| 1. |
- Mattiasson, Anders, et al.
(author)
-
Abnormal urethral motor function is common in female stress, mixed, and urge incontinence.
- 2006
-
In: Neurourology and Urodynamics. - : Wiley. - 0733-2467 .- 1520-6777. ; 25:7, s. 703-708
-
Journal article (peer-reviewed)abstract
- Aim: To investigate the urethral motor function in incontinent women. Materials and Methods: The intraurethral pressure was measured continuously in the high-pressure zone of the urethra at rest and during repeated short squeezes around the microtip transducer catheter in a group of 205 women with clinically manifest urinary incontinence (severe), and compared with the findings of investigations in 87 middle-aged women (53-63 years) with treatment naive incontinence (mild-to-mode rate) and healthy controls. Results: Women with established incontinence significantly (P < 0.001) more often (66%) had a pressure fall during or immediately following squeeze than women with treatment naive incontinence (35%) or asymptomatic women (25%). The acceleration of urinary flow and the maximal flow rate were significantly (P < 0.01) increased in patients with incontinence: acceleration was 13 +/- 2.2 (17.8), 20 +/- 2.8 (18.9), and 32 +/- 4.9 (24.9) degrees (mean +/- SEM;SD) for incontinence, naive incontinence and no incontinence, respectively; maximum urinary flow rate was 23, 22, and 16 ml/sec. No statistical differences in any of these measures were seen when stress and urge incontinence were compared. Conclusion: Women with stress, urge, and mixed urinary incontinence seem to have a primary neuromuscular disorder in the urethra, which presents itself as an overactive opening mechanism with a urethral pressure fall instead of a pressure increase on provocation during the filling phase of the bladder, and during bladder emptying a more efficient opening of the bladder outlet than in normal women. We suggest that one and the same pathophysiological mechanism participates in female stress, urge, and mixed incontinence.
|
|
| 2. |
|
|
| 3. |
|
|
| 4. |
|
|
| 5. |
|
|
| 6. |
- Crayton, Robert, et al.
(author)
-
Exogenously Administered Opioids Contract the Female Rat Intrinsic Urethral Sphincter In Vivo
- 2010
-
In: Neurourology and Urodynamics. - : Wiley. - 0733-2467. ; 29:5, s. 777-782
-
Journal article (peer-reviewed)abstract
- Background and objective: Previous studies have reported immunoreactive opioid nerve fibers in the detrusor and lower urinary tract sphincters. However, there is a paucity of in vivo studies demonstrating the direct effect of endogenous opioids in these structures. In the present study, we investigated the contractile actions of intra-arterially administered exogenous Dynorphin-A, Met-enkephalin, Leu-enkephalin, morphine, and the opioid antagonist naltrexone on the female rat intrinsic urethral sphincter in vivo. Methods: Intraurethral pressure was recorded by a catheter placed at the maximum pressure zone of the intrinsic urethral sphincter in anesthetized female Sprague-Dawley rats. The effects of different opioids were studied and expressed as means and as percentages of pressure change (cmH(2)O) of the baseline intraurethral pressure. Results: Dynorphin-A, Met-enkephalin, and Leu-enkephalin evoked rapid, long-lasting contractile effects on the female rat urethra. The greatest intraurethral pressure increase was evoked by Dynorphin-A (89.2 +/- 15.3%). For Met-enkephalin, intraurethral pressure increased by 70.2 +/- 21.8% and for Leu-enkephalin, the pressure increase was 60.6 +/- 20%. Morphine, however, evoked inconsistent intraurethral pressure changes, increasing the urethral pressure in three subjects and lowering the pressure in the remaining six subjects. The opioid antagonist naltrexone reduced the intraurethral pressure by a mean of -19.0 +/- 5.8%. Conclusion: Results of the present study suggest that endogenous opioids by their contractile action on the intrinsic urethral sphincter may play a role in the control of continence in rats, additional to cholinergic and noradrenergic pathways. Neurourol. Urodynam. 29:777-782, 2010. (C) 2010 Wiley-Liss, Inc.
|
|
| 7. |
- Radziszewski, P., et al.
(author)
-
Exogenously Administered Bombesin and Gastrin Releasing Peptide Contract the Female Rat Urethra In Vivo and In Vitro
- 2011
-
In: Neurourology and Urodynamics. - : Wiley. - 0733-2467. ; 30:7, s. 1388-1391
-
Journal article (peer-reviewed)abstract
- Background: Bombesin (BOM) and gastrin releasing peptide (GRP) have been located to the lower urinary tract (LUT). However, there is a paucity of data demonstrating the impact of these endogenous peptides. Objectives: The aim of the present study was to investigate the contractile actions of BOM and GRP on the female rat urethra in vitro and in vivo. Female Sprague-Dawley rats (n = 37) weighing approximately 225 g were used. Intraurethral pressure was recorded by a catheter placed at the maximum pressure zone corresponding to the intrinsic urethral sphincter. Measurements: In vitro, changes in intraurethral pressure was conducted on perfused intact urethral/bladder preparations and are expressed as percentages of sphincteric intraurethral pressure achieved with noradrenaline. In vivo, changes in intraurethral pressure was conducted in anesthetized subjects and compared with the baseline intraurethral pressure and sham controls. Results: In vitro, the increase in intraurethral pressure induced by BOM was 23.6 +/- 3.2 cmH(2)O, exceeding the pressure evoked with NA by 9.6 cmH(2)O or 174.4% whereas GRP induced a maximum pressure of 10.7 +/- 1.6 cmH(2)O, an increase of 2.2 +/- 0.5 cmH(2)O or 82.9% (P < 0.05) of the NA evoked pressure. In vivo, the mean baseline pressure was 22.9 +/- 1.4 cmH(2)O. The intraurethral pressure evoked by BOM was 50.6 +/- 6.3 cmH(2)O (P < 0.05), and for GRP, the evoked intraurethral pressure was 56.2 +/- 13.4 cmH(2)O (P < 0.05). Conclusions: The present data suggest that both BOM and GRP may contribute to the control of continence by their contractile action on the sphincters of the LUT outflow region. Neurourol. Urodynam. 30:1388-1391, 2011. (C) 2011 Wiley-Liss, Inc.
|
|
| 8. |
- Schafer, Werner, et al.
(author)
-
Good urodynamic practices: uroflowmetry, filling cystometry, and pressure-flow studies
- 2002
-
In: Neurourology and Urodynamics. - : Wiley. - 0733-2467. ; 21:3, s. 261-274
-
Journal article (peer-reviewed)abstract
- This is the first report of the International Continence Society (ICS) on the development of comprehensive guidelines for Good Urodynamic Practice for the measurement, quality control, and documentation of urodynamic investigations in both clinical and research environments. This report focuses on the most common urodynamics examinations; uroflowmetry, pressure recording during filling cystometry, and combined pressure-flow studies. The basic aspects of good urodynamic practice are discussed and a strategy for urodynamic measurement, equipment set-up and configuration, signal testing, plausibility controls, pattern recognition, and artifact correction are proposed. The problems of data analysis are mentioned only when they are relevant in the judgment of data quality. In general, recommendations are made for one specific technique. This does not imply that this technique is the only one possible. Rather, it means that this technique is well-established, and gives good results when used with the suggested standards of good urodynamic practice.
|
|
