Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0010200 (cough)
 23,843 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Urinary continence is maintained by the smooth-muscled system of the "internal sphincter". The striated external sphincter is not primarily responsible for continence. One of the chief functions of the external sphincter is the initiation of voluntary micturition. Its other functions are: random interruption of the urinary stream, reflex control during an increase in intra-abdominal pressure (such as coughing, sneezing, larghing, lifting) complete emp;ying of the urethra after micturition and stabilization of the posterior urethra in the urogenital diaphragm. After prostatectomy an intact external sphincter is important in order to support the smooth-muscled system which continues to be primarily responsible for continence to function as efficiently as possible. In approximately 90% of all postprostatectomy incontinences the external sphincter is intact and this cames a good prognosis following our correcture surgery without the need for prostheses. Only in rare post-prostatectomy incontinence cases (aprox. 10%) is the external sphincter also injured. Incontinence surgery according to our method has not been satisfactory in these cases.
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PMID:Post-prostatectomy incontinence. 8 55

Stress urinary incontinence was evaluated urodynamically in 86 women in private urologic practice. While 31 patients had failed prior surgical repairs and 58 patients (67.4 per cent) reported irritative symptoms of frequency, nocturia, urgency and urge incontinence unstable bladders were found in only 5 women (5.8 per cent) over-all, in 6.5 per cent of those patients failing a previous operation and in 8.6 per cent of those patients with irritative symptoms. Urethral pressure profiles were decreased mildly in patients with, compared to those without, stress urinary incontinence but considerable overlap existed and no improvement was seen in 20 patients cured with an operation. Excretory urography, post-voiding residual urine volumes and sphincter electromyography usually were normal. Women with stress urinary incontinence consistently showed poor transmission of cough to the urethra so that the intravesical pressure exceeded the intraurethral pressure.
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PMID:Urodynamics in stress urinary incontinence. 57 61

Urinary continence is guaranteed by the system of smooth urethral musculature, the so-called sphincter internus. The striated sphincter externus has primarily no responsibility for continence. One of its most important functions is the initiation of a voluntary micturition. Further functions are: the voluntary interruption of the urinary stream, the reflectory occlusion by elevated intraabdominal pressure (coughing, sneezing, laughing, heavy physical work), expression of the rest of urine in the urethra after micturition, stabilization of the proximal urethra in the urogenital diaphragm. To get an optimal function after prostatectomy an intact sphincter externus becomes important for the smooth urethral muscular system which is further responsible for the continence. About 90% of all patients with a postprostatectomy incontinence have an intact sphincter externus. In these cases we have a high incidence of incontinence cure. Only in 10% of incontinence after prostatectomy the sphincter externus is damaged. In those cases the incontinence operation is inadequate.
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PMID:[Prostatectomy incontinence]. 63 21

To determine the prevalence of urinary incontinence, a questionnaire was administered to 2,911 women by 60 general practitioners, in April and May 1989. The first 50 women seen by the physician in his practice were included in the study. 1,075 women out of 2,911 (37%) declared the presence of episodes of incontinence. Among these 1,075 women, 77% had genuine stress incontinence, 60% urge incontinence, 35% spontaneous leakage. One out of five had these three conditions together. 12% of women with incontinence were less than 31 years of age, 36% were between 31 and 51 years, 20% between 51 and 70 years, and 31% above 70 years. Incontinent women were more frequently post-menopausal; 83% had children (74% for those without incontinence), but the parity was comparable in the two groups. Perineal tears, use of forceps for delivery, high-birth-weight children (above 3,500 g) were more frequently found in incontinent women; but not episiotomy. Incontinent women had more urinary infections, were more often obese, were slightly older at their first childbirth. Post-partum incontinence was found more frequently in incontinent women. A positive association is found with the presence of diabetes, neurological diseases, and chronic bronchitis and cough. Incontinent women more frequently underwent a gynecological surgical procedure, particularly hysterectomies. Incontinence had been present for more than 5 years in 34% of cases, one year in 77% of cases. Only 47 women out of 2,911 (1.6%) consulted specifically for their incontinence.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:[The prevalence of female urinary incontinence in general practice]. 146 26

