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- Gladh, Gunilla, 1943-, et al.
(författare)
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Voiding pattern in healthy newborns
- 2000
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Ingår i: Neurourology and Urodynamics. - 0733-2467 .- 1520-6777. ; 19:2, s. 177-184
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Tidskriftsartikel (refereegranskat)abstract
- A 4-hour observation period has been used in infants to investigate suspected bladder dysfunction. The aim of the present study was to extend the usefulness of this protocol by establishing reference values for voiding frequency, intervals, volumes, and residual urine in healthy newborns. The study included 51 healthy newborns, 26 girls and 25 boys, aged 3 to 14 days. During a 4-hour period, all micturitions and residuals were recorded as well as feeding, sleeping, crying, and defecations. The observation was completed with the child undressed to observe the urinary stream during one void. Different provocation tests were tried to induce urinary leakage. All newborns voided with a stream, about once per hour, with a median volume of 23 mL. For each voiding parameter, there was a large inter- and intra-individual variability. Double voidings were common as well as sizable residual volumes. The diuresis was about six times higher than in healthy school children. The healthy newborns did not leak during provocation tests such as manual compression of the bladder.
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| 2. |
- Frederiksen, Hans, et al.
(författare)
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Nerve induced responses and force-velocity relations of regenerated detrusor muscle after subtotal cystectomy in the rat.
- 2004
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Ingår i: Neurourology and Urodynamics. - : Wiley. - 0733-2467 .- 1520-6777. ; 23:2, s. 159-165
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Tidskriftsartikel (refereegranskat)abstract
- AIMS: To study the pharmacological and mechanical properties of newly developed detrusor muscle after subtotal cystectomy, to explore if the regenerated detrusor has characteristics similar to the normal bladder base, from which it regenerated, or to the normal bladder body which it replaces. METHODS: Partial cystectomy was performed in female rats. Fifteen weeks later, detrusor strips were cut from supratrigonal and equatorial segments. Unoperated rats served as controls. Responses to field stimulation were obtained in the absence and presence of scopolamine, prazosin, and P2X1 blockade. Dose-response curves were obtained for carbachol, alpha,beta-methylene-ATP, and phenylephrine. Force-velocity data were obtained on maximally activated chemically skinned preparations. RESULTS: Maximal contractile response to field stimulation was 60% of that to high-K+ with no difference between strips from control and cystectomy bladders. Prazosin had no effect. Scopolamine decreased maximal response of supratrigonal strips to 62 +/- 6 (controls) and 61 +/- 4% (operated) of that without blocker. For equatorial strips the decrease was to 81 +/- 5 (controls) and 58 +/- 8% (operated). Frequency-response relations were obtained during blockade with scopolamine, alpha,beta-methylene-ATP, and prazosin. Supratrigonal strips showed a pronounced additional inhibition up to 40 Hz. Equatorial strips from controls were completely inhibited at all frequencies. Equatorial strips from operated bladders were inhibited up to 20 Hz but not at 40 and 60 Hz. Carbachol EC(50) values were similar in all groups. Maximum response to phenylephrine was 10-20% of high-K+ response. Maximal shortening velocity (Vmax) was similar in control supratrigonal and equatorial strips, but was significantly lower in the operated bladders. CONCLUSIONS: (1): A regional difference exists in pharmacological properties of control detrusor, with a considerable contractile response to stimulation remaining in the supratrigonal muscle after simultaneous cholinergic, adrenergic, and purinergic blockade. (2): The new detrusor was functionally well innervated with no supersensitivity to muscarinic stimulation. (3): The newly formed bladder body had pharmacological properties specific for the supratrigonal segment from which it had developed. (4): There was no regional difference in force-velocity characteristics of the control detrusor. (5): The lowered Vmax in the newly formed bladder might thus be related to growth and regeneration of muscle cells.
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| 3. |
- Frederiksen, Hans, et al.
(författare)
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Regeneration of detrusor muscle after subtotal cystectomy in the rat; effects on contractile proteins and bladder mechanics.
