bluuebunny/crossref_metadata_2025_split huggingface dataset:
Lower urinary tract dysfunctions in patients with spinal cord tumors
Authors: Uchiyama Tomoyuki , Sakakibara Ryuji , Hattori Takamichi , Yamanishi Tomonori 
Published: December 2003

AbstractAimsThe objective of this study was to elucidate the incidence and pathophysiology of lower urinary tract dysfunctions (LUTS) in patients with spinal cord tumors.MethodsUrinary questionnaire and urodynamic studies were done in 76 patients with spinal cord tumors.ResultsThe patients included 56 with cervical‐thoracic (C1 to T11) and 20 with lumbosacral tumors. The lumbosacral tumors consisted of 12 epiconus/conus medullaris (below T11) and 8 cauda equina tumors. These tumors were further subdivided into intramedullary, intradural extramedullary, and dumbbell‐type. More than 83% of the patients had urinary symptoms. Patients with cervical‐thoracic tumors commonly had voiding symptoms (75%). Detrusor hyperreflexia (39%), and detrusor areflexia on voiding (21%) were the main urodynamic features. Patients with epiconus/conus medullaris tumors commonly had voiding symptoms as well (58%), but decreased urge to void (50%), detrusor‐sphincter dyssynergia (42%), and detrusor areflexia on voiding (32%) were the main features. Patients with cauda equina tumors commonly had storage symptoms (88%), of which sensory urgency was most common (63%). Severe LUTS occurred in the epiconus/conus medullaris tumors and in the intramedullary tumors. These dysfunctions tended to appear late and rarely appeared as the initial symptom in the course of the disease. There was no significant relationship between neurologic abnormalities and LUTS. Urodynamics showed that spinal cord tumors cause a variety of LUTS, depending on the location and the type of the tumor.ConclusionSpinal cord tumors are commonly accompanied by LUTS. Clinical and urodynamic evaluation is crucial to diagnosis and management since there is little relationship between symptoms and findings. Neurourol. Urodynam. 23:68–75, 2004. © 2003 Wiley‐Liss, Inc.
Acupuncture reflexotherapy in the treatment of sensory urgency that persists after transurethral resection of the prostate: A preliminary report
Authors: Ricci Luigi , Minardi Daniele , Romoli Marco , Galosi Andrea B. , Muzzonigro Giovanni 
Published: December 2003

AbstractAimsIn this study, we wanted to evaluate whether acupuncture reflexotherapy is able to treat the sensory irritative components of LUTS (lower urinary tract symptoms) that persist after transurethral resection of the prostate.MethodsWe have evaluated 42 patients, randomly selected into three groups: 14 patients received placebo, 15 patients received oxybutynin, and 13 patient were treated with electrostimulation by acupuncture reflexotherapy.ResultsBefore treatment, the mean maximum flow rate (Qmax) was 21.0 ± 3.2 mL/sec, the mean International Prostate Symptom Score (I‐PSS) score was 12.9 ± 4.2, the mean I‐PSS Quality of Life (IPSS QoL) score was 3.6 ± 1.2. At the first check‐up performed after 3 months, we could observe that the I‐PSS and QoL scores were 12.6 ± 4.3 and 3.8 ± 1.3 in the group who received placebo; the scores decreased to 11.1 ± 3.2 and to 3.1 ± 1.0, respectively, in the 15 patients treated with oxybutynin and decreased to 6.1 ± 2.6 and 1.3 ± 1.1, respectively, in the 13 patients who underwent acupuncture reflexotherapy. At 1‐year follow‐up, these parameters were practically similar. The voiding diaries allowed us to deduce that the average number of daytime voidings decreased by 8% in patients who received oxybutynin and decreased by 20% in 13 patients who underwent reflexotherapy; the average number of nocturnal micturitions decreased by approximately 20% and 60%, respectively, in patients who received oxybutynin and reflexotherapy.ConclusionsThis study has pointed out that acupuncture reflexotherapy has a real benefit in patients with sensory urgency that persists after transurethral resection of the prostate. Neurourol. Urodynam. 23:58–62, 2004. © 2003 Wiley‐Liss, Inc.
Theoretical analysis of the effects of viscous losses and abdominal straining on urinary outlet function
Authors: Mijailovich Srboljub M. , Sullivan Maryrose P. , Yalla Subbarao V. , Venegas Jose G. 
Published: December 2003