Cough variant asthma is characterized as a persistent, nonproductive cough with minimal or no wheezing and dyspnea. The diagnosis can be overlooked or misdisagnosed. We describe the severity of cough, the misery of some patients who have this syndrome and the usefulness of a diagnostic-therapeutic trial in ten patients with cough variant asthma. We evaluated ten patients whose chief complaint was persistent nonproductive cough. During the course of evaluation, all patients received a diagnostic-therapeutic trial of prednisone for cough variant asthma after other major causes of cough had been excluded. The duration of cough ranged from 2 months to 20 years. Some patients had significant side effects from coughing including interference with social life, work and sleep, urinary incontinence, stool incontinence, hoarseness, and vomiting. After a diagnostic-therapeutic trial with prednisone, nine patients reported significant improvement of cough in three days. One patient required 2 weeks of therapy for optimal improvement. All were subsequently controlled primarily with inhaled conticosteroids. The diagnosis of cough variant asthma may not be made for a prolonged time. A short course of prednisone as a diagnostic-therapeutic trial can establish a diagnosis and be followed by an effective method of control of cough by inhaled corticosteroids.
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PMID:Cough variant asthma: usefulness of a diagnostic-therapeutic trial with prednisone. 836 52

Twenty-two clinically continent women with severe genitourinary prolapse were evaluated urodynamically to determine the prevalence of urodynamic abnormalities that could lead to potential urinary incontinence. Urodynamic testing found an occult incontinence disorder in 13 women (59%), of whom four had urine loss during cough pressure profiles after pessary placement, four had uninhibited detrusor contractions during retrograde medium-fill water cystometry, and five had both stress urinary incontinence and an unstable bladder. Therefore, nine of the 22 patients (41%) had uninhibited detrusor contractions during urodynamic testing. However, uroflowmetry did not reveal voiding dysfunction in this group, although peak flow rates appeared to be lower in the subgroup of women manifesting uninhibited detrusor contractions. Associated symptoms of frequency, nocturia, and urgency occurred in 41% of the women in this study; four of nine (44%) who had normal urodynamic test results, five of 13 (38%) who had abnormal test results, and five of nine (56%) who had an unstable bladder. Therefore, associated symptoms could not be used to determine which women would have abnormal urodynamic test results. These preliminary results suggest that women with genitourinary prolapse may be at risk for an occult incontinence disorder that is masked by the prolapse and that could manifest after corrective surgery for prolapse. Urodynamic testing is suggested for women with genitourinary prolapse who present with or without symptoms of incontinence, so that more data can be obtained to determine the importance of abnormal test results.
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PMID:Prevalence of abnormal urodynamic test results in continent women with severe genitourinary prolapse. 155 72

In order to understand the pathology of incontinence, it is important to investigate urinary symptoms, urological and neurological examinations and urodynamics. There are two kinds of incontinence. One is true incontinence in which urine passes through urethra, and the other is false incontinence due to the ectopic opening of the ureter, for example to the vagina. The former includes stress incontinence, urge incontinence, reflex incontinence, overflow incontinence and total incontinence. Stress incontinence occurs with the sudden increase of abdominal pressure such as cough, running and exertion. The cause of stress incontinence is thought to be weakening of pelvic floor muscles after delivery or aging. In these patients, the bladder base and urethra move downwards and backwards, which make the posterior vesico-urethral angle more than 120 degrees. Treatment of stress incontinence includes pelvic floor exercise, administration of alpha-stimulants which increase the tonus of the internal sphincter and surgery to elevate the urethra. Urge incontinence is observed when detrusor instability occurs. It is also seen in patients with neurological diseases such as multiple cerebral infarction or with benign prostatic hypertrophy (BPH). Treatment of urge incontinence includes administration of anticholinergics to decrease bladder hyperreflexia. Reflex incontinence is seen in patients with spinal cord disorders. It occurs due to reflex contraction of detrusor and the treatment involves administration of anti-cholinergics. Overflow incontinence is seen in patients with voiding difficulties due to BPH. It occurs when residual urine increases and when the intravesical pressure exceeds urethral pressure on body movement. Treatment for this is intended to improve voiding difficulties. Total incontinence occurs when total sphincter function is damaged.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:[The pathology and treatment of incontinence]. 159 84