- 2001
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Ingår i: Neurourology and Urodynamics. - : Wiley. - 0733-2467 .- 1520-6777. ; 20:6, s. 685-697
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Tidskriftsartikel (refereegranskat)abstract
- The aim of the present study was to determine to what extent adult rats can produce new contracting bladder muscle and to see if such newly formed bladder tissue possesses characteristic mechanical properties or whether the ability to recover mechanically is so pronounced that the prehistory of the bladder is unimportant. Subtotal cystectomy was performed in adult female rats, leading to a pronounced decrease in total bladder weight. At 10 weeks, bladder weight had normalized. The histological appearance of such bladders was similar to that of the controls. Active and passive length-tension relations for the detrusor muscle were determined in controls and up to 10 weeks after surgery. Immediately after surgery active and passive forces showed a leftward shift and maximum active force decreased markedly. With time the length-tension curves shifted back to normal, but a decreased active force still remained at 10 weeks. Detrusor actin concentration and detrusor myosin/actin ratio were unaffected by the subtotal cystectomy. Intermediate filament protein/actin ratio showed a significant but transitory increase. We conclude that there is a remarkable recovery of detrusor muscle function after subtotal cystectomy, leading to a normalization of optimum length for active force and a net synthesis of contractile and cytoskeletal proteins. The ability to produce active force does, however, not fully recover.
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| 4. |
- Gladh, Gunilla, 1943-
(författare)
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Effect of thoughtful preparation on the catheterization of children undergoing investigative studies
- 2003
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Ingår i: Neurourology and Urodynamics. - : Wiley. - 0733-2467 .- 1520-6777. ; 22:1, s. 58-61
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Tidskriftsartikel (refereegranskat)abstract
- Aims:To evaluate an anesthetic sedation free method of transurethral catheterization in children.Methods:The child and his or her parents are thoroughly prepared for the procedure by means of written and oral child-adapted information and practical instructions. To evaluate this routine, a simple questionnaire was given to 115 consecutive children undergoing transurethral catheterization.Results:The questionnaire was returned by 99 children (86%). Most children and parents (95) found the preparation“good”or“very good”and tolerated the catheterization procedure well. Only six children reported the catheterization to be“very painful”(without requiring that the procedure was terminated). Complications, such as urgency, smarting pain during voidings, or both, after withdrawal of the catheter, occurred in 12 children and urinary tract infections in 3. Unexpectedly, girls were affected more often than boys.Conclusions:Careful preparation of children and their parents allows the great majority of diagnostic studies that require urethral catheterization to be accomplished without anesthesia. Neurourol. Urodynam. 22:58–61, 2003. © 2003 Wiley-Liss, Inc.
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| 5. |
- Gladh, Gunilla, 1943-, et al.
(författare)
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Intravesical electrical stimulation in the treatment of micturition dysfunction in children
- 2003
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Ingår i: Neurourology and Urodynamics. - : Wiley. - 0733-2467 .- 1520-6777. ; 22:3, s. 233-242
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Tidskriftsartikel (refereegranskat)abstract
- Aims To evaluate the results of intravesical electrical stimulation (IVES) in an open prospective study to treat underactive detrusor in children. The treatment was offered as an alternative to clean intermittent catheterization (CIC).Methods Forty-four children were included, 21 girls and 3 boys (6–16 years, md 10) with idiopathic, 9 girls and 11 boys (4–18 years; md 13) with neurogenic underactive detrusor. IVES was given by a catheter electrode in the bladder (cathode) with the anode attached to the suprapubic abdominal skin. Continuous stimulation at 20 or 25 Hz was delivered by battery powered stimulators giving unipolar square-wave pulses (0,2 or 0,7 ms). Stimulation intensity was adjusted individually according to the acceptance of the child (12–64 mA). IVES was initially given at the clinic but 18 children had additional treatment at home. Effect of treatment was monitored by micturiton/incontinence diary, reports of bladder sensation, recordings of urinary flow, residual volume and frequency of urinary tract infections.Results The IVES-treatment was completed by 39/44 children. Long term normalization of the voiding (md 2,5 years follow up) was obtained for 20/24 children with idiopathic problems (83%) and 8/20 with neurogenic problems (40%). Another four had much improved bladder function. The neurogenic group required more stimulation sessions than the idiopathic group. Of those on CIC, 11/15 who completed IVES could discontinue the catheterization. The frequency of urinary tract infections and incontinence decreased significantly (P < 0.01).Conclusions It is concluded that IVES is a promising method to treat the underactive detrusor in children.
