Prevalence of bladder dysfunction, urodynamic findings, and their correlation with outcome in guillain-barre syndrome.:
Prevalence of bladder dysfunction, urodynamic findings, and their correlation with outcome in guillain-barre syndrome.
Neurourol Urodyn. 2012 Apr 6;
Authors: Naphade PU, Verma R, Garg RK, Singh M, Malhotra HS, Shankwar SN
Abstract
AIMS: The micturitional disturbances and related urodynamic studies are infrequently reported in Guillain Barre syndrome (GBS). In the present study, we evaluated patients of GBS for bladder dysfunction and urodynamic abnormalities. We also tried to assess relation between urodynamic findings with disability in patients diagnosed as GBS. METHODS: In this study, 38 patients of GBS were assessed for micturitional disturbances and disability using Hughes motor grade, Overall Disability Sum Score (ODSS), Medical Research Council (MRC) sum score. Urodynamic studies were carried out at baseline and at 2 months. RESULTS: Out of 38 patients, 10 patients had urinary symptoms, 23 patients had urodynamic abnormalities and most common being detrusor underactivity in 15 patients. Other findings were detrusor sphincter dyssynergia in six patients, acontractile bladder in five patients, and detrusor overactivity in three patients. Decreased uroflow rates were seen in 14 patients. Severe disability in the form of Hughes motor grades 4-5, ODSS leg scores 4-7, low MRC scores were significantly more common in patients with urodynamic abnormalities. The axonal variant of GBS patients demonstrated more frequent abnormal urodynamic findings. CONCLUSIONS: Our study revealed fair incidence of micturitional disturbances and urodynamic dysfuctions in GBS. The subclinical bladder involvement was frequently observed, substantiated by urodynamic assessment. The disability, particularly of lower limbs had positive correlation with urodynamic abnormality. Neurourol. Urodynam. © 2012 Wiley Periodicals, Inc.
PMID: 22488834 [PubMed – as supplied by publisher]
Last Updated: July 27, 2020 by uabadmin
Vasoactive intestinal polypeptidergic innervation of human urinary bladder in normal and pathological conditions.
Vasoactive intestinal polypeptidergic innervation of human urinary bladder in normal and pathological conditions.:
Vasoactive intestinal polypeptidergic innervation of human urinary bladder in normal and pathological conditions.
Urol Int. 1988;43(4):205-10
Authors: Van Poppel H, Stessens R, Baert L, Van Damme B, Carton H
Urinary bladder biopsies from 31 multiple sclerosis patients, 9 diabetics, 5 patients after transtrigonal phenolization and 20 control patients were stained for acetylcholinesterase, S100 and vasoactive intestinal polypeptide (VIP). The VIP immunoreactivity was not decreased in all neuropathic bladders and its depletion was not related to cholinergic depletion. There was no correlation between bladder over- or underactivity and VIP content. VIP can act as a modulator of detrusor function in normal conditions. The significance of its depletion in neurogenic bladders needs further elaboration.
PMID: 3188288 [PubMed – indexed for MEDLINE]
Last Updated: July 27, 2020 by uabadmin
Re: detrusor underactivity: a plea for new approaches to a common bladder dysfunction.
Re: detrusor underactivity: a plea for new approaches to a common bladder dysfunction.:
Re: detrusor underactivity: a plea for new approaches to a common bladder dysfunction.
J Urol. 2012 Jun;187(6):2154-5
Authors: Wein AJ
PMID: 22579190 [PubMed – in process]
Last Updated: July 27, 2020 by uabadmin
Incontinence of urine due to instability of micturition reflexes: Part I. Detrusor reflex instability.
Incontinence of urine due to instability of micturition reflexes: Part I. Detrusor reflex instability.:
Incontinence of urine due to instability of micturition reflexes: Part I. Detrusor reflex instability.
Urology. 1980 Mar;15(3):229-39
Authors: Mahony DT, Laferte RO, Blais DJ
Micturition reflex instability may result from malfunction of the detrusor reflex or instability of the pudendal nucleus which innervates the pelvic floor muscles and external sphincter. Detrusor instability is the result of sacral micturition reflex center (SMRC) hyperexcitability. This may be caused by underinhibition or overfacilitation of the SMRC, and there are both central and peripheral causes of each. Detrusor hypertrophy may invoke chronic overactivity of the detrusodetrusor facilitative reflex causing SMRC overfacilitation. Similarly, distal urethral stricture and/or chronic urethritis causing chronic overactivity of the urethrodetrusor facilitative reflex is a common cause of SMRC overfacilitation. Pathologic relaxation and weakness of the striated muscles of the pelvic floor and perineum resulting in underactivity of the perineodetrusor inhibitory reflex, is a common cause of SMRC underinhibition. In adult women these factors often coexist. Each may predispose to stress-induced detrusor instability and are often seen in association with, or are confused with, true stress incontinence. The distinguishing characteristics of detrusor hypertonicity and detrusor hyperreflexia are reviewed, and the various mechanisms of pseudostress incontinence and of urgency incontinence are discussed in detail.
