bluuebunny/crossref_metadata_2025_split huggingface dataset:
Age‐related changes in the response of the rat urinary bladder to neurotransmitters
Authors: Saito Masahiko , Kondo Atsuo , Gotoh Momokazu , Kato Kumiko , Levin Robert M. 
Published: March 2007

AbstractThe effect of age on the contractile response of the rat urinary bladder to various neurotransmitters was studied using in vitro detrusor strips isolated from female Wistar rats. The contractile responses to 8 neurotransmitters were determined for rat urinary bladders isolated from 3 age groups: 24, 16, and 6 months old. The results can be summarized as follows: 1) There was no age‐dependent change in the maximum response to KCl. 2) The contractile response to norepinephrine, adenosine 5′‐triphosphate (ATP), and serotonin increased with age. 3) The relaxation response to isoproterenol was significantly less in 24‐month‐old rats than in the other 2 age groups. 4) There were no age related changes in the responses to acetylcholine, prostaglandin F2 alpha, and angiotensin II. 5) Vasoactive intestinal polypeptide (VIP) failed to induce any response in the rat bladders of any group. 6) There were no significant differences in the ED50s for the 5 neurotransmitters among the 3 age groups. In summary, significant differences in the response to adrenergic, purinergic, and serotonergic stimulation were found as a function of age, whereas no age related changes in the response to cholinergic or generalized depolarization with KCl were found.
Effects of apomorphine and L‐dopa on the parkinsonian bladder
Authors: Aranda Bernard , Cramer Philippe 
Published: March 2007

AbstractNeurogenic bladder frequently occurs in Parkinson's disease. Detrusor hyperreflexia is a consequence of nigrostriatal dopamine depletion, whereas the cause of hyporeflexia remains unclear. We compared the results of cystometry and urethral profilometry with and without apomorphine (and L dopa) in 12 idiopathic parkinsonians with urinary disorders free of dopaminergic treatment. Whereas hyperreflexic patients improved with apomorphine, and to a lesser extent with L dopa, these drugs had no effect on hyporeflexic patients. These results confirm the role of dopaminergic lesions in the occurrence of bladder hyperreflexia and the possible implication of nondopaminergic lesions in the occurrence of hyporeflexia.
Urodynamic biofeedback training for children with bladder‐sphincter dyscoordination during voiding
Authors: Kjølseth Dorthe , Knudsen Lis Mønster , Madsen Bodil , Nørgaard Jens Peter , Djurhuus Jens Christian 
Published: March 2007

AbstractNeurologically normal children with recurrent urinary tract infections (UTIs), night‐ and daytime wetting, and urge and painful voiding may have staccato voiding due to pelvic floor contractions.The immediate effect of non‐invasive urodynamic biofeedback (BF) therapy was assessed using a historical follow‐up study in 31 children aged 5–15 years suffering from urodynamically proven overactive urethra during voiding. A long‐term follow‐up study was performed to investigate whether improvement was maintained.Twenty‐four children (77.5%) benefited from the treatment. Of these 16 (51.5%) were cured, while 8 (26%) had a pronounced reduction in their symptoms. Although the flow was normalized in 17 (55%) and nearly normalized in 7 (22.5%), there was no significant correlation between subjective and objective criteria of improvement. Similarly, no relationship was found between the initial urodynamic characteristics and the treatment outcome.During a mean follow‐up time of 4 years (range: 1–7.5 years) two of the initially cured patients relapsed. They were recured with a refresher course. Three had had a single or a few episodes of cystitis in the course of several years. Of the patients with pronounced reduction in their symptoms, three relapsed. A refresher course was attempted in two patients; one was successful.It can thus be concluded that BF is an effective way of treating this disturbance and the beneficial effect is to a wide degree maintained.
Dimensions of urine loss among older women with genuine stress incontinence
Authors: Nochajski Thomas H. , Burns Patricia A. , Pranikoff Kevin , Dittmar Sharon S. 
Published: March 2007