AbstractAims The aim of this study was to theoretically explore the relationship between the tube law (TL) of the urethra and the pressure–flow (p–Q) relationship during micturition. The understanding of this relation is important for the evaluation of outlet obstruction by urodynamic interpretation of p–Q plots.Methods We simulated the outlet function by a lumped theoretical model, and suggested how the TL can be used to quantitatively predict the p–Q relationship of the system. Our analysis considered the relation between the TL and the steady state p–Q plot for various TLs including the hysteresis of the pressure–area relationship.Results and ConclusionsThe inclusion of pressure losses distal to the flow controlling zone and experimentally measured p–A relations of the urethra in the model lead to the predictions that flow in the flow controlling zone is not always critical but is often in the sub‐critical range, that an increase in abdominal pressure can increase the flow under certain conditions, and that hysteresis in the pressure–area relation is correlated to the hysteresis in the p–Q plot. Neurourol. Urodynam. 23:76–85, 2004. Published 2003 Wiley‐Liss, Inc.
Observations on the function of the female urethra: II: Relation between maximum urethral closure pressure at rest and the degree of urethral incompetence
Authors: Schick Erik , Bertrand Pierre E. , Jolivet‐Tremblay Martine , Dupont Charles , Tessier Jocelyne 
Published: December 2003

AbstractAimsTo study the relation between maximum urethral closure pressure (MUCP) at rest and the degree of urethral incompetence in the female.Patients and MethodsTwo hundred fifty five patients aged 20 years or older, with stable bladders on multichannel urodynamics, without known neurological pathology, and with no previous history of pelvic or anti‐incontinence surgery were included in the study. Resting urethral pressure profile (UPP) and the grade of urethral incompetence was registered.ResultsMean age of the group was 45.6±12.7 years; mean MUCP was 62.7±28.5 cm of water. There was a statistically significant difference in the MUCP when the different grades of urethral incompetence were compared to each other, the higher grades being associated with a lower maximal closure pressure.ConclusionsThis study demonstrates that there is a highly significant relationship between MUCP and between all grades of urethral incompetence. This supports previous observations that MUCP decreases when abdominal leak point pressure (ALPP) is low and that this might be secondary to some mechanical failure in the pressure transmission from the abdominal cavity to the urethra. Studies should never compare continent to incontinent cohorts without considering their ALPP because in doing so they are comparing groups that are functionally heterogeneous. Neurourol. Urodynam. 23:16–21, 2004. © 2003 Wiley‐Liss, Inc.
Observations on the function of the female urethra: III: An overview with special reference to the relation between urethral hypermobility and urethral incompetence
Authors: Schick Erik , Jolivet‐Tremblay Martine , Tessier Jocelyne , Dupont Charles , Bertrand Pierre E. 
Published: December 2003

AbstractAimsTo analyze the relation between urethral hypermobility and urethral incompetence, and to summarize the interdependence between maximum urethral closure pressure (MUCP), urethral hypermobility, and urethral incompetence.Patients and MethodsA group of 255 patients was selected from a large bank of cases. Inclusion criteria were age 20 years or above, no neurological disease, stable bladder, and no previous incontinence surgery or hysterectomy. The degree of hypermobility (cysto‐urethrocele) and the degree of urethral incompetence (abdominal leak point pressure (ALPP)) were determined. Statistical analyses between urethral hypermobility and incompetence were performed with Spearman's correlation and the Jonckherre‐Terpstra test.ResultsThe Spearman's rank correlation test showed a statistically significant relation between urethral hypermobility and the degree of urethral incompetence (P = 0.0049).ConclusionsThe statistically significant relation between urethral incompetence and hypermobility suggests that urethral incompetence will increase as the degree of urethral hypermobility does. Optimal conditions for urinary continence include a high maximum urethral closure pressure, absence of hypermobility, and a low degree of urethral incompetence. This last factor is assured by a strong support underneath the urethra permitting compression of the latter during straining. Failure of the urethral closure mechanism is highly probable with a diminished maximum closure pressure accompanied by urethral hypermobility often associated with a high degree of urethral incompetence. Clinically significant urinary incontinence may appear in many intermediate circumstances between these two extreme states, but stress urinary incontinence is essentially an activity‐related phenomenon. Neurourol. Urodynam. 23:22–26, 2004. © 2003 Wiley‐Liss, Inc.
Primary nocturnal enuresis persistent to adulthood, functional evaluation
Authors: Wadie Bassem S. 
Published: December 2003

