摘要:

Occlusive ureteral peristalsis is simulated in an enlarged technical model of the ureter with a lobe-shaped lumen. The local pressure pulse is measured with catheters of different caliber and the influence of the catheters size and position on the uromanometrogram (UMG) is examined. The measurements are compared with UMGs at pathologically changed conditions (stagnation, residual urine depot etc.) and suggestions are given concerning size and shape of catheters to be used for urodynamic measurements.

ISSN:0042-1138    

DOI:10.1159/000281147

出版商:S. Karger AG    

年代:1986

数据来源: Karger

摘要:

For long-term ureteral replacement an artificial ureter has to be able to pump against the outflow resistance into the bladder at any physiological flow rate (0.2–2.0 ml/min). This demand is satisfied only by active prostheses. The active prosthesis described in this paper is driven by the intra-abdominal pressure fluctuations caused by the respiratory movements. The comparison of in vitro results with the parameters of physiological peristalsis proves the applicability of the prosthesis at physiological conditions. Compared to active prostheses with foreign energy supply, this concept promises less burden for patients.

ISSN:0042-1138    

DOI:10.1159/000281148

出版商:S. Karger AG    

年代:1986

数据来源: Karger

摘要:

Oxybutynin chloride has been clinically used for the relief of symptoms associated with voiding in patients with uninhibited neurogenic and reflex neurogenic bladder in the USA. The present clinical and urodynamic studies were the first made meticulously in patients with uninhibited neurogenic and reflex neurogenic bladder in Japan. A single oral dose of oxybutynin chloride (3 or 6 mg) did not induce any change either in subjective symptoms or in urodynamic studies; however, in the continual administration study, 7 of 9 patients showed an improvement in the symptoms associated with voiding. The drug reduced urinary frequency, urgency and incontinence, and significantly increased the volumes at the first desire to void (FDV) and maximum desire to void (MDV) in cystometry. Furthermore, no serious adverse reactions were observed, and hence the drug seems to be of clinical significance.

ISSN:0042-1138    

DOI:10.1159/000281150

出版商:S. Karger AG    

年代:1986

数据来源: Karger

摘要:

Coecocystoplasty for substituting or augmenting the bladder is a relatively common operation in the United States, but not in Scandinavia. In order to focus the attention on this voiding-preserving operation we evaluated the late postoperative results of 8 patients. Median follow-up was 5 years. Seven of the patients had symptoms from a contracted bladder and 1 patient with epispadias was undiverted from a ureteroileocutaneostomy. There were some early postoperative complications. Two patients had a revision of the coecocystoplasty, 1 patient ended up with a ureteroileocutaneostomy and 1 patient needed a nephrectomy because of a perirenal abscess. The patient with epispadias later had an artificial urinary sphincter because of persisting incontinence. At follow-up time all patients found that they had a better life than prior to operation since the invalidating symptoms from the contracted bladder had disappeared. One patient with residual urine had chronic urinary tract infection. All patients were continent at daytime, 3 patients had nocturnal incontinence. Urodynamic studies showed no infravesical obstruction and bladder capacity between 75 and 380 ml H2O. Three patients had decreased renal function. Based on our limited material we conclude that coecocystoplasty is a reasonable, though not unproblematic, treatment in patients with severe symptoms from a small contracted bladder and a therapeutical alternative in patients with a previously defunctionalised bladder and that this method should always be taken into consideration before a urinary diversion.

ISSN:0042-1138    

DOI:10.1159/000281152

出版商:S. Karger AG    

年代:1986

数据来源: Karger

摘要:

Simultaneous registration of urethral pressure profile and pull-through force was performed to study the dynamics of sphincteric function in 25 female patients. Three separate types of catheters of six different sizes were used. A 6-French smooth catheter was used to measure maximal urethral closure pressure, functional profile length and length to maximal urethral pressure. The results were divided into three groups (A, B and C) with significantly different closure pressure values, only correlated to the age of the patient. In all three groups (A, B and C), the mean maximal urethral closure pressure increased in linear correlation to the catheter diameter and did not bear any relation to the shape of the catheter tip, either of the bulb or the ball type. A significant exponential correlation was demonstrated between pull-through force and catheter diameter. Also the correlation between force and length of the pull-through force curve was exponential, while only the mean values of closure pressure and force correlated exponentially. No further correlations were found, even after force values were ranked to form three other groups (I, II and III). In contrast to the groups A, B and C, no distinct differences in clinical diagnosis was noticed between groups I, II and III. The pressure and force curves can be explained on a physical basis, despite the variety in pathology. On the basis of this evidence it appears that a more accurate measurement of sphincter function in the female can be obtained by measuring pressure and force simultaneously with different sizes of catheters, especially with a diameter of 15 French or more.

