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

A power spectrum of the electromyographic signals in urethral and anal sphincters has been analyzed in 25 patients. Different spectra are observed in each muscle, with higher frequencies in the urethral sphincter. The high frequencies are manifest at short brisk contractions (e.g. cough) and disappear quicly during a sustained voluntary contraction. High frequencies are less pronounced in stress incontinence, but increase in spastic syndromes. The hypothesis is advanced that the proportion of active tonic and phasic motor units determines the efficiency of sphincter reactions.
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PMID:Frequency analysis of the electromyographic activity in striated pelvic floor muscles: a preliminary report. 56 70

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

Two rapid exercise pad tests, the vitamin B test, and the methylene blue test, are introduced for the diagnosis of urinary stress incontinence. The vitamin B test is entirely non-invasive, takes only a few minutes to perform, and is especially useful as an office test. The methylene blue test has fewer variables, and fits easily into a urodynamic routine. With the methylene blue test, a direct correlation was noted between amount of urine lost and pressure generated by the tests. This conforms to the definition of stress incontinence as a passive process. The sensitivity of the test in a group with mainly mixed symptoms was 89.5%, and the specificity 100%. The test is useful where objective diagnosis of stress incontinence is important. A group of 38 patients with a history (questionnaire) of stress incontinence exhibited a total of 105 positive individual symptoms out of a possible 228 symptoms (6 x 38), comprising a history of leaking at sneezing, coughing, exercise, laughing, walking, or bending. The individual symptoms were analyzed for accuracy and predictability by comparing them with six graded provocative exercises comprising a trampoline test, star jumps, coughing, stepping, bending and hand washing. The symptoms were graded into a hierarchy from the results. A history of stress incontinence was found to be an accurate determinant of stress incontinence, even in patients with mixed symptoms. This allows the questionnaire as presented to be used as a semiquantitative index for assessment purposes.
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PMID:An analysis of rapid pad testing and the history for the diagnosis of stress incontinence. 133 73

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

The urethral and bladder pressure increments registered during a cough were investigated in 30 woman with genuine stress incontinence (GSI) and compared with those from 30 previously investigated healthy women. The pressures were measured by means of a double microtip transducer catheter with the bladder sensor uncovered and the urethral sensor covered with a water-filled rubber cylinder and placed at the bladder neck, midurethrally, or distally in the urethra. In GSI women the pressure increment preceding the pressure spike produced by coughing was significantly higher in the bladder compared with the urethra, and the pressure increment seemed to be initiated in the bladder and all along the urethra simultaneously. In healthy women the pressure increment preceding a pressure spike was significantly higher in the midurethra compared with the bladder and it seemed to be initiated in the midurethra. These findings seem to reflect a defective active closure mechanism in GSI which may be a contributing factor in its pathogenesis.
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PMID:Initial urethral pressure increase during stress episodes in genuine stress incontinent women. 153 23

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

Chronic cough is a side effect of the angiotensin-converting enzyme (ACE) inhibitor class of antihypertensives. The cough is thought to be a result of inhibition of the enzymes that break down some of the mediators of inflammation, such as the bradykinins and tachykinins. We report 20 patients with chronic cough caused by ACE inhibitors and some of the characteristics of the cough. The cough is typically dry, nonproductive, and worse at night. Interference with sleep is common and was severe in three patients. Women outnumbered men in this series: urinary stress incontinence developed in five, rectal and vaginal prolapse developed in one. Three patients felt they were incapacitated by the cough. Most had been on multiple medications; only oxycodone was reported to be effective in controlling the cough, and four patients thought they were addicted to that. All coughs resolved with withdrawal of the ACE inhibitor. Chronic cough is common among individuals taking ACE inhibitors. It may be severe and associated with complications. The incidence and potential severity is understated in drug information sources, and patients and physicians often fail to recognize cough as a drug side effect.
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PMID:Characterization of cough associated with angiotensin-converting enzyme inhibitors. 175 56

With a curved array real-time ultrasound scanning machine and the probe placed sagitally onto the vulva, symphysis, bladder, urethra and the pelvic floor can be visualized in one frame. With this technique we studied 10 women with stress incontinence and 10 control women. In both groups active contraction of the pelvic floor resulted in a similar elevation of the urethrovesical junction (UVJ). During Valsalva maneuver an equal descent of the UVJ was found in patients and controls. During coughing a significant descent of the UVJ only occurred in the patient group. This suggests that women with stress incontinence are capable of operating the pelvic floor muscles but do not use them adequately during a cough.
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PMID:Perineal ultrasonography in women with stress incontinence and controls: the role of the pelvic floor muscles. 175 99

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


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