AbstractThe specific maneuvers that cause women to be incontinent can become important diagnostic aids and major factors in differentiating the effectiveness of the current pharmacological, surgical, and behavioral treatments for urinary incontinence. The purpose of this study was to evaluate whether meaningful dimensions could be identified within the multiple movements that produce urine loss in stress‐incontinent women. The Stress Incontinence Questionnaire (SIQ) was constructed from items derived from a compilation of studies and reports of urinary incontinence experts. An exploratory factor analysis using maximum likelihood method of extraction and a varimax rotation procedure identified four dimensions: active maneuvers, passive maneuvers, planned maneuvers, and unplanned maneuvers. The alpha coefficients for the four identified factors were acceptable and ranged from 0.71 to 0.79, with 8‐week test‐retest correlations for the active (r =.87), passive (r =.87), planned (r =.85), and the unplanned maneuvers (r =.60) all highly significant. The four factors also showed differential patterns of relationships with various gynecologic and urologic measures. These latter findings suggest that the factors identified in this study may be acknowledging different types or components of stress incontinence. In either case, the findings may have implications for treatment approaches to stress incontinence. Further research is needed to substantiate the various components of stress incontinence found in this study and the implications these findings may have for treatment of incontinence.
Inhibiting the hyperreflexic bladder with electrical stimulation in a spinal animal model
Authors: Walter James S. , Wheeler John S. , Robinson Charles J. , Wurster Robert D. 
Published: March 2007

AbstractUninhibited bladder contractions are a problem in spinal cord injured patients. Accordingly, methods using electrical stimulation to inhibit the bladder were investigated in chronic spinal cord injured (C6‐T1) male cats. In unanesthetized, restrained animals, spontaneous bladder contractions were observed after the bladder was filled above the micturition threshold. In 3 of the 5 cats studied, this bladder activity could be inhibited with stimulation of either sacral nerves or pudendal nerves. Pudendal nerve stimulation, however, was more selective than sacral nerve stimulation for inhibition with fewer side effects such as leg spasms. Tibial nerve stimulation was ineffective and caused leg spasms and increased bladder activity. Finally, high‐frequency stimulation (1,000 Hz) of the sacral nerves was shown to block bladder contractions in 2 of 3 cats investigated. However, this method had adverse side effects such as leg flexion and secondary bladder contractions. We conclude that pudendal nerve/pelvic floor stimulation at low frequency is a relatively effective method in this model.
A critical comparison of methods proposed for quantification of bladder outlet obstruction
Authors: Kranse Ries , van Mastrigt Ron 
Published: March 2007

AbstractPerformance studies of parameters for bladder outlet obstruction in BPH patients before and after a TURP in terms of sensitivity and specificity can easily be criticized because in roughly 25% of the patients it is not clear if the clinical symptoms are related to increased outlet obstruction or impaired bladder contractility. This abstract presents objective alternatives.
Learning procedure in a neural control model for the urinary bladder
Authors: Bastiaanssen Erica H. C. , Vanderschoot Jan , van Leeuwen Johan L. 
Published: March 2007

AbstractA continuous neural network coupled to a dynamical model of the urinary bladder is defined. The neural network is trained to control the bladder model to track a prescribed volume fluctuation, by adjusting weights and time constants. The gradients of the error in the output neurons of the neural network are unknown. Therefore, the learning procedure discussed here minimizes the error functional without using gradient descent.
Effect of transurethral resection of the prostate on detrusor instability and urge incontinence in elderly males
Authors: Gormley E. A. , Griffiths D. J. , McCracken P. N. , Harrison G. M. , McPhee M. S. 
Published: March 2007

