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Query: UMLS:C0011570 (depression)
 172,036 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

The state of the urethral musculature was studied using the urethral pressure profile and electromyographic recording in periurethral striated muscle. In dogs under chloralose anesthesia a micturition reflex could be elicited by bladder distension and somatic reflexes could be elicited by various stimuli. Both the urethral profile and electromyographic activity could be recorded immediately after surgical transection of the spinal cord between T2 and T8 but the bladder remained areflexic for more than 12 hr. Pharmacologic analysis of the urethral pressure profile revealed a substantial contribution from both sympathetic and somatic components. The periurethral striated musculature usually responded to bladder filling in a similar manner both before and after transection, although there was no bladder contraction in the latter circumstance. It is concluded that the urethra does not experience the same depression of reflex activity as does the bladder in the acute stage after spinal cord transection.
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PMID:The state of urethral musculature during the detrusor areflexia after spinal cord transection. 44 88

Using a newly devised chair for transperineal sonography we performed ultrasonic voiding cystourethrography in a total of 219 male patients and volunteers. The study produced adequate images in more than 80% of the people examined. Valsalva's maneuver during urination elicited an intermittent depression of the bladder dome toward the bladder base. In patients with benign prostatic hyperplasia or bladder neck contracture the bladder neck did not open well. Urethral stricture was associated with a marked opening of the bladder neck and posterior urethra. In patients with detrusor-sphincter dyssynergia an involuntary contraction of the external sphincter was observed. These results indicate that this method is useful for screening male patients for diseases causing voiding disturbance and for making differential diagnosis of such diseases.
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PMID:Transperineal ultrasonic voiding cystourethrography using a newly devised chair. 187

The correlation between clinical and tonometric incontinence is frequently poor, with urethral profile results that do not correspond to clinical reality. Among potential causal factors, we have attempted to determine the importance of the absorption of kinetic energy from the mass of urine driven against the urethral captor (the hydraulic ram effect). Twenty patients (average age 50 +/- 10 years, para 2) suffering from genuine stress urinary incontinence, underwent urodynamic investigation with a constant air-flow pneumatic catheter equipped with two captors separated by an inflatable cuff located just above the urethral captor to block the inrush of urine into the urethra. After cystometric examination had excluded an unstable bladder, two urethral profiles were registered successively, first with cuff deflated, and then with cuff inflated. The values for urethral functional length (FL) and transmission factor (TF) show no significant changes. The values for the maximal urethral closing pressure (MUCP) were significantly lower in the second profile (cuff inflated) in 18 of 20 cases (average decrease 7 cm H2O), which corresponds to 14 percent of the average MUCP measured during the first profile (cuff deflated). The depression quotient increased from an average 0.80 to 1.05 from first to second profile. This study allows quantification of the urethral "hydraulic ram effect" which modifies determination of the MUCP during registration of urinary stress profile.
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PMID:Effect of occluding the urethra while recording urethral stress profile. 187 34

245 women who underwent surgery for stress urinary incontinence between 1982 and 1989 were tested urodynamically before and after surgery; lateral colpocystograms were obtained in 118 patients. 116 women underwent colpoperineoplasty, 59 Burch colposuspension, and 70 Stamey/Raz endoscopic suspension of the bladder neck. 72% of the patients were continent after the Burch operation, 70% after the Stamey/Raz procedure, and 54% after colpoperineoplasty. In patients with severe stress incontinence, the Burch and Stamey/Raz procedures were effective significantly more often than colpoperineoplasty (73% and 66% vs 37%). In patients with a hypotonic urethra, the Burch procedure was successful significantly more often than the other two operations (88% v. 62% and 47%). Colpoperineoplasty and the Stamey/Raz procedure both significantly decreased the urethral closure pressure (UCP) at rest while significantly improving the UCP under stress, the depression quotient, the pressure transmission factor. Urodynamic criteria of the urethral stress profiles differed significantly between continent and incontinent women. Colpocystography showed that the Burch and Stamey/Raz operations moved the vesicourethral junction well above the lower margin of the symphysis while colpoperineoplasty moved it to the lower margin. The angle beta was significantly smaller after Burch and Stamey/Raz operations than after colpoperineoplasty. There was no difference in any of the parameters between women with or without micturition complaints.
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PMID:[Effect of various operations for incontinence on the dynamics and topography of the bladder and bladder neck]. 202 20

Between 1984 and 1987 31 patients underwent a colposuspension according to Burch for stress urinary incontinence. Seventeen women were available for clinical and urodynamic follow-up after an average of 17.6 months. Clinically, 2 women had postoperative stress-urge incontinence and 2 had stress incontinence only. 13 (77%) patients were continent while straining, 9 (53%) patients complained of urge and voiding disorders, 7 reported post micturition dribble, 2 patients lost urine during intercourse. Urodynamically, 14 (82%) patients were continent during straining, 3 showed mild stress incontinence. The functional urethra length and urethral closure pressure at rest were unchanged. The urethral pressure under stress, depression quotient, and transmission factor increased significantly. The average uroflow sank from 16.8 ml/s to 7.8 ml/s, reflecting the subjective voiding disorders. Bladder compliance was unchanged. We saw no autonomous detrusor contractions and thus no correlation with subjective urge complaints.
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PMID:[Urodynamic results of Burch colposuspension]. 237 88