PMID: 7189070 [PubMed – indexed for MEDLINE]
Last Updated: July 27, 2020 by uabadmin
Can Staccato and Interrupted/Fractionated Uroflow Patterns Alone Correctly Identify the Underlying Lower Urinary Tract Condition?
Can Staccato and Interrupted/Fractionated Uroflow Patterns Alone Correctly Identify the Underlying Lower Urinary Tract Condition?:
Can Staccato and Interrupted/Fractionated Uroflow Patterns Alone Correctly Identify the Underlying Lower Urinary Tract Condition?
J Urol. 2012 Apr 12;
Authors: Wenske S, Combs AJ, Van Batavia JP, Glassberg KI
Abstract
PURPOSE: Worldwide, uroflowmetry without simultaneous electromyography is often the only testing performed during the initial assessment of children with lower urinary tract symptoms. Various alterations in uroflow pattern are thought to indicate particular types of lower urinary tract conditions, specifically staccato uroflow indicating dysfunctional voiding and intermittent/fractionated uroflow indicating detrusor underactivity. We determined how reliable uroflow pattern alone is as a surrogate for simultaneously measured pelvic floor electromyography activity during voiding, and how well staccato and interrupted uroflow actually correlate with the diagnoses they are presumed to represent. MATERIALS AND METHODS: We reviewed uroflow/electromyography studies performed during the initial evaluation of 388 consecutive neurologically and anatomically normal patients with persistent lower urinary tract symptoms. We identified those with staccato, interrupted/fractionated and mixed uroflow based on current International Children’s Continence Society guidelines. RESULTS: A total of 69 girls (58.5%) and 49 boys (41.5%) met inclusion criteria. Staccato uroflow was noted in 60 patients, interrupted/fractionated uroflow in 28 and a combination in 30. An active electromyography during voiding confirmed the diagnosis of dysfunctional voiding in 33.3% of patients with staccato, 46.4% with interrupted/fractionated and 50% with mixed uroflow patterns. CONCLUSIONS: Diagnoses based on uroflow pattern appearance without simultaneous electromyography to support them can be misleading, and reliance on uroflow pattern alone can lead to overdiagnoses of either dysfunctional voiding and detrusor underactivity. When assessing patients with uroflow, an accompanying simultaneous pelvic floor electromyography is of utmost importance for improving diagnostic accuracy and thereby allowing for the most the appropriate therapy.
PMID: 22503030 [PubMed – as supplied by publisher]
Last Updated: July 27, 2020 by uabadmin
Prevalence of bladder dysfunction, urodynamic findings, and their correlation with outcome in guillain-barre syndrome.
Prevalence of bladder dysfunction, urodynamic findings, and their correlation with outcome in guillain-barre syndrome.:
Prevalence of bladder dysfunction, urodynamic findings, and their correlation with outcome in guillain-barre syndrome.
Neurourol Urodyn. 2012 Apr 6;
Authors: Naphade PU, Verma R, Garg RK, Singh M, Malhotra HS, Shankwar SN
Abstract
AIMS: The micturitional disturbances and related urodynamic studies are infrequently reported in Guillain Barre syndrome (GBS). In the present study, we evaluated patients of GBS for bladder dysfunction and urodynamic abnormalities. We also tried to assess relation between urodynamic findings with disability in patients diagnosed as GBS. METHODS: In this study, 38 patients of GBS were assessed for micturitional disturbances and disability using Hughes motor grade, Overall Disability Sum Score (ODSS), Medical Research Council (MRC) sum score. Urodynamic studies were carried out at baseline and at 2 months. RESULTS: Out of 38 patients, 10 patients had urinary symptoms, 23 patients had urodynamic abnormalities and most common being detrusor underactivity in 15 patients. Other findings were detrusor sphincter dyssynergia in six patients, acontractile bladder in five patients, and detrusor overactivity in three patients. Decreased uroflow rates were seen in 14 patients. Severe disability in the form of Hughes motor grades 4-5, ODSS leg scores 4-7, low MRC scores were significantly more common in patients with urodynamic abnormalities. The axonal variant of GBS patients demonstrated more frequent abnormal urodynamic findings. CONCLUSIONS: Our study revealed fair incidence of micturitional disturbances and urodynamic dysfuctions in GBS. The subclinical bladder involvement was frequently observed, substantiated by urodynamic assessment. The disability, particularly of lower limbs had positive correlation with urodynamic abnormality. Neurourol. Urodynam. © 2012 Wiley Periodicals, Inc.
