bluuebunny/crossref_metadata_2025_split huggingface dataset:
Posterior tibial nerve stimulation in the treatment of urge incontinence
Authors: Vandoninck Vera , van Balken Michael R. , Agró Enrico Finazzi , Petta Filomena , Caltagirone Carlo , Heesakkers John P.F.A. , Kiemeney Lambertus A.L.M. , Debruyne Frans M.J. , Bemelmans Bart L.H. 
Published: December 2002

AbstractAims:The objective of this study was to evaluate the effect of posterior tibial nerve stimulation (PTNS) for treatment of urge incontinence.Methods:In a prospective multicentre study, 35 patients with complaints of urge incontinence underwent 12 weekly sessions of PTNS at one of five sites in the Netherlands and one site in Italy. Frequency/volume charts and I‐QoL and SF‐36 questionnaires were completed at 0 and 12 weeks. Success was analysed by using subjective and objective criteria. Overall subjective success was defined as the willingness to continue treatment, whereas objective success was defined as a significant decrease (to<50%) in total number of leakage episodes.Results:Twenty‐two patients (63%) reported a subjective success. Twenty‐four patients (70%) showed a 50% or greater reduction in total number of leakage episodes. Sixteen (46%) of these‐patients were completely cured (i.e., no leakage episodes) after 12 sessions. Quality of life parameters improved significantly.Conclusions:We conclude that posterior tibial nerve stimulation is an effective, minimally invasive option for treatment of patients with complaints of urge incontinence, as improvement was seen in subjective as well as objective parameters. Neurourol. Urodynam. 22:17–23, 2003. © 2003 Wiley‐Liss, Inc.
Assessment of prostatic obstruction: A cuff may be enough
Authors: Drinnan Michael J. , Pickard Robert S. , Ramsden Peter D. , Griffiths Clive J. 
Published: December 2002

AbstractAims:To investigate the use of an inflatable perile cuff to obstruct flow progressively during voiding in order to provide a noninvasive measure of bladder pressure.Methods:In this study, we explain the observed relationship of flow rate with applied cuff pressure by analogy with a simple physical model. The model comprised a fixed‐pressure reservoir (simulating the bladder), a collapsible tube around which a fixed pressure could be applied (simulating the prostatic urethra), connected by rigid conduit to a further collapsible tube around which pressure could be applied (simulating the penile urethra and cuff). Flow was progressively obstructed by incremental increase of pressure applied to the “penile urethra,” with the experiment being repeated for a range of fixed pressures applied to the “prostatic urethra.”Results:The model reproduced the typical pressure/flow curves recorded during voiding by using penile cuff inflation in normal and obstructed men.Conclusions:Our data led us to hypothesise that the relationship between cuff pressure and flow rate can be used to deduce bladder pressure during voiding, prostatic opening pressure, and urethral diameter at the flow‐controlling zone, three indicators of lower urinary tract function. These measurements may add to the accuracy of diagnosis and quality of care for a large number of men with lower urinary tract symptoms. Neurourol. Urodynam. 22:40–44, 2003. © 2003 Wiley‐Liss, Inc.
Urodynamic changes induced by the intravaginal electrode during pelvic floor electrical stimulation
Authors: Resplande Julio , Gholami Shahram , Bruschini Homero , Srougi Miguel 
Published: December 2002

AbstractAims:The goal of this study was to evaluate whether the intravaginal electrode used to perform vaginal electrical stimulation could induce acute changes on the cystometrograms and urethral pressure profiles (UPP) recordings.Methods:Three consecutive urodynamic examinations were performed on 30 women with stress urinary incontinence (SUI) symptoms. The first exam was performed without the electrode, the second with the electrode inserted into the vagina, but with the stimulator switched off and the third with the stimulator turned on. We used the INNOVA (Empi) stimulator with electrical parameters set at 50 Hz and 60 mA and on an intermittent cycle during the cystometries and a continuous stimulation during the UPP. The data of functional profile length (FPL), maximum urethral closure pressure (MUCP), and area of the resting UPP, as well as the filling sensations and its respective bladder volumes during the cystometries, were compared. With regard to the cystometries.Results:No effect of the electrode was observed on cystometry. However, the simple presence of the electrode improved the FPL, MUCP, and areas of the UPP similar to those when the stimulation was applied.Conclusions:We conclude that, the presence of the intravaginal electrode induces changes in the UPP not related to the stimulation itself. The physiotherapeutic effect of the electrode itself is still to be evaluated. Neurourol. Urodynam. 22:24–28, 2003. © 2003 Wiley‐Liss, Inc.
Differing effects of NG‐monomethyl L‐arginine and 7‐nitroindazole on detrusor activity
Authors: Theobald Robert J. 
Published: December 2002

