Gene/Protein Disease Symptom Drug Enzyme Compound
Pivot Concepts:   Target Concepts:
Query: UMLS:C0026827 (hypotonia)
 5,860 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Between March 1988 and February 1991, 47 patients with urinary stress incontinence (USI) were treated by Gittes' operation, suspension thread traction being determined by perioperative ultrasonography in 31 of these cases. All patients were re-examined on February 1992 after a mean follow-up of 26 months (range 12 to 24 mths). The global success rate (recovery and improvement) was assessed as 72% at 3 months and 56% at follow-up. Rated as a function of closure pressure (CP), the success rate at evaluation was 62% with normal CP, 42% with CP low for age, and 33% with CP < 30 cm H20. For the 31 patients with perioperative ultrasonography examination the success rate was 80% at 3 months and 70% at follow up. As a function of CP the rate was 83% at follow up with a normal CP, 50% with a CP low for age, 37.5% with a CP < 30 cm H20. Although Gittes' operation is a simple, fairly non-aggressive intervention, results diverge widely from those obtained with "classical" techniques. Optimization of indications is essential, therefore, only patients with pure USI without hypotonia of the sphincter obtaining maximum benefit from the intervention, carried out preferably under perioperative by control ultrasonography.
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PMID:[Treatment of urinary stress incontinence in women by percutaneous cervico-cystopexy. Gitte's operation: contribution of intraoperative ultrasonography. Apropos of 47 patients]. 143 Nov 91

Today's treatment of female urinary incontinence is not merely surgical. Provided the indications are clearly established (stress incontinence due to sphincter hypotonia, bladder instability and overflow urination in some cases, sensitive frequency) and the therapist properly trained, vesicosphincteral physiotherapy represents an alternative or a complement to the other therapies. The various aspects of this rehabilitation (manual techniques, electrostimulation, biofeedback) are reported here.
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PMID:[Treatment of urinary incontinence by feedback in women]. 181 Oct 25

The authors present a series of 30 unstable bladders treated only by perineal muscular reeducation by contact. The best results are obtained in the group presenting with pelvic floor hypotonia and USI (urinary stress incontinence) (efficiency 71.5%), especially when the closure pressure is normal (100%). The urodynamic control and the ominous disappearance of the associated USI confirm a muscular role of the treatment rather than a psychogenic one, the stabilization of the bladder being achieved through the perineo-detrusor inhibitory reflex. Because of this specific and efficient treatment the attention is drawn to the pelvic muscular weakness in the genesis of detrusor instability which is then called "deficitory instability". The interest of a clinical classification of detrusor instability is discussed.
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PMID:[Bladder instability and kinesitherapy. The concept of deficient bladder instability]. 207 29

The authors propose an original technical based on the concept of bladder neck support by a sling (Goebell-Stoeckel) to treat urinary stress incontinence, without cystocele, in young women. The technical modifications concern: the incision: retropubic endoscopy facilitated by a dissection balloon and combined with a short vaginal incision. The use of synthetic material for the sling: expanded polytetrafluoroethylene (Gore-Tex) attached to Cooper's ligaments by a suture tied extracorporeally. The long-term objective is to achieve results comparable to those of open surgery with a lower morbidity. From 1992 to 1994, 24 patients were treated according to this technique by the same operator. The mean age was 48 years. In every case, this operation constituted the first procedure for incontinence, and only one patient had a history of previous pelvic surgery (Caesarean section). Incontinence was classified as stage 3 according to the Ingelmann Sundberg classification in 46% of cases. 35% of patients present uninhibited contractions, and 35% presented urethral hypotonia. Two intraoperative complications and immediate postoperative complications were only minor. The mean operating time was 2 hours 45 minutes. With experience, it gradually decreased, as did the hospital stay, which was an average of 4.3 days. With a short mean follow-up (1 year 7 days), the results were good in 71% of cases, satisfactory in 8% of cases (1 case of urgency, 1 case of persistent retention), with a failure in 5 cases (21%); 1 case of true incontinence confirmed by clinical examination and 4 cases of minor incontinence during occasional violent effort.
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PMID:[Bladder suspension by retropubic endoscopy. Techniques and preliminary results (24 cases)]. 862 29