in the GAG composition might play a role in painful bladder disease.
Evoked potential of the sacral arc reflex: Technical aspects
Authors: Hassouna Magdy , Lebel Michel , Abdel‐Rahman M. , Elhilali Mostafa 
Published: March 2007

AbstractThe evoked potential of the sacral arc is becoming an important tool in testing the integrity of the sacral arc reflex in various neurologic conditions. We compared several known techniques on 40 patients with normal and diseased spinal cords. The somatic and autonomic components should be tested in each patient, particularly those with peripheral neuropathies. We present some considerations in the procedure of testing that may be of help in detecting subtle neurologic deficits of the sacral arc.
Sympathetic contribution to bladder outlet obstructions: Quantitative analysis of tissue catecholamine content
Authors: Park Young‐Chol , Sugiyama Takahide , Kaneko Shigeo , Kurita Takashi 
Published: March 2007

AbstractThe concentration of noradrenalin in bladder neck and prostate tissue was studied in normal subjects and in patients with bladder neck dysfunction and benign prostatic hypertrophy. The concentration in the bladder neck tissue was high in normal subjects (619.3 ng/g), moderate in patients with bladder neck dysfunction (360.7 ng/g), and low in patients with benign prostatic hypertrophy (75.4 ng/g). The values were statistically different from each other. The sympathetic innervation of the bladder neck is suggested to be diminished in the patients with bladder outlet obstructions compared to normal subjects.