AbstractAims:Previous studies reported that nitric oxide (NO) synthase (NOS) inhibition decreases micturition volume threshold (MVT), the volume required to produce a centrally mediated micturition contraction, and that NO can be released from urothelium by means of certain stimuli. With elucidation of multiple isoforms of NOS, studies were performed to determine whether inhibition of specific isoforms of NOS altered MVT in different ways.Methods:In naive, anesthetized cats, the urinary bladder was exposed by means of a midline abdominal incision and cannulated through a slit in the internal urethra approximately 4–5 cm distal to the neck of the bladder. The left renal artery and left radial vein were cannulated for the intra‐arterial and intravenous administration of drugs, respectively. All nerves were left intact. A control MVT was determined by slowly infusing saline into the bladder at a rate of 0.018 mL/kg per minute. Varying doses of L‐NMMA (NG‐monomethyl‐L‐arginine) or 7‐NI (7‐nitro indazole) were administered and the MVT was again determined.Results:Inhibition of endothelial NOS (eNOS), by L‐NMMA, or neuronal NOS (nNOS), by 7‐NI, produces varying effects on certain detrusor activities and that inhibition of different isoforms of NOS produces qualitatively different effects. L‐NMMA significantly decreases MVT (up to 60% decrease), whereas 7‐NI significantly increases MVT (over 300% increase). L‐NMMA increases frequency and onset of small bladder contractions, whereas 7‐NI produces opposite effects.Conclusions:The results suggest that detrusor relaxation and contractility may be modulated by NO levels and that NO released from the urothelium may be a mediator of detrusor relaxation during the storage phase of micturition. Neurourol. Urodynam. 22:62–69, 2003. © 2003 Wiley‐Liss, Inc.
Modelized analysis of pressure‐flow studies of patients with lower urinary tract symptoms due to benign prostatic enlargement
Authors: Valentini Françoise A. , Zimmern Philippe E. , Besson Gilbert R. , Nelson Pierre P. 
Published: December 2002

AbstractAims:To gain insight from an adaptable computer model of micturition into the pathophysiological phenomena occurring during voiding in men with lower urinary tract symptoms due to benign prostatic enlargement (BPE).Methods:By using the Valentini‐Besson‐Nelson (VBN) micturition model, we proceeded with an in‐depth and systematic analysis of the pressure‐flow studies of 71 patients (119 tracings) provided by three different institutions.Results:The modelized analysis identified and quantified several pathophysiological phenomena during voiding: compressive obstruction, variations in detrusor contraction force (enhanced or reduced), progressive relaxation of the prostatic fossa, occasional detrusor‐bladder neck coupling, and sphincteric control dysfunctions. Once these phenomena were taken into account by using a set of new parameters, the computed flow rate and detrusor pressure curves became very similar to the recorded ones.Conclusions:The accuracy of this sophisticated analysis allows us to separate and to study during each voiding the phenomena belonging to the urethra, the detrusor, the bladder neck, the prostate, and their neurologic coordination in BPE patients. Neurourol. Urodynam. 22:45–53, 2003. © 2003 Wiley‐Liss, Inc.
Effect of the Bowman‐Birk inhibitor (a soy protein) on in vitro bladder neck/urethral and penile corporal smooth muscle activity
Authors: Malkowicz S. Bruce , Liu Shih‐Ping , Broderick Gregory A. , Wein Alan J. , Kennedy Ann R. , Levin Robert M. 
Published: December 2002