PMID: 22488834 [PubMed – as supplied by publisher]
Last Updated: July 27, 2020 by uabadmin
A novel animal model of underactive bladder: Analysis of lower urinary tract function in a rat lumbar canal stenosis model.
A novel animal model of underactive bladder: Analysis of lower urinary tract function in a rat lumbar canal stenosis model.:
A novel animal model of underactive bladder: Analysis of lower urinary tract function in a rat lumbar canal stenosis model.
Neurourol Urodyn. 2012 Mar 30;
Authors: Sekido N, Jyoraku A, Okada H, Wakamatsu D, Matsuya H, Nishiyama H
Abstract
AIMS: An animal model of neurogenic underactive bladder (UAB) has not been established. It was reported that a rat lumbar spinal canal stenosis (LCS) model created by cauda equina compression manifested intermittent claudication and allodynia. In this study, we examined the lower urinary tract function of the rat LCS model. METHODS: One small hole was drilled at the fifth lumbar vertebral arch (sham), and a rectangular piece of silicone rubber was inserted into the L5-L6 epidural space (LCS). Before and after surgery, a metabolic cage study was performed. After surgery, awake cystometry (CMG) and an in vitro muscle strip study were performed. Bladder morphology was evaluated by hematoxylin and eosin staining. RESULTS: The LCS rats showed a significant decrease in voided volume and a significant increase in postvoid residual volume and residual urine rate compared with Sham rats. CMG showed that the postvoid residual urine volume and numbers of non-voiding contractions significantly increased, while the voided volume, threshold pressure, and maximum intravesical pressure during voiding significantly decreased. There were no significant differences between sham and LCS rats in response to carbachol. In contrast, there was a significant increase in response to field stimulation, especially at lower frequencies, in LCS rats. LCS rats showed no obvious difference in detrusor morphology. CONCLUSIONS: This rat model requires a relatively simple surgical procedure and has characteristics of neurogenic UAB. It seems to be useful in the pathophysiological elucidation of UAB and might have potential for assessment of pharmacotherapy of UAB. Neurourol. Urodynam. © 2012 Wiley Periodicals, Inc.
PMID: 22473471 [PubMed – as supplied by publisher]
Last Updated: July 27, 2020 by uabadmin
Low-frequency electrotherapy for female patients with detrusor underactivity due to neuromuscular deficiency.
Low-frequency electrotherapy for female patients with detrusor underactivity due to neuromuscular deficiency.:
Low-frequency electrotherapy for female patients with detrusor underactivity due to neuromuscular deficiency.
Int Urogynecol J. 2012 Mar 23;
Authors: Xu DF, Zhang S, Wang CZ, Li J, Qu CY, Cui XG, Zhao SJ
Abstract
INTRODUCTION AND HYPOTHESIS: The aim of the study was to assess the efficacy of low-frequency electrotherapy (LFE) for female patients with early-stage detrusor underactivity (DUA) due to neuromuscular deficiency. METHODS: A total of 102 female patients were divided randomly into four groups: LFE-NC (normal compliance), LFE-LC (low compliance), CON (control)-NC and CON-LC. Patients in the LFE-NC and LFE-LC groups received LFE, and those in the CON-NC and CON-LC groups received conservative treatment. Urodynamic evaluation was performed before and after treatment. RESULTS: After treatment, 82 % of the LFE-NC regained detrusor contractility, whereas only 2 (8 %) of the CON-NC had normal detrusor contraction. None of LFE-LC or CON-LC regained detrusor contractility (p < 0.01). The per cent of LFE-NC who relied on catheterization for bladder emptying decreased by 43 % (p < 0.01). Those in the LFE-LC, CON-NC and CON-LC groups decreased by only 4, 12 or 0 % (p > 0.05). CONCLUSIONS: LFE was more effective for DUA patients with normal compliance; these patients benefited from LFE, but DUA patients with low compliance did not.
PMID: 22441580 [PubMed – as supplied by publisher]
Last Updated: July 27, 2020 by uabadmin
Risk factors that affect the treatment of interstitial cystitis using intravesical therapy with a dimethyl sulfoxide cocktail.
Risk factors that affect the treatment of interstitial cystitis using intravesical therapy with a dimethyl sulfoxide cocktail.:
Risk factors that affect the treatment of interstitial cystitis using intravesical therapy with a dimethyl sulfoxide cocktail.
