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Query: UMLS:C0010200 (cough)
 23,843 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

The value of cystometry in the diagnosis of recurrent urinary incontinence is to differentiate between urge and stress incontinence. This is possible through determination of detrusor hyperactivity characterized by uninhibited detrusor contractions. Cystometry is necessary since neither history nor clinical examination can differentiate between urge and stress incontinence. Both types of incontinence are in many patients found together and factors causing stress incontinence, for instance coughing, may also cause spontaneous, uninhibited detrusor contractions. The diagnosis of detrusor hypoactivity is also important although lack of detrusor contractions is not identical to lack of contractility. In only 50% of patients are detrusor contractions present following correction of the urinary incontinence and increase of urethral resistance. In the other half of the patients, lack of detrusor contractility remains. There is evidence that a so-called micturition-stop-test may allow a prognosis in cases of lack of bladder contractility. Cystometry is, therefore, a conditio sine qua non although it only gives information concerning the function of the detrusor. Concerning the evaluation of the bladder outlet, additional radiological and urodynamic examinations are necessary.
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PMID:[Recurrent urinary incontinence: cystomanometry--conditio sine qua non?]. 378 89

Thirty-one female patients were investigated 4.8 +/- 2.5 years after pubococcygeal repair for stress urinary incontinence (SUI). Eighteen patients had a successful operation with total cure or marked improvement and 13 had a failed operation. The results of the operation were further evaluated clinically by detailed patient history and urodynamically by urethrocystometry (UCM). The severity of the SUI symptoms was evaluated by recording the physical stress causing incontinence, restrictions of daily activities and social life and use of protective pads. The symptoms were graded by the SUI score ranging from 0 to 10. The bladder pressure rise necessary for urinary leakage during coughing (The SUI threshold) was measured by UCM. The mean SUI score was 2.2 +/- 1.0 and 6.9 +/- 4.8 after successful and failed operations, respectively and the SUI threshold was 85 cm H2O and 57.5 cm H2O after successful and failed operations, respectively. The SUI threshold had a significant negative correlation with the SUI score. It is suggested that the SUI threshold is a valuable addition to UCM determining objectively the results of incontinence surgery. It should be measured each time an UCM is performed.
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PMID:Quantification of urethral closure function by SUI threshold after pubococcygeal sling operation. 386 25

Urethral closure pressures are examined with respect to continence and aging. An attempt is made to interpret the inherent orientation sensitivity of microtip transducer profilometry. The transmission of cough pressures along the length of the urethra is also examined, showing that incontinence is associated with low transmission.
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PMID:Resting and stress urethral pressures as a clinical guide to the mechanism of continence in the female patient. 403 86

The striated musculature of the dog urethra was studied histochemically. Two main groups of muscle fibers could be identified: 1 with slow twitch oxidative fibers, which are fatigue resistant (type 1), and 1 with fast twitch fibers (type 2). The fast twitch fibers were subdivided into glycolytic (fatiguable) and oxidative glycolytic (fatigue resistant) fibers: the latter constitute 20 per cent of all fast twitch fibers. Type 1 constitutes of 35 per cent of the whole musculature and its proportion tends to decrease toward the distal end of the external urethral sphincter. From these observations we infer that type 1 fibers are likely responsible for continence at rest and that type 2 fibers are recruited in stress conditions, for example, during coughing or sneezing. Additional studies are needed to confirm this conjecture. The clinical implications of these studies for the control of incontinence, urinary retention and dyssynergic urethral sphincter are presented.
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PMID:Histochemical study of urethral striated musculature in the dog. 621 91

Sixty female patients with clinically demonstrable stress incontinence of urine have had a Stamey operation during the last 3 years. The results have been good in curing stress incontinence, whilst the majority of the failures have been in patients with severe detrusor instability or a chronic cough. There have been few post-operative complications and urodynamic studies have shown improved cough urethral profiles and no evidence of bladder outflow obstruction. The Stamey procedure can be recommended as the initial operation for surgically curable incontinence. Mild bladder instability is not a contraindication to the operation and it is also useful in elderly, unfit or obese patients.
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PMID:Stamey endoscopic bladder neck suspension for stress incontinence. 653 80

Urodynamic examinations carried out on 45 patients with stress urinary incontinence (SUI) and 17 women without a history of incontinence using simultaneous microtransducer urethrocystometry were examined in order to develop an objective indicator of the severity of the condition. Five urethral pressure profiles (UPP) with stress were recorded, maintaining a constant coughing strength as seen in the bladder pressure rises. The coughing strength was increased stepwise for successive profiles. Zero urethral closure pressure, indicating genuine SUI, appeared with bladder pressure rises of less than 50, 75 and 100 mm Hg and of 100 mm Hg or more in 7, 27, 45 and 67% of the 45 symptomatic patients, respectively. 33% had a positive closure pressure in every UPP. 2 women without symptomatic incontinence had negative urethral closure pressures. The lowest bladder pressure rise needed for zero urethral closure pressure showed a significant negative correlation with the clinical grade of SUI and the degrees of social restriction experienced. We suggest that SUI can be classified urodynamically into minimal (lowest bladder pressure rise producing zero urethral closure pressure 100 mm Hg or more), mild (75-99 mm Hg), moderate (50-74 mm Hg) and severe forms (less than 50 mm Hg).
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PMID:Degree of female stress urinary incontinence: an objective classification by simultaneous urethrocystometry. 654 Nov 76

Characteristic alterations of urethral pressure and length occur in patients with stress urinary incontinence. Urodynamics in this group of 50 patients revealed a significant decrease in urethral functional length under the stress of bladder filling and change of position from supine to sitting. A decrease in urethral closure pressure was present in individual patients and was significant. All patients with stress urinary incontinence demonstrated a decreased ability to voluntarily increase urethral pressure and also had evidence of pressure equalization on Valsalva maneuver and coughing. Cough pressure profiles also demonstrated equalization of urethral and bladder pressures. These profiles also were performed in a subgroup of 12 patients with genuine stress incontinence after treatment of incontinence by retropubic urethropexy. These profiles became normal after surgery and correlated with the clinical cure of stress urinary incontinence.
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PMID:Urodynamics in women with stress urinary incontinence. 689 Jun 57

The value of the patient's history, the nappy-test (urilos meter) and urethro-cystometry with microtip-transducers was analized in 125 "stressincontinent" women. We consider the results of the nappy-test together with urine loss during coughing in the erect position as an objective evidence of incontinence. On this basis, two groups of patients were formed which allowed that statistical comparison of the different urethro-cystotonometric parameters. The urethral closure pressure under stress (urethral stress profile) is still the best criterium for the diagnosis of an urethral insufficiency. We studied especially the urethral closure pressure at rest and the pressure transmission from the bladder to the urethra. Although we could prove that both these parameters were statistically more often altered in cases of "proven" incontinence (urine loss when erect and positive nappy-test) than in cases without "proven" incontinence (no urine loss when erect and negative nappy-test), the lower limits of normal could not be determined because of the broad range of confidence. The diagnostic and therapeutic consequences are discussed.
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PMID:[The importance of the sphincterometric parameters using microtip-transducers and of the urilos-nappy-test for the investigation of female urinary incontinence (author's transl)]. 718 67

The objective of the study was to ascertain if the determination of urethral data in static conditions allows to discriminate between sphincter and detrusor incontinence. Using a standardized recording technique with three Millar microtransducer catheters (in bladder, urethra and rectum) urethral pressure profile measurements were done in two groups of female patients, with either sphincter incontinence (n = 38) or detrusor incontinence (n = 28). The urethral examination was performed in two conditions, with an empty bladder when the patient was in supine position and with a full bladder in standing position. A Millar catheter with a small balloon was drawn through the urethra at a speed of 25 mm per minute (static, i.e. without coughing). The parameters measured were the functional urethral length, the anatomical urethral length and the maximal urethral closure pressure. Results showed that there was no clear difference between both groups with respect to the urethral lengths or the maximal closure pressure. Comparing the data in the condition of empty bladder supine, with those in the condition of full bladder standing, we could not demonstrate clear specificity for either sphincter or detrusor incontinence. It was concluded that static urethral profile studies are of poor value to discriminate between sphincter incontinence and detrusor incontinence.
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PMID:The static urethral closure pressure profile in female incontinence. A comparison between sphincter and detrusor incontinence. 719 29

The study has resulted from comparing urethral pressure curves measured with the use of a catheter with two micropressure gauges in 34 continent and 100 incontinent women. Two types of tracing were obtained: first of all at rest and then with the woman coughing repeatedly. Of the different parameters that were measured at rest only one seems to be advantageous over the others. That is the pressure at the maximum closure which becomes less with incontinence and with ageing. The curves that have been produced with effort make it possible to analyse what happens to this pressure when maximum closure is effected. This always rises in patients who are continent and always lessens in patients who are incontinent. The ratio of these two values, Pc with maximum effort over Pc at maximum rest, allows an index of continence (IC) to be drawn; and which conveys the ability of the sphincter apparatus to adapt itself, and which gives a quantitative value to female continence. Its practical application makes if possible to confirm the diagnosis and adapt the therapy to be used in many incontinent patients in whom other tests have been unrevealing, and to unmask incontinences that have been masked by prolapse and to identify possible future incontinent patients.
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PMID:[An urethromanometric study using micro-pressures gauges for female urinary incontinence. A definition of the index of continence. Applications (author's transl)]. 720 Jan 5


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