AbstractDetrusor instability is common in men with evidence of outflow obstruction due to benign prostatic hypertrophy and typically reverses in about two thirds of patients after transurethral resection of the prostate (TURP). It is also common among the elderly without outflow obstruction and may lead to urge incontinence. To determine whether TURP has an effect on detrusor instability and urge incontinence in elderly men, or whether these abnormalities are due to other age‐associated changes, 12 males (mean age 80 years) with urge incontinence or frequency and urgency of micturition, and symptomatic benign prostatic hypertrophy, were studied by 24‐hour monitoring of incontinence and videourodynamic examination, before and after TURP; 7/12 patients were significantly cognitively impaired.Preoperatively, all patients showed detrusor instability, which reversed postoperatively in only one patient, a significantly smaller proportion than that consistently reported in younger patients. Preoperatively, 11/12 patients were incontinent. After TURP, 8/11 patients had an improvement in the amount of incontinence, by up to 458 g in 24 hours. Those who improved had been urodynamically more severely obstructed preoperatively. Those with the most improvement were also cognitively impaired.We conclude that, in the geriatric population, detrusor instability and urge incontinence may be the result of age‐associated changes and not secondary to obstruction. Detrusor instability is likely to persist following TURP. Preoperative urodynamic assessment of obstruction in the incontinent male with benign prostatic hypertrophy may be useful since the severity of incontinence responds well to TURP if there is marked obstruction. Cognitive impairment should not be a deterrent to operation.
Neurophysiological evaluation in detrusor instability
Authors: Del Carro U. , Riva D. , Comi G. C. , Locatelli T. , Magnani G. , Levati N. , Viganó R. , Sambruni I. , Canal N. 
Published: March 2007

AbstractDifferent and complex neuronal systems are involved in the control of continence. Detrusor overactivity has been divided by the International Continence Society into two functional subgroups: a) detrusor instability and b) detrusor hypereflexia. Only in the latter group has neurological damage been shown, but pathophysiological mechanisms are still unknown. In order to complete a full investigation of sensory and motor pathways 12 female patients affected by idiopathic detrusor instability (mean age 60.2 years; range 49–73) and 13 age‐matched healthy women were studied. All patients were submitted to a subtracted cistometrogram (CMG), anal sphincter electromyography (EMG) with a bipolar coaxial needle, sacral reflex analysis after stimulation of the dorsal nerve of the clitoris, tibial and pudendal somatosensory evoked potentials, motor evoked potentials after magnetic cortical coil stimulation, and recording from anal sphincter and abductor brevis hallucis muscles. All patients had normal neurophysiological tests, and no significant differences between patients and controls could be seen. Our data confirms the absence of both clinical and subclinical damage of central sensory or motor pathways in detrusor instability; an alteration of suprasegmental mechanisms cannot be excluded.
New concepts in relation to urge and detrusor activity
Authors: Coolsaet Bo L. R. A. , Van Duyl Wim A. , Van Os‐Bossagh Pooran , De Bakker Hans V. 
Published: March 2007

AbstractInvestigations of micromotion characteristics of bladder wall strips and pressure wave phenomena in total bladders in vitro and in vivo indicate that micromotion phenomena occur in the bladder wall. Local contractions can occur without an increase in tension or pressure, because other parts are in antiphase. Local contractions stretch surrounding tissues, which can stimulate fast stretch receptors. Synchronisation of these micromotion phenomena appears to be possible. Hence, above threshold levels urge can theoretically occur, even in the absence of a pressure increase. This hypothesis could explain the weak relation between urge and pressure. The distinction between motor and sensory urge could be artifactual based on a misunderstanding of fundamental bladder wall processes.
Effect of partial urinary outlet obstruction in the rabbit on the incorporation of adenine into adenine nucleotides in bladder smooth muscle
Authors: Haugaard Niels , McKenna Beth A. W. , Wein Alan J. , Levin Robert M. 
Published: March 2007

