ISSN:0042-1138    

DOI:10.1159/000280211

出版商:S. Karger AG    

年代:1978

数据来源: Karger

摘要:

This is a report of a special method of a temporary intravesical electrostimulation of the bladder for the treatment of the urinary incontinence of spina bifida children. The technique with presentation of apparatus and catheter is described in detail. The criterias for the selection of the patients are explained, the most important of which is the response of the detrusor muscle during the stimulation recorded by uromanometry. 26 spina bifida children were treated. There is at least a success in 50% of the patients, if the criteria are fulfilled.

ISSN:0042-1138    

DOI:10.1159/000280212

出版商:S. Karger AG    

年代:1978

数据来源: Karger

摘要:

The urodynamic findings of 247 patients with a neurogenic bladder dysfunction were analyzed to evaluate factors which influence the X-ray picture of the bladder neck and urethra. Patients were classified according to the classification of Bors and Comarr, additionally different types of reflex detrusor activity could be differentiated in cases suffering from a supranuclear lesion. As the micturition cystourethrography of female patients with a supranuclear lesion looks similar to the X-ray picture of young girls with a WBNA a second analysis was made to compare the urodynamics of both groups. It is to note that in supranuclear lesions detrusor-sphincter dyssynergia and the type of reflex detrusor activity mainly form the shape of the posterior urethra, neither the duration of the lesion nor the level of spinal cord injury have any influence.

ISSN:0042-1138    

DOI:10.1159/000280213

出版商:S. Karger AG    

年代:1978

数据来源: Karger

摘要:

Reflexes concerned with viscerosomatic and somatovisceral interplay in the sacral spinal cord were evaluated in spinalized animals, as part of a study on direct spinal cord stimulation of micturition. Urodynamic evaluation consisted of continuous recording of bladder pressure, urethral pressures and electromyograms of striated anal and urethral sphincters. All exteroceptive stimuli to urethral or anal mucosa caused an inappropriate increase in afferent input to the sacral micturition center: such stimuli should be avoided in the evaluation of suprasacral lesions of bladder innervation. Early in the spinal shock phase, hyperreflexia of striated pelvic floor muscles was apparent, in the absence of detrusor reflex activity. Clinical implications for early management of neurogenic bladder dysfunction are discussed. In all spinalized animals early balanced bladder function could be achieved, due to the absence of detrusor-sphincter dyssynergia: the opposite is true for spinalized man.

ISSN:0042-1138    

DOI:10.1159/000280214

出版商:S. Karger AG    

年代:1978

数据来源: Karger

摘要:

In 11 patients with upper motor neuron bladder paresis due to spinal trauma, 2 patients with lower motor neuron bladder paresis, and 4 patients with multiple sclerosis, α-adrenergic blockade with 10 mg Regitine® intravenously decreased the maximum urethral closure pressure to an average of 42%. The decrease was most pronounced in a patient with lower motor neuron bladder paresis and a flaccid pelvic floor. Treatment with phenoxybenzamine was found valuable in patients with multiple sclerosis and poor bladder emptying as well as in patients with lower motor neuron bladder paresis. In patients with detrusor-sphincter dyssynergia this treatment was of no valu

ISSN:0042-1138    

DOI:10.1159/000280215

出版商:S. Karger AG    

年代:1978

数据来源: Karger

摘要:

The bladder capacity of patients with a neurogenic bladder disorder was determined. Since the bladder capacity varies according to the type of neurogenic lesion (supranuclear, infranuclear), it was to be determined, whether reflex detrusor activity and duration of the lesion would influence bladder capacity. It was found that in supranuclear lesions a sufficient bladder capacity can be maintained with a balanced micturition, and that spincterotomy does not result in reduced bladder capacity. In infranuclear lesions intermittent catheterization is a good therapeutic method to preserve continence and an intact renal function as well.

ISSN:0042-1138    

DOI:10.1159/000280216

出版商:S. Karger AG    

年代:1978

数据来源: Karger

摘要:

Detrusor hyperreflexia was found in 54 patients or 14.6% of 369 consecutive patients referred for urinary incontinence and/or genital genital prolapse during a 2-year period. The dominant symptom was urge incontinence. The urological investigation consisted of a medium fill water cystometry in the supine position. 20 patients (37%) suffered from cerebral or pyramidal nervous disorders. The treatment of choice was pharmacological with parasympatholytica, methantheline bromide (Banthine®). The follow-up examinations performed in 33 patients after 6 months treatment showed an improvement rate of 82%. The importance of performing a cystometry in all female patients referred for urinary incontinence is stressed

ISSN:0042-1138    

DOI:10.1159/000280217

出版商:S. Karger AG    

年代:1978

数据来源: Karger

摘要:

Over the last 8 years 64 cases of bladder hyperactivity have been subjected to bladder transection. The patients selected have been mainly adult enuretics, but have also included some others with daytime bladder hyperactivity without nocturnal incontinence who had failed to respond to medical and simple surgical procedures. A bladder capacity greater than 400 ml under general anaesthesia was used as a major criterion in selecting the cases for operation. The operation was very successful in the enuretic syndrome where the daytime symptoms or urgency and urge incontinence were severe. Other patients who had frequency, urgency and urge incontinence without demonstrable neurological or urological abnormalities also responded well.

ISSN:0042-1138    

DOI:10.1159/000280218

出版商:S. Karger AG    

年代:1978

数据来源: Karger

摘要:

18 children, from 1 year of age to 15, presenting lower motor neuron bladder (myelomeningocele) were studied. All had overflow incontinence and urinary infection resistant to all trials of treatment, attributed to severe vesicoureteral reflux. The failure of training on bladder emptying for urinary infection control and/or the severity of reflux and its consequences over upper urinary tract, motivated the reflux surgical correction associated to bladder training as a first step alternative treatment to urinary diversion.

ISSN:0042-1138    

DOI:10.1159/000280219

出版商:S. Karger AG    

年代:1978

数据来源: Karger

摘要:

Several micturition parameters in healthy volunteers have been studied with digital computer analysis. The accuracy of the uroflowmeter has also been tested. Total voiding time, average flow rate, maximum flow rate, volume and time at maximum flow rate are all the function of volume voided. The first half of urinary volume is rapidly evacuated in the first one third of the total voiding time, and the rest in the remaining two thirds of the voiding period. When the constant stream hits at the center of the disk, the response of the flowmeter is fairly good. Once the urinary stream is accelerated and/or hits at the edge of the disk, the response is not reliable.

ISSN:0042-1138    

DOI:10.1159/000280220

出版商:S. Karger AG    

年代:1978

数据来源: Karger