AbstractAims:The Bowman‐Birk inhibitor (BBI), is a serine protease inhibitor derived from soy beans, which is presently being evaluated in clinical trials for its ability to serve as a cancer preventive or anti‐inflammatory agent. The form of BBI currently in clinical trials is known as Bowman‐Birk inhibitor concentrate (BBIC). There have been anecdotal reports from patients of improved voiding and sexual functions in the ongoing BBIC trials. The objective of this study was to quantify the effect of BBI and BBIC on urethral and corporal smooth muscle activity.Methods:In vitro muscle strip studies of New Zealand White rabbit urethra/bladder neck and penile corpora in the presence or absence of BBI or BBIC incubation (5 mg/mL) were performed.Results:In dose‐response curves to alpha stimulation, BBI mediated a shift to the right (decreased receptor sensitivity in bladder/urethra as well as corpora with no change in the maximal response). Bladder base/ urethra contraction by field stimulation was significantly inhibited by BBI at higher frequencies (1–32 Hz) (12.2 + 0.8 g vs. 6.3 + 0.75 g, P < 0.05). BBI inhibited field stimulated relaxation of corporal muscle at lower frequencies. Muscarinic contraction of the bladder neck/urethra in alpha prestimulated tissue was significantly inhibited by BBI (5.3 + 0.2 g vs. 2.7 + 0.1 g, P < 0.05). BBI has an inhibitory effect on alpha adrenergic dose‐response curves in bladder neck/urethral and corpora smooth muscle. BBI also significantly inhibited neurohumoral cholinergic release and in vitro muscarinic contraction of the urethra. The effects on corpora relaxation were less pronounced.Conclusions:The data suggest that the phytochemical BBI may promote physiologic effects of urethral relaxation and improved voiding by unique mechanisms and deserves further study as a pharmacologic agent for lower urinary tract symptoms. Neurourol. Urodynam. 22:54–57, 2003. © 2003 Wiley‐Liss, Inc.
Baseline abdominal pressure and valsalva leak point pressures‐correlation with clinical and urodynamic data
Authors: Madjar Shahar , Balzarro Matteo , Appell Rodney A. , Tchetgen Marie‐Blanche , Nelson David 
Published: December 2002

AbstractAims:To characterize the factors contributing to changes in baseline abdominal pressure (Pabd) and the correlation between ΔVLPP, VLPPtot, and other clinical and urodynamic variables.Methods:Two hundred sixty‐four female patients who had undergone an anti‐incontinence procedure between February 1994 and October 1999 were retrospectively reviewed. The urodynamics performed for each patient included abdominal and vesical pressures measured in a standardized manner with the patient sitting upright and the pressure sensors maintained at the level of the symphysis pubis. VLPP was determined at bladder volumes of 200 mL during a gradually increasing Valsalva maneuver.Results:Baseline Pabd varied between 10 and 55 cm H2O (mean, 32.7 ± 8.8) and were significantly correlated with patient weight (P<0.001) and with patient body mass index (P<0.001). Baseline Pabd was not found to be correlated with patient age, Baden and Walker Classification of the grading of pelvic floor prolapse, degree of incontinence (determined by the number of pads used per day), or prior surgical procedures for stress incontinence. Higher baseline Pabd were significantly correlated with the peak abdominal pressure reached during the Valsalva maneuver (P<0.0001) and with VLPPtot (P<0.0001) but not with ΔVLPP. Higher VLPPtot significantly correlated with decreased age (P=0.004), less severe incontinence (P=0.004), higher peak Valsalva pressure (P<0.0001), and the ability to increase abdominal pressure for a longer period of time (time to peak Pabd during Valsalva). VLPPtot and ΔVLPP had similar statistical correlation with all the clinical variables examined and neither could predict the outcome of any anti‐incontinence surgery. By using a VLPP of 60 cm H2O as a cutoff to differentiate severe ISD from GSUI, 211 (67.4%) of the patients would be categorized as having ISD according to their ΔVLPP compared with only 106 (40.1%) by using the VLPPtot.Conclusions:Baseline Pabd varies considerably among patients, is correlated with patient weight and habitus. In addition, it varies with both the ability to be increased for longer periods of time and with VLPPtot. Looking at VLPPtot and ΔVLPP will result in a different categorization of the type of incontinence in at least 25% of patients and, thus, affect the physician's selection of an anti‐incontinence procedure for an individual patient. Neurourol. Urodynam. 22:2–6, 2003. © 2003 Wiley‐Liss, Inc.
Developmental expression of glial cell‐line derived neurotrophic factor, neurturin, and their receptor mRNA in the rat urinary bladder
Authors: Kawakami Takahiro , Wakabayashi Yoshihiko , Aimi Yoshinari , Isono Takahiro , Okada Yusaku 
Published: December 2002