ISSN:0042-1138    

DOI:10.1159/000281153

出版商:S. Karger AG    

年代:1986

数据来源: Karger

摘要:

The pathophysiological considerations for regaining continence are discussed first. Our operation method for postprostatectomy incontinence is described and the results ennumerated. The success rate is approximatively 80%.

ISSN:0042-1138    

DOI:10.1159/000281155

出版商:S. Karger AG    

年代:1986

数据来源: Karger

摘要:

Collateral circulation and recanalization represent the main problems of organ-ablating renal embolization. Different animal models were used to study the influence of central, peripheral, and capillary occlusion on organ necrosis. The first laboratory experiments were performed to optimize transcatheteral application of the embolization media tested (Gelfoam powder, Histoacryl, Ethibloc). Experiments with the model of a normal rat kidney (n = 400) showed that only capillary embolization homogenously occluding the entire arterial system resulted in complete organ necrosis, while following central (renal artery ligation) or peripheral (Gelfoam powder) occlusion, areas of intact parenchyma remained. Ethibloc/glucose proved to be the embolization medium best suited for capillary embolization (radiopaque, inert, slow resorption). Studies with the model of unilateral renal hypertension of the rat (n = 146) demonstrated the equivalent therapeutic efficiency on blood pressure of Ethibloc embolization (57% cured, 21% improved) compared to surgical nephrectomy (50% cured, 29% improved), whereas renal artery ligation (85% failed) resulted in minor improvement only. In order to adapt capillary embolization with Ethibloc/glucose to clinical angiographic techniques, we performed angioinfarction of canine kidneys (n = 15): the use of a balloon catheter is mandatory. This guarantees blood stasis during the embolization procedure and avoids embolic reflux. Possible clinical indications of capillary embolization in renal hypertension as a less invasive method are, e.g.: malignant nephrosclerosis; renovascular or glomerulonephritic contracted kidneys, and renal dysplasia. Indications for super-selective vaso-occlusion are renal aneurysms, a-v malformations, and segmental hypoplasia.

ISSN:0042-1138    

DOI:10.1159/000281157

出版商:S. Karger AG    

年代:1986

数据来源: Karger

摘要:

A fluorescence study was performed in 16 renal cell carcinomas using antibodies to renal tubular antigens (RTA), two intermediate filaments, cytokeratin and vimentin, and two lectins, soybean agglutinin (SBA) and peanut agglutinin (PNA). We observed the presence of RTA, cytokeratin, and vimentin in all of our specimens. The expression of vimentin, the cytoskeletal protein of mesenchymal cells, was considered to be a very interesting feature of the tumor. Binding sites of SBA, normally present in glomeruli, proximal and distal tubules, were detectable in the neoplastic cells in only 37.5% of our specimens. PNA did not react with the tumor except for the small area of 2 specimens. Lectins may be useful for estimating the characteristics or renal cell carcinoma including its malignant potentials, and antidodies to RTA and intermediate filaments seem to be available for the diagnosis of the tumor in metastatic lesions.

ISSN:0042-1138    

DOI:10.1159/000281158

出版商:S. Karger AG    

年代:1986

数据来源: Karger

摘要:

Transcutaneous electrical stimulation was applied to the perianal skin of 25 patients with frequency, urgency or incontinence. Repeated cystometrogram during this stimulation disclosed suppression of detrusor activity, inhibition of detrusor instability in 4 of 8 patients and increase of maximum cystometric capacity in 5 of 25 patients. Electromyographic activity of the anal sphincter muscle increased in all the 25 patients. Poststimulation improvement was observed clinically in 9 of 12 patients.

ISSN:0042-1138    

DOI:10.1159/000281160

出版商:S. Karger AG    

年代:1986

数据来源: Karger

摘要:

The value of clinical decision on antibiotic treatment of fever episodes following transurethral resection of the prostate was assessed in 134 patients. Besides bacteriuria, need of blood transfusions and various catheter problems were associated with a significant number of fever episodes. The majority of patients with fever not given antibiotic therapy had negative urine cultures (90%), whereas 41 % of the patients with fever treated with antibiotics showed negative urine cultures indicating an overtreatment of these patients. Out of the total number of patients, only 10% with subsequent negative urine cultures received antibiotics, a figure which should be compared to the inevitable rate of overtreatment when general antibiotic prophylaxis is preferred.

ISSN:0042-1138    

DOI:10.1159/000281162

出版商:S. Karger AG    

年代:1986

数据来源: Karger