ISSN:0963-0643    

出版商:OVID    

年代:1993

数据来源: OVID

摘要:

The complexities of neuromuscular mechanisms of voiding continue to be the subject of investigation. One target of recent attention is the organization and inter-relationship of neural pathways in the sacral spinal cord and their possible bearing on the control of micturition. Another subject of continued interest has been the contribution of neuromuscular factors in maintaining urethral closure and continence of urine. Some new morphologic studies have continued to probe the role of intrinsic nerves within the detrusor in the pathogenesis of various forms of its abnormal behavior, particularly the contribution of sensory innervation and neuropeptides.

ISSN:0963-0643    

出版商:OVID    

年代:1993

数据来源: OVID

摘要:

Voiding disorders occur frequently and may be secondary to detrusor, urethral or pelvic-floor dysfunction. Anatomic, neurogenic and psychogenic causes are reviewed. Neurologic causes are usually well defined, but the etiology of detrusor and pelvic-floor abnormalities remains enigmatic. Neither diagnosis nor treatment have advanced significantly, except for the promising results with sacral nerve stimulation in patients with neurologic ciisorders.

ISSN:0963-0643    

出版商:OVID    

年代:1993

数据来源: OVID

摘要:

Urodynamic techniques have assumed an important place as a clinical and research tool in urology. The standard techniques of cystometry and uroflowmetry have been further refined and improved. Controversy continues in the area of pressure-flow analysis and its application to the estimation of detrusor contractility. New electrophysiologic tests of bladder innervation using magnetic nerve stimulation appear to be capable of extending our diagnostic abilities in neurogenic bladder dysfunction.

ISSN:0963-0643    

出版商:OVID    

年代:1993

数据来源: OVID

摘要:

Treatments of benign prostatic hyperplasia with drugs or balloon dilatation yield urodynamic changes smaller than those produced by transurethral resection and no greater than the natural variability. In spite of this variability, urodynamics shows that the 25–30% of transurethral-resection patients who are not clearly obstructed respond less well to operation than obstructed patients. Alternative therapies may be preferable in this group, but the necessary studies have not been performed.

ISSN:0963-0643    

出版商:OVID    

年代:1993

数据来源: OVID

摘要:

Urinary incontinence affects a large proportion of the female population. Investigation into the causes of incontinence has featured in the world literature in the past year, with special emphasis on the elderly, in recognition of the increasing problems for patients in this age group who suffer from incontinence. The appropriate selection of treatment depends on correct assessment and diagnosis. The outcome of treatment is important in terms of a therapeutic cure and in the effect it has on the quality of life.

ISSN:0963-0643    

出版商:OVID    

年代:1993

数据来源: OVID

摘要:

Urinary incontinence may arise from several causes, a major one being bladder hyperactivity. Improvements to the standard antimuscarinic drug therapy have been sought in the form of drugs blending musculotropic and antimuscarinic properties or intravesical administration. Recently, afferent nerves in the bladder and central nervous system sites have been the targets for drugs. The continuing search for causes of bladder hyperactivity may lead to more novel therapeutic approaches.

ISSN:0963-0643    

出版商:OVID    

年代:1993

数据来源: OVID

摘要:

This review summarizes the latest developments in surgery for genuine stress urinary incontinence, vaginal vault prolapse, and vesicovaginal fistula repair. Abdominal or endoscopie bladder-neck procedures are superior to classic anterior colporrhaphy in restoring continence. Needle suspension procedures tend to produce slightly higher long-term failure rates than the Burch operation does; pathophysiological reasons for this are discussed, as is the development of genital prolapse (an important complication after bladder-neck elevation). The anatomical and functional background of surgical therapy for vaginal vault prolapse is still poorly understood, although the existence of this distressing condition has long been established, and new aspects of it are being investigated. The role of injectables continues to be discussed controversially; recent results have tended to be disappointing.

ISSN:0963-0643    

出版商:OVID    

年代:1993

数据来源: OVID

摘要:

The recent strides in management of voiding dysfunction have heen based on a more comprehensive understanding of the neural pathways of continence and micturition in animals and humans. The potential application of this new knowledge in human therapy is being explored from many directions. This review describes some of this new research basis and the newer surgical techniques which have resulted from it.

ISSN:0963-0643    

出版商:OVID    

年代:1993

数据来源: OVID

摘要:

Neuroprostheses for the treatment of voiding disorders have become an important part of modern urology. Neurostimulation of the anterior sacral spinal roots and dorsal rhizotomy offers control of bladder function in spinal-cord injured patients with hyper-reflexic bladders and discoordinated sphincters. In non-neurogenic patients with detrusor instability or functional voiding disorders, the balance between the excitatory and inhibitory nervous inputs can be restored by electrical neuromodulation of the sacral spinal nerves or electrical stimulation of the pelvic floor using an external vaginal or anal stimulator.

ISSN:0963-0643    

出版商:OVID    

年代:1993

数据来源: OVID