AbstractAims:Glial cell‐line derived neurotrophic factor (GDNF) and related factors neurturin (NRTN), artemin, and persephin are members of the GDNF family of neurotrophic factors. GDNF and NRTN bind to the tyrosine kinase receptor Ret and the receptors GFRα1 and GFRα2. The objective was to examine the developmental expression of GDNF, NRTN, and their receptors within the rat urinary bladder.Methods:Rat bladders dissected from embryonic day (E) 15, postnatal day (P) 0, P14, P28, and adult rats (P60) were investigated by semiquantitative reverse transcriptase polymerase chain reaction. Embryos (E15, E16, and E17) were immunohistochemically stained for neurofilament.Results:GDNF and Ret mRNA levels at E15 were the highest of all the stages we examined and then immediately decreased. In contrast, NRTN mRNA levels did not change between E15 and postnatal day 14; thereafter, they gradually but insignificantly increased. GFRα1 and GFRα2 mRNA levels were high at E15, after which their signal intensities decreased. In whole‐mounted specimens, neurofilament‐positive axons were first detected in the bladder at E16.Conclusions:Our results suggest that GDNF and NRTN may act as trophic factors for neural in‐growth to the bladder and/or for the maintenance of mature neurons innervating the bladder. These factors might also be involved in bladder morphogenesis. Neurourol. Urodynam. 22:83–88, 2003. © 2003 Wiley‐Liss, Inc.
Role of the T‐type Ca2+ current on the contractile performance of guinea pig detrusor smooth muscle
Authors: Chow K.‐Y. , Wu C. , Sui G.P. , Fry C.H. 
Published: December 2002

AbstractAims:The importance of the T‐type Ca2+ current in determining detrusor contractile function was investigated by using guinea pig muscle in vitro.Methods:NiCl2 (200 μM) was used to block selectively the T‐type Ca2+ current, and 20 μM verapamil was used to block the L‐type Ca2+ current in this tissue. The selectivity of these agents at such concentrations has been previously demonstrated.Results:In normal extracellular solution (4 mM KCl) 200 μM NiCl2 and 20 μM verapamil reduced electrically stimulated contractions by 17 ± 6% and 65 ± 10%, respectively. At high concentrations of the two agents, the contraction was completely abolished by NiCl2 but by only 74 ± 18% in the case of verapamil; this finding suggests that NiCl2 has additional negative inotropic actions at higher concentrations. Carbachol and KCl contractures were attenuated to a similar extent to that of electrically stimulated contractions by NiCl2 and verapamil, which suggests that they act on the muscle rather than the motor nerve. The dependence of the membrane potential on the relative ability of NiCl2 and verapamil to attenuate the contraction was tested by varying the extracellular [KCl], [KCl]o. Varying [KCl]o between 2 and 10 mM depolarised detrusor myocytes from (−65.1 ± 4.7 mV to −42.7 ± 4.0 mV (a slope of 32 mV per 10‐fold change of [KCl]o). In low [KCl]o,blockade by NiCl2 was more effective and that of verapamil less effective; at high [KCl]o, the reverse potency was recorded.Conclusions:The data are consistent with the hypothesis that Ca2+ influx through both T‐type and L‐type Ca2+ channels determines the contractile status of detrusor smooth muscle and that T‐type channel activity is more important at membrane potentials near the resting level. A significant role for T‐type channel activity in the resting state was evident in that spontaneous contractions were attenuated to a greater extent than evoked contractions. Neurourol. Urodynam. 22:77–82, 2003. © 2003 Wiley‐Liss, Inc.
Measuring the sensations of urge and bladder filling during cystometry in urge incontinence and the effects of neuromodulation
Authors: Oliver Sarah , Fowler Clare , Mundy Anthony , Craggs Michael 
Published: December 2002