The time separation of cough-induced urethral and bladder pressure spikes were studied in 32 female patients: 16 with urinary incontinence due to sphincter incompetence, 9 with urinary incontinence and a competent urethral closure mechanism, and 7 after incontinence surgery. There were no significant differences in time separation between the three groups at different positions in the urethra. Age and menopausal status did not affect time separation of pressure spikes. It is concluded that time separation of pressure spikes during cough cannot be used as a discriminator of the etiology of urinary incontinence. Surgery does not restore the latency seen in normal continent women and may restore continence by a mechanism different from that of normal continent women.
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PMID:Temporal separation of cough-induced urethral and bladder pressure spikes in women with urinary incontinence. 173 12

One hundred ninety-five male and female patients over 65 years old presenting with urinary incontinence were evaluated by clinical and urodynamics. Urinary incontinence was in the form of urgency-incontinence in 68% of the cases, incontinence at cough in 26%, and urinary incontinence which the patient referred to no specific situation in 6%. Among the different urodynamics data, bladder instability was the most common (73%). Urinary stress incontinence was observed in 35% of the cases. Bladder instability was demonstrated in 77% of the cases with urgency-incontinence and in 69% of the cases with incontinence not referred to a specific situation. All the male patients with lower urinary tract obstruction had urgency-incontinence. Stress incontinence was demonstrated in 60% of the cases with incontinence at cough. Stress incontinence was not observed in male patients without associated diseases. The associated neurological disorder was accompanied by bladder hyperreflexia in 90% of the cases. A prior adenomectomy or hysterectomy was associated with a greater number of cases with stress urinary incontinence, accounting for 62% in both males and females.
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PMID:[Urinary incontinence in the elderly: clinical and urodynamic review of 195 cases]. 186 7

The assessment and treatment of urinary incontinence and related urogenital symptoms using an algorithm model was evaluated in 364 elderly women complaining of urinary incontinence. The women (age 72.1 +/- 1.5 years, range 65-84 years) were assessed by a 48-hour pad test, a cough provocation test, micturition lists and a gynecological examination which included a smear test, measurement of vaginal pH and bacterial cultures. The diagnosis of urinary incontinence was confirmed in 346 women (stress 26.3%; urge: 32.7%; mixed: 41.0%). Women suffering from stress incontinence were younger (p less than 0.05) and had experienced a larger number of deliveries (p less than 0.05) than women with urge incontinence. All the women were treated with oral estriol, 3 mg daily for 4 weeks followed by 1-2 mg daily. The total urinary leakage per 48 hours (p less than 0.01) and maximum single leakage (p less than 0.05) were reduced in women with mixed incontinence, while the frequency of micturition decreased (p less than 0.05) in women with urge incontinence after 12 weeks treatment with oral estriol. There were no significant changes in any of the objective micturition parameters in women with stress incontinence following treatment. Karyopyknotic index and the presence of lactobacilli were increased (p less than 0.001), and vaginal pH decreased (p less than 0.001) following treatment in women with all types of incontinence. More than 70% of all the women treated in this algorithm model judged themselves to be improved, much improved or cured.
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PMID:A health care program for the investigation and treatment of elderly women with urinary incontinence and related urogenital symptoms. 188 60


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