AbstractIntroduction and ObjectivesThe incidence of nocturnal enuresis (NE) in adults (over 18 years of age) ranges from 0.5 to 2% for most authors. NE is a multifactorial disease. Lack of circadian rhythm of antidiuretic hormone (ADH) is one of the commonly accepted causes, however, disorders affecting bladder function is another important pathophysiologic factor that has not been settled. The target of the present study is to define bladder function in adults having persistent NE.MethodsFifty two adult patients were included. Mean age was 23.6 ± 6.9 years. All of them had primary NE persistent to adulthood. No treatment was received within 2–7 days prior to the urodynamic examination. All of them had intact neuro‐urological examination. Filling (in all patients) and voiding cystometry (in 29 patients) were carried out, using 8 F urodynamic and 8 F rectal catheters. Pressure flow analysis was interpreted using Schafer's nomogram.ResultsOverall mean maximum cystometric capacity was 419.2 ± 142 ml, mean bladder compliance was 51.3 ± 39.7 ml/cmH2O. In males (n = 25), mean maximum cystometric capacity was 453 ± 173 ml and compliance was 56 ± 42 ml/cmH2O, while in females (n = 27), mean capacity was 388 ± 98 ml and compliance was 46.7 ± 36.7 ml/cmH2O. Twenty patients had detrusor instability (38.5%). Twelve out of 27 (44.4%) females had instability while only 8 out of 25 (32%) males had the same finding. Differences relevant to maximum bladder capacity and compliance between the patients with and without instability were significant (P < 0.0001). Mean detrusor opening pressure was 55.3 ± 25 cmH2O, mean detrusor pressure at maximum flow and maximum detrusor pressure, were 53.5 ± 21 and 78.9 ± 35 cmH2O respectively.ConclusionsUrodynamic studies in adults with persistent NE reveals a relatively high incidence of instability, normal capacity and compliance. The presence of instability was associated with smaller bladder and poorer compliance and with diurnal urgency. Voiding bladder function in adult enuretics was found to be normal. Neurourol. Urodynam. 23:54–57, 2004. © 2003 Wiley‐Liss, Inc.
The association between overactive bladder symptoms and objective parameters from bladder diary and filling cystometry
Authors: van Brummen H.J. , Heintz A.P.M. , Vaart C.H. van der 
Published: December 2003

AbstractAimsTo investigate the association between overactive bladder symptoms and objective parameters from the bladder diary and conventional filling cystometry.MethodsWe reviewed the records of the 95 consecutive patients presenting at our center for urodynamic investigation. These women were asked to self‐complete a questionnaire and a bladder diary for 48 hr. Urogenital symptoms and disease‐specific quality of life were assessed with standardized questionnaire, namely the Dutch version of the Urogenital Distress Inventory (UDI) and the Incontinence Impact Questionnaire (IIQ).ResultsThe frequency symptom as well as the urge incontinence symptom is significantly associated with the presence of detrusor overactivity. In univariate analysis both frequency and urgency symptoms are associated with lower micturition and bladder sensation volumes. In multivariate (ANOVA) analysis, the frequency symptom is associated with a higher 24‐hr frequency, lower maximum volume voided, and mean volume voided per micturition on the bladder diary. It is also associated with lower sensation volumes on the filling cystometry.ConclusionsOf the four symptoms that are currently considered to be part of the overactive bladder syndrome, the frequency symptom is the best associated with objective parameters from the bladder diary, filling cystometry, and with the occurrence of detrusor overactivity. Therefore, we would like to suggest that reporting subjective symptoms frequency is obligatory for considering one to have an overactive bladder. Neurourol. Urodynam. 23:38–42, 2004. © 2003 Wiley‐Liss, Inc.
Measuring the severity of stress urinary incontinence using the Incontinence Impact Questionnaire
Authors: Handa Victoria L. , Massof Robert W. 
Published: December 2003