AbstractAims:As urge and urgency contribute greatly to a patient's symptoms, it follows that sensory evaluation combined with noninvasive neuromodulation during urodynamics may provide new criteria for improving patient selection for an implantable stimulator. The purpose of this research was to develop and validate an objective measure of bladder sensations during filling cystometry and then to apply this technique to evaluate the effects of neuromodulation on the sensations of urge measured in this way.Methods:In study 1 a new patient‐activated keypad device was tested during urodynamics to measure bladder sensations according to a 0–4 scale and validated by using a technique adapted from a standard psychophysical sensory threshold testing method. In study 2 the effects of pudendal afferent nerve stimulation on measured sensations of urge were assessed during cystometry with patients as their own controls. Forty‐three patients diagnosed with idiopathic detrusor instability were studied; 10 participated in study 1 and 35 in study 2.Results:The new device gave reliable and repeatable measures of sensations with statistically significant differences in bladder volume at each of the urge levels tested (Wilcoxon matched pairs test). Neuromodulation suppressed urinary urge in 89% of the 35 patients. This effect was associated with a statistically significant increase in bladder volume at all urge levels.Conclusions:A new patient operated key‐pad device provided a reliably objective measure of sensations of urge during urodynamics without the need for prompting. Neuromodulation using noninvasive pudendal afferent stimulation suppressed these sensations whilst increasing bladder volume. Neurourol. Urodynam. 22:7–16, 2003. © 2003 Wiley‐Liss, Inc.
Prenatal diagnosis of 21‐hydroxylase deficiency caused by gene conversion and rearrangements: pitfalls and molecular diagnostic solutions
Authors: Mao Rong , Nelson Lesa , Kates Richard , Miller Christine E. , Donaldson David L. , Tang Wei , Ward Kenneth 
Published: December 2002

AbstractObjectivesThe present paper reports the prenatal diagnosis of congenital adrenal hyperplasia (CAH) in two cases of 21‐hydroxylase deficiency. DNA diagnostic errors can be caused by the presence of the highly homologous 21‐hydroxylase pseudogene, CYP21P, adjacent to the functional gene, CYP21. The present paper details how complex gene conversions and rearrangements between the CYP21 and CYP21P pose unique complications for prenatal diagnosis.MethodsAnalysis of eight common mutations in the 21‐hydroxylase gene as well as deletion of the entire gene is accomplished using polymerase chin reaction (PCR) followed by amplified created restriction site (ACRS) or allele‐specific oligohybridization (ASO) and Southern blot followed by hybridization to a CYP21‐specific probe. Linkage analysis was performed using microsatellite markers flanking the CYP21 gene.ResultsThe direct mutation detection assay indicated a complicated gene conversion and rearrangement in the probands of both families. Interpretation of these rearrangements made it difficult to determine whether or not the fetuses would be affected with CAH. Linkage studies revealed that each fetus had inherited both parental disease chromosomes and was therefore predicted to be affected with CAH.ConclusionAs observed in the two reported cases, direct DNA analysis may provide limited information due to gene conversion or rearrangement between the CYP21 and CYP21P genes. These cases suggest that direct mutation detection should be supported by linkage analysis, whenever possible, to provide more comprehensive information for the family. Copyright © 2002 John Wiley & Sons, Ltd.
Compromise ultrasound dating policy in maternal serum screening for Down syndrome
Authors: Rahim R. R. , Cuckle H. S. , Sehmi I. K. , Jones R. G. 
Published: December 2002

AbstractRoutine ultrasound biometry is the method of choice for gestational dating when screening for Down syndrome. However, it is costly and an alternative policy is to restrict ultrasound to women most likely to have menstrual dating errors. This was evaluated by statistical modelling with parameters from 14 274 women screened between January 1997 and July 2001 using free beta‐human chorionic gonadotrophin (free β‐hCG), α‐fetoprotein (AFP) and unconjugated estriol (uE3). A total of 12 711 (89%) women had both ultrasound and menstrual gestations, but in 4101 (29%) women either the last menstrual period (LMP) was uncertain or a pill‐withdrawal period, or there were irregular or abnormal length cycles. The LMP was not entered in the test request form for a further 1404 (9.8%) women. Routine ultrasound dating yielded a predicted detection rate higher than for menstrual dating by 3.9–7.1%, depending on the marker combination and cut‐off. The false‐positive rate was reduced by 0.2–1.1%. Selectively scanning the 39% with unreliable dates increased detection by 2.6–4.6%, and reduced the false‐positive rate by 0.04–0.6%. Some centres only use the ultrasound estimate of gestation when it differs from the menstrual estimate by more than 7 days. Such a rule reduces the gain in detection rate to 2.5–4.6% for routine ultrasound and 1.7–3.1% with the compromise policy; the false‐positive rate reductions are 0.06–0.6% and 0.0–0.3%, respectively. We conclude that if routine ultrasound is not financially and practically feasible, the compromise policy yields a clinically important improvement in screening performance compared to menstrual dating. Copyright © 2002 John Wiley & Sons, Ltd.