AbstractBladder outlet obstruction induces marked morphological, functional, and metabolic changes within the urinary bladder. Recent studies indicate that there is a close correlation between the contractile dysfunction induced by partial outlet obstruction and a marked decrease in mitochondrial oxidative activity of the hypertrophied bladder tissue. The current study investigates the effect of partial outlet obstruction on adenine metabolism within the bladder tissue.After transport into the cell, adenine becomes available as a substrate for adenine phosphoribosyl transferase (APRT), the enzyme that catalyses the non‐mitochondrial conversion of adenine into AMP. Subsequently, AMP is phosphorylated to ADP, the phosphate acceptor in mitochondrial oxidative phosphorylation.The results of these studies demonstrate that partial outlet obstruction induces a significant increase in 14C‐adenine uptake into the urinary bladder smooth muscle which in turn provides substrate for APRT and results in an increase in 14C‐AMP synthesis. In contrast, the rate of incorporation of adenine into ATP + ADP was similar for both control and obstructed tissue. The activity of APRT was not significantly different in control and obstructed tissue.
Sacral anterior root stimulation: Prerequisites and indications
Authors: Madersbacher H. , Fischer J. 
Published: March 2007

AbstractAn intact sacral reflex arc, or at least an intact second motor‐neuron and a detrusor being able to contract, are the two prerequisites for implanting an anterior sacral root stimulator. Transrectal electrostimulation or direct needle stimulation of the sacral roots may reveal if patients despite absent or only weak detrusor contractions on routine investigation are suitable. Patients with a complete midthoracic paraplegia are the ideal candidates, but tetraplegics also benefit. Patients with incomplete lesions and preserved pain sensations are suitable provided that they can undergo posterior sacral root rhizotomy. Non‐traumatic spinal cord lesions follow the same rules, provided that the type of lesion does not allow recovery and is not progressive. Myelomeningocele patients may be suitable provided that the pathoanatomy of the sacral roots permits the operation (may be possible only in thoracolumbar myelomeningocele). Vesico‐uretero‐renal reflux is no contraindication; it may even be a strong indication, if a low compliance bladder or high detrusor contractions are the main reasons for it. In most patients the procedure should or must be combined with posterior sacral root rhizotomy in order to normalize a low compliance, to abolish spontaneous reflex contractions, and to achieve continence. The benefit of following these rules is reflected in our own series of 30 patients. In all of them the operation has improved considerably the quality of life and no patient so far has regretted the operation.
Adjuvant drug therapy: A review of 30 cases of sacral anterior root stimulator
Authors: Isambert J. L. , Egon G. , Colombel P. 
Published: March 2007

AbstractImplantation of a sacral anterior root stimulator in spinal cord injured patients must achieve two main goals to maintain a vesicosphincteral balance: complete bladder voiding and correct continence.During the postoperative period, difficulties may arise or persist with either an incontinence due to an insufficient deafferentation with bladder hyperreflexia or an incomplete voiding because of an insufficient contraction of detrusor and/or too high urethral resistances (vesicosphincteral dyssynergia).A third of our patients required specific therapies after implantation to promote interstimulation continence and complete bladder voiding.Regarding continence, adjuvant therapies are effective for bladder hyperreflexia in connection with a too‐partial deafferentation. On the other hand, these therapies have little effect on low bladder compliance.In regard to bladder voiding, nonsurgical treatments are equally effective. These treatments (parasphincteral infiltrations, alpha‐blockers) must not be permanent, but allow a reharmonizing between expulsive strengths and urethral resistances.Eighty percent of our patients who required adjuvant therapies have been improved significantly. This confirms the efficiency of adjuvant therapy and speaks for patience.
L N S C3: A Proposed classification system for female urethral diverticula
Authors: Leach Gary E. , Sirls Larry T. , Ganabathi Kumaresan , Zimmern Philippe E. 
Published: March 2007

AbstractNo descriptive criteria for the preoperative classification of female urethral diverticula have been proposed. Consequently, alternative therapies and different treatment series are not easily compared. Since 1982 the authors have evaluated 61 women with urethral diverticula and have identified those preoperative factors critical to an organized surgical approach to urethral diverticula. From this experience, a simple, comprehensive classification system for female urethral diverticula is proposed. The classification system is called L/N/S/C3. Each letter of the system represents a different characteristic of urethral diverticula. L = Location, the site of the diverticulum, i.e., distal, mid, or proximal urethra, with or without extension beneath the bladder neck. N = Number, whether single or multiple diverticula are present. S = Size, expressed in centimeters (cm). C3 = Configuration, Communication, and Continence Configuration (C1) describes whether the diverticulum is single, multiloculated, or saddle shaped. Communication (C2) indicates the site of communication with the urethral lumen, i.e., distal, mid, or proximal urethra. Continence (C3) is the presence of genuine stress urinary incontinence.Adhering to this format provides the surgeon a systematic means of approaching a urethral diverticulum and thus may minimize postoperative complications. Finally, the authors encourage other surgeons reporting series of urethral diverticula to adopt this system so that standard terminology may allow accurate comparison of surgical results.
Magnetic stimulation of the sacral roots
Authors: Brodak Philip P. , Bidair Mohamed , Joseph Angela , Szollar Susan , Juma Saad 
Published: March 2007