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| 6. |
- Ishizuka, O, et al.
(författare)
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Role of supraspinal serotonin receptors for micturition in normal conscious rats
- 2002
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Ingår i: Neurourology and Urodynamics. - : Wiley. - 0733-2467 .- 1520-6777. ; 21:3, s. 225-230
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Tidskriftsartikel (refereegranskat)abstract
- Serotonin (5-HT) receptors are widely distributed in the central nervous system, including several areas involved in the control of micturition reflex pathways. However, the roles of the different subtypes of 5-HT receptors are not well known. We studied in normal, conscious rats, the effects on the cystometrogram of intracerebroventricular (i.c.v.) administration of 5-HT, 8-hydroxy-2-(di-N-propylaminotetralin) (8-OH-DPAT; agonist at 5-HT1A receptors), alpha-methol-5-hydroxytryptamine maleate (agonist at 5-HT2 receptors), 2-methyl-5-hydroxytryptamine hydrochloride (agonist at 5-HT3 receptors), and 1-(4-amino-5-chloro-2methoxyphenyl)-3-(1-n-butyl-4piperidinyl)-1-propano ne hydrochloride (RS67506; agonist at 5-HT4 receptors). Female Sprague-Dawley rats, weighing approximately 230 g, were used. A polyethylene catheter was inserted into the bladder through the dome for cystometric investigations. For administration of drugs, a catheter was implanted into the right cerebral ventricle. Three days after implantation of the bladder catheter, continuous cystometry was performed. Administration of 5-HT (6 nmol/kg i.c.v.), 8-OH-DPAT (6 nmol/kg), alpha-methyl-5-hydroxytryptamine maleate (6 nmol/kg), or RS67506 hydrochloride (6 nmol/kg) significantly (P < 0.05) increased micturition pressure and decreased bladder capacity and micturition volume. The effects increased in a dose-dependent manner (18, 60 nmol/kg). Intracerebroventricular administration of 2-methyl-5-hydroxytryptamine hydrochloride (60 nmol/kg) caused no change in the cystometric parameters. The results suggest that in normal conscious rats, at the supraspinal level, 5-HT (via 5-HT1A, 5-HT2, and 5-HT4 receptors) can enhance the micturition reflex induced by bladder filling. Whether this means that 5-HT1A, 5-HT2, and 5-HT4 receptors can be targets for drugs meant for treatment of bladder hyperactivity, should be explored. (C) 2002Wiley-Liss, Inc.
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| 9. |
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| 10. |
- Stenzelius, Karin, et al.
(författare)
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Symptoms of urinary and faecal incontinence among men and women 75+ in relation to health complaints and quality of life
- 2004
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Ingår i: Neurourology and Urodynamics. - 0733-2467 .- 1520-6777. ; 23:3, s. 211-222
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Tidskriftsartikel (refereegranskat)abstract
- Aims: The aim was to investigate the prevalence of s elf-reported symptom of urinary, faecal, anddouble incontinence (UI, FI, and DI) in men and women 75þ and to identify how other he althcomplaints and Quality of Life (QoL) relate to incontinence symptoms. Methods: Arandomiseds ample, strati¢ed for age, of eligible men and women from the p opulation were included in the studyand 4,277 out of 8,500 completed a postal questionnaire (61.6% women). The questions focused ondi⁄culties in controlling urine and faeces, other health compl aints, socio-economic background,and social relat ions. Resu lts: Among all respondents 39% reported symptom of UI (more so amongwomen P < 0.001), sympto m of FI in 16.9% (ns between sexes), DI, i.e., a combination of UI and FI,was reported among 14.5% (ns between sexes). Incontinence increased with a ge, and perso ns re port-ing incontinence also had signi¢cantly more of all other health compl aints compared with personswithout incontinence. Those reporting DI comprised an especially vulnerable group. Health com-plaints associated with U I were communicative and mobility problems, other urinary complaints,dizziness, cough, and fati gue. FI was associated with diarrhoea, stomach pain, fatigue, and otherpain. Ris k fa ctors for DI wer e diarrhoea, communication, and mobility problems. Conclu sions: UIand FI were common among elderly men and women and incr eased with age. Furt hermore, incon -tinence was associated with many other co-exis ting health complaints, and the most frail were thosewith DI.
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