Int Urogynecol J. 2012 Mar 17;
Authors: Hung MJ, Chen YT, Shen PS, Hsu ST, Chen GD, Ho ES
Abstract
INTRODUCTION AND HYPOTHESIS: Dimethyl sulfoxide (DMSO) bladder instillation is a standard therapy for interstitial cystitis (IC); however, there are varying degrees of success. We hypothesize that first-line intravesical therapy with a DMSO cocktail will optimize treatment outcome. METHODS: Ninety women with newly diagnosed IC were enrolled consecutively for the treatment. The IC symptom and problem index was used as an outcome measure. RESULTS: Six (6.7%) patients dropped out of the treatment due to intolerable bladder irritation. Fifty-five (65.5%) of the remaining 84 patients, who completed the treatment, experienced ≧50% symptomatic improvement. After a regression analysis, three clinical variables were found to affect treatment adversely, i.e., the presence of advanced cystoscopic glomerulations, microscopic hematuria, and urodynamic detrusor underactivity, respectively. CONCLUSIONS: Our results suggest bladder instillation with a DMSO cocktail may well be considered as first-line therapy for IC patients. However, there exists a subgroup of nonresponders who may have severe disease.
PMID: 22426874 [PubMed – as supplied by publisher]
Last Updated: July 27, 2020 by uabadmin
Does diabetes mellitus-induced bladder remodeling affect lower urinary tract function?-ICI-RS 2011.
Does diabetes mellitus-induced bladder remodeling affect lower urinary tract function?-ICI-RS 2011.:
Does diabetes mellitus-induced bladder remodeling affect lower urinary tract function?-ICI-RS 2011.
Neurourol Urodyn. 2012 Mar 13;
Authors: Kirschner-Hermanns R, Daneshgari F, Vahabi B, Birder L, Oelke M, Chacko S
Abstract
AIMS: Due to an increase in aging population and changing eating habits diabetes mellitus (DM) type II is a rapidly increasing condition worldwide. Although not so detrimental as other co-morbidities, uropathy contributes to a significantly reduced quality-of-life in those affected. The purpose of this ICS-RS report is to highlight clinical and basic research data to outline directions for further research and possible treatment approaches. METHODS: This report is based on a think tank presentation and discussion at the ICI-RS 2011, original research data and literature research. RESULTS: Clinical and experimental data confirm that detrusor overactivity, both neurogenic and myogenic, and changes in transmitter regulation leading to a hyper- excitability of the detrusor are the major findings in diabetic neuropathic bladders. These findings seem to be related to an earlier stage of DM, whereas detrusor underactivity appears to be linked to later stages of DM. Detrusor smooth muscle cells seem to be modulated directly by hyperglycemia. Data support the theory that hyperglycemia-induced oxidative stress in the detrusor smooth muscle and that micro- and macrovascular events are also responsible for urologic complications of DM. CONCLUSIONS: DM causes bladder remodelling leading to uropathy in a mulitfactorial way. Future research should focus on the effects of DM as a function of time and develop novel animal models looking at defined aspects as well as interaction of different aspects- such as oxidative stress in neurogenic, myogenic and urothelial components and the role of inflammation and hypoxia caused by vascular complications. Neurourol. Urodynam. © 2012 Wiley Periodicals, Inc.
PMID: 22415965 [PubMed – as supplied by publisher]
Last Updated: July 27, 2020 by uabadmin
The role of prostanoids in urinary bladder physiology.
The role of prostanoids in urinary bladder physiology.:
The role of prostanoids in urinary bladder physiology.
Nat Rev Urol. 2012 Mar 13;
Authors: Rahnama’i MS, van Kerrebroeck PE, de Wachter SG, van Koeveringe GA
Abstract
Five primary prostanoids are synthesized by the cyclooxygenase enzymes, COX-1 and COX-2: the prostaglandins PGE(2), PGF(2α), PGI(2), PGD(2) and thromboxane A2. High levels of these signaling molecules have been implicated-in both animal models and human studies-in decreased functional bladder capacity and micturition volume and increased voiding contraction amplitude. Thus, inhibition of prostanoid production or the use of prostanoid receptor antagonists, might be a rational way to treat patients with detrusor muscle overactivity. Similarly, prostanoid receptor agonists, or agents that stimulate their production, might have a function in treating bladder underactivity. Although some promising results have been reported, the adverse effects of nonselective cyclooxygenase inhibitors are a major concern that restricts their use in the treatment of functional bladder disorders. Further preclinical and clinical studies are needed before cyclooxygenase inhibitors, prostanoid receptor agonists and antagonists become worthwhile therapeutic tools in this setting.
PMID: 22410675 [PubMed – as supplied by publisher]
Blog Archives
Recent Posts
Categories
Bladder Health Links
Tag Cloud