AbstractAimsQuestionnaires, including the Incontinence Impact Questionnaire (IIQ), have been used to assess the severity of urinary incontinence in clinical trials. However, the summed score derived from the IIQ does not have any inherent clinical meaning. Also, a summed score does not have interval properties, complicating the interpretation of changes in severity. The purpose of this study is to test the hypothesis that incontinence‐related disability is a measurable variable and that the IIQ can measure that variable accurately.MethodsWe used Rasch analysis, a logistic regression technique, to estimate an interval scale of incontinence severity. Rasch analysis is based on the mathematical assumption that each subject's response to any given item is a function of (a) the individual's inherent level of disability and (b) the inherent difficulty of that item.ResultsTwenty‐seven women with urodynamic stress urinary incontinence (USUI) completed the IIQ. Using Rasch analysis, we found that women with USUI had the most difficulty engaging in “physical recreational activities” and the least difficulty participating in “relationship with family.” We also assessed the ability of the IIQ to discriminate between individuals with respect to disease severity. We found that most of the items in the IIQ are useful for discriminating incontinence severity among women with mild or moderate incontinence, but very few IIQ items distinguish among women with severe incontinence.ConclusionsOur results have important implications for clinical trials using the IIQ: among women treated for severe incontinence, the standard IIQ summed score will underestimate the magnitude of any change in incontinence severity. Neurourol. Urodynam. 23:27–32, 2004. © 2003 Wiley‐Liss, Inc.
Surgical complications and medium‐term outcome results of tension‐free vaginal tape: A prospective study of 313 consecutive patients
Authors: Levin Ishai , Groutz Asnat , Gold Ronen , Pauzner David , Lessing Joseph B. , Gordon David 
Published: December 2003

AbstractObjectiveA prospective study was undertaken to examine the incidence of surgical complications and medium‐term outcomes of tension‐free vaginal tape (TVT) surgery in a large, heterogeneous group of stress‐incontinent women.MethodsSurgery was tailored according to preoperative clinical and urodynamic findings: stress‐incontinent women underwent TVT surgery, whereas those with concomitant urogenital prolapse underwent combined TVT and prolapse repair. Post‐operatively the patients were scheduled for evaluation at 1, 3, 6, and 12 months, and annually thereafter. All underwent urodynamics at 3 months post‐operatively.ResultsThree hundred and thirteen consecutive patients were prospectively studied. The mean follow‐up period was 21.4 ± 13.5 months. Sixteen (5.1%) cases of intravesical passage of the prolene tape occurred in our series, two of which were diagnosed at 3 and 15 months post‐operatively. Eight (2.5%) patients had post‐operative voiding difficulties, necessitating catheterization for more than 7 days. However, transvaginal excision of the tape was required in one case only. Vaginal erosion of the tape was diagnosed in four (1.3%) patients, all of whom were successfully treated by local excision of the eroded tape. Outcome analysis was restricted to 241 consecutive patients with at least 12 months of follow‐up. Subjectively, 16 (6.6%) patients had persistent mild stress urinary incontinence, although urodynamics revealed asymptomatic sphincteric incontinence in 17 (7%) other patients. De‐novo urge incontinence developed post‐operatively in 20 (8.3%) patients.ConclusionsThe TVT procedure is associated with good medium‐term cure rates, however, it is not free of troublesome complications and the patients should be informed accordingly. Only well‐trained surgeons, familiar with pelvic anatomy, surgical alternatives, and endoscopic techniques should perform the operation. Neurourol. Urodynam. 23:7–9, 2004. © 2003 Wiley‐Liss, Inc.
Opening detrusor pressure and the influence of age on success following colposuspension
Authors: Dolan Lucia M. , Smith Anthony R.B. , Hosker Gordon L. 
Published: December 2003

