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Query: UMLS:C0030193 (pain)
 261,466 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Thirty two patients suffering from radiation or interstitial cystitis were treated according to a method, first described by Marberger, Innsbruck. This method consists of intramural PeroxinormR (orgotein) injections into the bladder wall. The injections were administered during 4 to 6 weekly intervals and were given 1 to 6 times. The dose of injection was between 4 and 6 mg, mostly 12 mg, the total dose administered was between 8 and 72 mg. For the evaluation of the treatment objective and subjective criteria, such as cystoscopic picture, pain at rest, urgency, pollakisuria, incontinence, as well as bladder capacity and micturition frequency, during day and night, were used. In all patients a definite improvement in the symptoms could be observed. All the parameters and especially the bladder capacity and micturition frequency showed remarkable results. Orgotein treatment tolerability was found to be in 90% of the cases from very good to good.
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PMID:[Results of a multicenter orgotein study in radiation induced and interstitial cystitis]. 734 22

The syndrome of syringomyelia in children has been extensively described in the literature and is said to most commonly involve the cervical and thoracic spinal cord. We here present two children who had an unusual constellation of signs and symptoms, characterized by bowel and bladder disturbance in one, and in the other with intermittent paroxysmal severe pain and cramping and flexion of the lower extremities accompanied at times by episodes of incontinence. Both were found on magnetic resonance imaging (MRI) to have a syrinx localized to the most distal cord. This was not associated with Arnold-Chiari malformation, trauma, tumors or any other form of spinal dysraphism. