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

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

To determine the validity of the Bonney test as a prognostic screening test for urinary incontinence, the urethral and urethrovesical functions were studied under resting and stressful conditions. The characteristic similarity of changes was evident in the functional profile length, closure pressure, and cough pressure profile of the urethra during performance of the Bonney test and intentional urethral occlusion. This study clearly invalidated the Bonney test by objectively demonstrating that the Bonney test restored continence under stress of coughing by obstructing the urethra and urethrovesical junction.
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PMID:Urodynamic appraisal of the Bonney test in women with stress urinary incontinence. 668 70

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

A new test for detecting urethral incompetence during coughing has been used in the investigation of women with urinary incontinence. The test detects fluid descending into the urethra and the results is positive a "fluid-bridge" is established between the bladder and a test point in the urethra. For the purpose of this study the test point selected was 0.5 cm from the urethrovesical junction. Sixty-seven incontinent patients and 23 women with normal urinary control were studied. Thirty-nine of the 67 incontinent women had a positive fluid-bridge test compared with only one of the women in the control group. The difference between the test results in the 2 group was highly significant (P < 0.001). In the incontinent patients a diagnosis was made after cystometry had been performed and after the urethral closure pressure profile had been measured. In 46 (69%) of these 67 patients there was agreement between the the diagnosis made following these urodynamic investigations and the one made from the new test. The advantages and shortcomings of the new method are compared with those of other stress tests in current use.
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PMID:Detection of urethral incompetence in women using the fluid-bridge test. 719 43

From a questionnaire survey dealing with urinary incontinence during pregnancy and after childbirth 62 women were randomly selected. These women underwent simultaneous urethrocystometry including urethral profile measurement 7--14 days after parturition. From the case history two groups of patients could be distinguished. One group consisted of women who experienced only occasionally urine leakage after delivery. Pressure recordings in these previous patients were normal, moreover the urethral closure pressure was positive, also at cough provocations. The urethral length and pressure were similar to that found in continent females. The other group of patients reported stress incontinence of a more serious and permanent nature; the symptoms did not disappear after delivery. In all these women negative urethral closure pressures were recorded at cough provocations and simultaneously leakage of urine from the urethra was observed. In addition the urethral length was shorter and urethral resting pressure lower than that recorded in the first group of patients. The reversible symptoms in the first group of women may be a consequence of the pressure exerted by the uterus upon the bladder at coughing combined with a hormonal relaxation of the urethral suspension. In the second group, the enduring symptoms suggest irreversible damage to the urethra and its suspension system during pregnancy.
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PMID:Postpartum incontinence. 719 4

The fluid-bridge test (FBT) detects the entry of urine into the proximal urethra during coughing. In this study it was applied in the investigation of incontinent patients when they were first supine and then standing up. The test results in 76 women with urinary incontinence and 27 women with normal urinary control are reported. When the test was performed erect at 0.5 cm from the urethrovesical junction, it was positive in 68 (90%) of the study group and 4 (15%) of the controls. The difference between the results in the 2 groups is highly significant (P less than 0.001). In 12 (16%) of the incontinent group the test at 0.5 cm became positive only when the subject was standing up, indicating that erect testing adds to the diagnostic efficiency of the method. Erect testing seems more relevant to the investigation of stress urinary incontinence. This study has shown that this is possible using simple urodynamic apparatus.
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PMID:Detection of urethral incompetence. Erect studies using the fluid-bridge test. 719 73

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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