ISSN:0007-1331    

DOI:10.1111/j.1464-410X.1992.tb15447.x

出版商:Blackwell Publishing Ltd    

年代:1992

数据来源: WILEY

摘要:

Summary—In 10 patients with urodynamically proven outflow tract obstruction, detrusor biopsies were taken prior to and following relief of obstruction. The changes in detrusor innervation were compared following the relief of obstruction within the study group and also with an age‐matched control group who were urodynamically normal. There was a significant reduction in detrusor innervation in the study group when compared with controls pre‐operatively. Within the study group there was a significant increase in detrusor innervation in 8 patients following relief of outflow tract obstruction. Persistence of symptoms after prostatectomy may be explained by failure of detrusor reinnerv

ISSN:0007-1331    

DOI:10.1111/j.1464-410X.1992.tb15448.x

出版商:Blackwell Publishing Ltd    

年代:1992

数据来源: WILEY

摘要:

Summary—Gamma‐amino‐butyric acid (GABA) is an established inhibitory neurotransmitter in the central nervous system (CNS) and it has also been identified in the bladder. We have investigated in the rabbit the effect of GABA on detrusor activity.Rabbit detrusor muscle strips were made to contract by electrical stimulation of their autonomic nerves or by the addition of carbachol. The addition of GABA caused substantial inhibition of muscle contraction. GABA acts on 2 classes of receptors‐GABAAand GABAB. The inhibition was mediated via the GABABreceptors as its effect was mimicked by baclofen (a GABABagonist) and inhibited by 2‐hydroxysaclofen (a GABABreceptor antagonist). Inhibition was not prevented by bicuculline (a GABAAreceptor antagonist). This inhibition may be due to a direct muscle effect since the inhibition, which occurred with carbachol‐induced contraction, was not abolished by the addition of tetrodotoxin.GABA, acting via the GABABreceptor, produces substantial inhibition of muscle contraction in the rabbit uinary bladder. This raises the possibility of using GABABanalogues in the treatment of detrusor

ISSN:0007-1331    

DOI:10.1111/j.1464-410X.1992.tb15449.x

出版商:Blackwell Publishing Ltd    

年代:1992

数据来源: WILEY

摘要:

Summary—We assessed the agreement between 2 methods of data gathering of particular interest in urology: patient questionnaire and examination vs. frequency‐volume charts. One hundred consecutive patients consulting our out‐patient clinic were chosen for this study; 88 completed the study. Urinary frequency and bladder capacity were evaluated in each patient by using the above methods. The agreement between different methods of measurement was assessed by determining whether the 2 methods were interchangeable, a condition occurring if results of both methods fall within predetermined limits of variability. The results showed poor agreement between subjectively estimated unnary frequency and chart‐determined urinary frequency. Moreover, different methods of measuring bladder capacity (endoscopic vs. chart) gave different results. Since chart‐determined data are probably a more valid indication of urinary habits, we suggest that frequency‐volume charts should be used more often in the investigation and follow‐up of patients with micturit

ISSN:0007-1331    

DOI:10.1111/j.1464-410X.1992.tb15450.x

出版商:Blackwell Publishing Ltd    

年代:1992

数据来源: WILEY

摘要:

Summary—Sixteen women whose ages ranged from 42 to 73 years (mean 57) and 2 men, aged 76 and 80 years respectively, were treated for urinary stress incontinence with transurethral implantation of submucosal glutaraldehyde cross‐linked collagen (GAX); 15 females had had several continence operations previously and 1 female was totally incontinent following low anterior resection of the sigmoid colon for cancer. All but 2 patients received 8 ml GAX in a single operative session under general anaesthesia. Before implantation, patients underwent urodynamic evaluation, cystoscopy, urinary stress test and the two‐thirds capacity pad weighing test. Post‐operative evaluations were carried out after 3, 6 and 9 months and included urinary flow rate, urine analysis, residual urine determination and the two‐thirds pad weighing test. The results were encouraging.After 3 months, 8/18 patients were cured, 7/18 had improved and 3/18 had failed to respond. Nine months post‐operatively, 7 patients were still continent, 8 had improved and 3 remained unchanged. One of the improved group had a reinjection 18 months post‐operatively and has been continent since then.We feel that GAX collagen injection is a safe and easy method for the treatment of urinary stress incontinence; it has no observable or measura