In 555 stress-induced urinary incontinent and 119 continent women patients, we studied the history, clinical and urodynamic investigations to define the hypotonic urethra and to find out important etiological factors of the low urethral closure pressure. The linear depression of the urethral pressure and the urethral closure pressure at rest--well known from literature--has been confirmed in this study. With hypotonic urethra, closure pressure values were found to be below the simple standard deviation from a norm-curve. Also, in cases of stress urinary incontinence, we found a nearly linear depression of closure pressure. The stress incontinent patients could be divided in two groups: 46% with hypotonic urethra, 54% with nearly normal closure pressure. History of former incontinence surgery, but also of other operations such as simple abdominal or vaginal hysterectomy, is correlated with low urethral closure pressure. The degree of closure pressure is correlated with shortening of the functional urethral length. The maximum closure pressure shifts distally. Women, who, despite hypotonic urethras, are continent, build up a positive closure pressure throughout a broad zone of the functional urethral length. Contrarily, in the case of incontinent patients, even a weak coughing spasm, which does not even break through the bladder sphincter in maximum closure, can cause opening of the urethra and establishment of pressure equilibration between bladder and urethra.
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PMID:[Definition and etiologic factors of hypotonic urethra in relation to urinary stress incontinence in the female]. 258 28

Urodynamic parameters are changed by stress incontinence surgery. Our study, comparing pre- and postoperative measurements in 141 women with urinary stress incontinence, shows an increase of the transmission ratio in the proximal urethra and a decrease of depression factors in the proximal and mid urethra after surgery. The functional urethral length remains unchanged while the maximum urethral pressure decreases. Except for the maximum pressure decrease, these changes were only found after successful surgery and not in failures. Thus, effectiveness of operations can be quantificated by urodynamic measurements. The unfavourable prognostic influence of a preoperative hypotonic urethra on the results of surgery was confirmed by this study.
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PMID:[Effect of stress incontinence operations on urodynamic parameters. 1. Is surgical success measurable?]. 341 90

Urodynamic tests and clinical and anamnestic assessments of continence were carried out in 47 patients before and after the Marshall-Marchetti-Krantz operation. The operation resulted in a subjective cure in 35 (74.5%) of the patients; 12 women were again incontinent within a period of between 6 and 24 months. There was an insignificant postoperative rise in urethral occlusion pressure at rest. It was only possible to ensure an elongation of the urethra in the resting pressure curve. The urethral occlusion pressure at rest in patients with recurrent incontinence was considerably lower preoperatively than in postoperatively continent patients. Hence, high urethral occlusion pressure at rest signifies a good surgical prognosis. In the stress pressure curve, surgery improved the transmission factor, the depression factor, and the urethral occlusion pressure under stress. However, no clear surgical prognosis was possible on the basis of these parameters. The best postoperative results for the transmission and depression factors and the urethral occlusion pressure under stress were obtained in the stress pressure curve at 300 ml with the patient in seated position. On comparing preoperative and postoperative measurements, improvements in pressure transmission and in urethral occlusion pressure under stress were seen in particular in the proximal one-third of the urethra. Hence, the question arises whether the proximal one-third of the urethra is as important as the medial one-third in stress incontinence diagnosis by measurement.
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PMID:[Urodynamic observations on the Marshall-Marchetti-Krantz operation]. 377 Apr 15

Urodynamic investigations with urethral pressure profile, and vesical, intrarectal and anal pressure recordings were performed in 37 patients with spinal cord lesions. The recordings were done before and after phentolamine injections and/or pudendal nerve blocks to evaluate the respective contribution of sympathetic and somatic innervation to the maximum urethral closure pressure in the mid and distal portions of the membranous urethra. A pressure gradient was demonstrated in the membranous urethra with higher values in the distal than in the mid portion. These results emphasize that the interrupted withdrawal technique is superior to the continuous technique in patients with upper motor neuron bladders. Mid urethral striated and smooth muscle components were shown to represent approximately 60 and 30 per cent of the maximum urethral closure pressure, respectively. In the distal urethra striated and smooth components are more abundant than in the mid portion and contribute in equal proportion to the maximum urethral closure pressure. No substantial role was found for the vascular bed in the maximum urethral closure pressure. The greatest pressure decrease in the mid and distal urethra of patients with lower motor neuron bladders was believed to be an effect of denervation supersensitivity. The results of pudendal blocks showed sphincter dyssynergia to be mediated through pudendal nerves via spinal reflex arcs. Phentolamine effects on bladder activity suggest that blockade of alpha-adrenergic receptors inhibits primarily the transmission in vesical and/or pelvic parasympathetic ganglia and acts secondarily through direct depression of the vesical smooth muscle. Our neuropharmacological results raise strong doubts as to the existence of a sympathetic innervation of the striated urethral muscle in humans.
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PMID:Role of striated and smooth muscle components in the urethral pressure profile in traumatic neurogenic bladders: a neuropharmacological and urodynamic study. Preliminary report. 612 98

122 patients with urinary incontinence of all degrees and 32 controls are investigated by means of a complex urodynamic unit constructed by the authors. Essential part is a robust selfmade three-canal-catheter of heatsealed angiographic material with an external diameter of 10 Charr., which undamagedly can be used at least forty times. The unit enables to do cystometries and simultaneous cystourethrotonometries with electromyography of pelvic floor and mictiometries. The investigations are possible at a normal expense in lying or sitting and all intermediate positions. Many urometric parameters had been determined with aid of perfusion uromanometry according to the principle of Heidenreich and Beck. New combinations had been elaborated. The functional length of urethra in stress profile, the maximal urethral closing pressure, the electronically registered urethral closure pressure, the depression factor and the stress quotient are of special importance. By means of these criteria the qualification of the apparently old fashioned perfsuion uromanometry for a modern urodynamic diagnosis could be demonstrated. The results are compared with those obtained with microtransducer technique.
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PMID:[New aspects of the Heidenreich and Beck perfusion method in urodynamics. I: Practical experience with a complex urodynamic work station]. 661 98


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