AbstractObjectiveWomen with urodynamic stress incontinence (USI) have lower opening and closing detrusor pressures than women without USI. This study was undertaken to determine whether a change occurs in opening and closing detrusor pressures after colposuspension, whether cure is associated with change, and whether age influences cure.DesignRetrospective cohort study.SettingTertiary referral urogynaecology department.ParticipantsConsecutive women who had undergone colposuspension between 1998–2000 and 1993–1995.MethodsPre‐ and post‐operative urodynamic records were reviewed. Eighty eight women were included. Objective cure was defined as an absence of USI and subjective cure as an absence of symptoms of stress incontinence.ResultsMean age was 52.4 (11.0) years. Sixty nine percent (61/88) were objectively cured and 48% (42/88) were subjectively cured. Postoperatively, opening detrusor pressure increased (P = 0.0001) and maximum flow rate decreased (P= 0.0464) in women objectively cured but these parameters did not change in the not cured group (P > 0.05). Women had a 4.5 times higher chance of failed surgery if post‐op opening detrusor pressure was ≤20 cmH2O (P = 0.035). Opening detrusor pressure declined with age (P < 0.001) and women who were objectively cured were on average almost 7 years younger (P = 0.0330).ConclusionsIncrease in opening detrusor pressure occurs only in women who are cured following colposuspension. Change in opening detrusor pressure is dependent on age and objective cure is higher in younger women. The effects of ageing on sub‐ urethral supports might explain why surgery is more likely to fail in older women. Neurourol. Urodynam. 23:10–15, 2004. © 2003 Wiley‐Liss, Inc.
Cesarean section: Does it really prevent the development of postpartum stress urinary incontinence? a prospective study of 363 women one year after their first delivery
Authors: Groutz Asnat , Rimon Eli , Peled Simona , Gold Ronen , Pauzner David , Lessing Joseph B. , Gordon David 
Published: December 2003

AbstractAimsStress urinary incontinence (SUI) in young women is usually the result of pelvic floor injury during vaginal delivery. Whether cesarean section delivery may prevent such injury is questionable. We undertook a prospective study to compare the prevalence of SUI among primiparae 1 year after spontaneous vaginal delivery versus elective cesarean section, or cesarean section performed for obstructed labor.MethodsThree hundred and sixty‐three consecutive primiparae were recruited immediately after delivery and were followed for 1 year. Women were asked upon recruitment whether they had ever experienced SUI before pregnancy. Those who had SUI before pregnancy were excluded. Thus, only cases of de novo childbirth‐associated SUI were analyzed. Patients were divided into three subgroups according to the mode of delivery: spontaneous vaginal delivery (n = 145), elective cesarean section (n = 118), and cesarean section performed for obstructed labor (n = 100). Patients who underwent elective cesarean section were not given a trial of labor. Cesarean sections for obstructed labor were performed at a mean cervical dilatation of 8.7 ± 1.6 cm and arrest of 184 ± 24 min. Prevalence, frequency, and severity of postpartum SUI, as well as demographic and obstetric parameters, were analyzed in each subgroup.ResultsThe three subgroups were comparable with respect to maternal age, weight, and height. Prevalence of postpartum SUI was similar after spontaneous vaginal delivery (10.3%) and cesarean section performed for obstructed labor (12%). However, SUI was significantly less common following elective cesarean section with no trial of labor (3.4%, P < 0.05). Approximately half of the symptomatic patients in each subgroup reported either moderate or severe symptoms, however, only 15–18% expressed their desire for further evaluation.ConclusionsPrevalence of postpartum SUI is similar following spontaneous vaginal delivery and cesarean section performed for obstructed labor. It is quite possible that pelvic floor injury in such cases is already too extensive to be prevented by surgical intervention. Conversely, elective cesarean section, with no trial of labor, was found to be associated with a significantly lower prevalence of postpartum SUI. Whether the prevention of pelvic floor injury should be an indication for elective cesarean section is yet to be established. Neurourol. Urodynam. 23:2–6, 2004. © 2003 Wiley‐Liss, Inc.