ISSN:0007-1331    

DOI:10.1111/j.1464-410X.1992.tb15451.x

出版商:Blackwell Publishing Ltd    

年代:1992

数据来源: WILEY

摘要:

Summary—This report deals with 720 incontinent males injected with Polytef paste. In all cases the incontinence resulted from some form of prostatic surgery. All patients had been incontinent for at least 1 year. Approximately 88% of patients incontinent from transurethral resection (TURP) were cured or improved; 74% of patients undergoing prostatectomy were improved, and approximately 67% of patients incontinent after radical prostatectomy were cured or improved. No major complications or clinical evidence of particle migration were observed. Our 20 plus years' experience with Polytef paste has shown it to be a safe and effective method for the treatment of post‐operative male incontinence, with a high success r

ISSN:0007-1331    

DOI:10.1111/j.1464-410X.1992.tb15452.x

出版商:Blackwell Publishing Ltd    

年代:1992

数据来源: WILEY

摘要:

Summary—Injectable polytetrafluoroethylene (Polytef) has been used in many patients for vocal cord augmentation and for the management of urinary incontinence since the early 1960s and noninjectable forms have been used for sutures, hernia repair, replacement of the stapes, hip prostheses, cardiac valves and vascular grafts.Since 1984, many children have been treated with subureteric Polytef injection for the management of vesicoureteric reflux. Its use in young patients has heightened the concern about particle migration and carcinogenesis, particularly in view of the fact that the substance may be in the patient for decades.The available evidence does not confirm a significant carcinogenic effect in humans; rather it suggests that, if there is a risk, it is extremely low. However, human specimens, taken decades after the implantation of Polytef, and long‐term, non‐rodent animal experiments are needed to substantiate the probable safety of Polytef in chi

ISSN:0007-1331    

DOI:10.1111/j.1464-410X.1992.tb15453.x

出版商:Blackwell Publishing Ltd    

年代:1992

数据来源: WILEY

摘要:

Summary—There are few options now available to treat patients with severe genuine stress incontinence caused by urethral failure. These patients usually have a low maximum urethral closure pressure (<20 cm of water) and anterior vaginal wall scarring caused by previous surgery. In 32 such patients we used the Martius fat pad insertion procedure, in addition to the Stamey procedure, and achieved a 91% symptomatic success rate over a mean 13‐month follow‐up period. Because of its simplicity, reliability and low morbidity, we recommend this procedure in this difficult group of patients before performing a sling procedure or insertion of an artificial urinary sphi

ISSN:0007-1331    

DOI:10.1111/j.1464-410X.1992.tb15454.x

出版商:Blackwell Publishing Ltd    

年代:1992

数据来源: WILEY

摘要:

Summary—Lumbar disc prolapse with urinary dysfunction is an uncommon condition. The clinical, pathological and follow‐up details of 30 patients are presented. Detrusor recovery is rare and most patients are left with an areflexic bladder.Female patients with lumbar disc prolapse and an areflexic detrusor who strain to empty their bladders are likely to develop genuine stress incontinence. This may be managed by the early institution of intermittent self‐catheterisation, which may reduce the need for incontinence su

ISSN:0007-1331    

DOI:10.1111/j.1464-410X.1992.tb15455.x

出版商:Blackwell Publishing Ltd    

年代:1992

数据来源: WILEY

摘要:

Summary—All manner of foreign bodies have been extracted from the bladder. Introduction into the bladder may be through self‐insertion, iatrogenic means or migration from adjacent organs. Extraction should be tailored according to the nature of the foreign body and should minimise bladder and urethral trauma. Complete extraction should also be confirmed by panendoscopy at the end of the extraction procedure.A 5‐year review of our experience in this field has been conducted and the management and complications of intravesical foreign bodies are described. Of the 15 patients presenting to this department, 11 presented acutely and 4 presented with chronic symptoms due to complications which arose later. The possibility of an intravesical foreign body should be considered in any patient with chronic unexplained lower urinary tract sym

ISSN:0007-1331    

DOI:10.1111/j.1464-410X.1992.tb15456.x

出版商:Blackwell Publishing Ltd    

年代:1992

数据来源: WILEY