AbstractMagnetic stimulation using an external surface coil induces an electrodynamic field that penetrates various tissues and stimulates peripheral nerves in a similar fashion to conventional electrical stimulation. An 83 mm magnetic surface coil was used to stimulate 11 spinal cord injury (SCI) patients, during which time detrusor activity and evoked potentials of the striated urinary sphincter motor pathways were evaluated. AH patients had urodynamic studies and conventional sacral evoked potentials prior to magnetic stimulation. The mean bladder capacity was 337 ml (range 109–590), mean leak point pressure was 50 cm H2O (range 10–80), and mean sacral reflex (afferent‐efferent) latency was 37.9 ms (range 25.1–49.3). Eight patients had detrusor‐sphincter dyssynergia. Magnetic stimulation over the sacral spine at different bladder volumes was performed. Detrusor and striated sphincter responses were recorded during stimulation. In all patients the technique was easy and the results were reproducible. The mean sacral motor pathway (efferent) latency was 27.9 ms (range 18.7–39.6). Using maximal stimulation, no detrusor response was recorded at bladder volumes <200 ml. However, a detrusor response was recorded in 7 patients (>10 cm H2O in 2, <10 cm H2O in 5) when the bladder volume was >200 ml. No complications were seen. Sacral evoked potential measurements assess the function and integrity of the sacral arc but it does not distinguish between afferent and efferent pathways. Magnetic stimulation is a safe and effective method to assess the integrity and function of the detrusor and striated sphincter motor (efferent) pathways. When combined with sacral evoked potential studies, the sensory (afferent) pathways can be evaluated indirectly. Independent assessment of the motor (efferent) and sensory (afferent) pathways of the sacral arc has significant implications in the understanding of the pathophysiology of the different types of neuropathic voiding dysfunction. The magnitude of the detrusor contraction induced by magnetic stimulation was too small to allow any conclusions. However, it appears that the detrusor threshold for stimulation increases with increased bladder volumes.
Effect of partial urethral obstruction on force development of the guinea pig bladder
Authors: Van Koeveringe Gommert A. , Mostwin Jacek L. , Mastrigt Ron Van , Van Koeveringe Bram J. 
Published: March 2007

AbstractWe created gradual partial urethral obstruction in 20 guinea pigs using silver jeweler's jump rings. After 4 or 8 weeks obstruction all animals underwent cystometry and were assigned to one of five urodynamic categories: normal, high pressure voiding, unstable, low compliance, or decompensated. After sacrifice, the contractile responses of bladder strips to electrical field stimulation of intramural nerves, direct electrical muscle stimulation, 0.1 mM carbachol, and high K + solution were sampled by computer for phase plot analysis. Following 8 weeks obstruction, the value of the phase plot parameter Fiso, indicative of the number of contractile muscle units, was reduced to 60% of the control response to nerve stimulation (P < 0.05) and to 77% of the control response to carbachol stimulation (P < 0.05). Parameter C, the slope of the phase plot (indicative of unit recruitment during force development), was unchanged for all forms of stimulation. Although in the latter case not statistically significant, obstruction affected responses to nerve and muscle stimulation similarly suggesting that muscle change may possibly be a common denominator of dysfunction. In view of the reduction in Fiso and the increase in bladder weight, instability may represent a more advanced form of dysfunction due to obstruction than high pressure voiding.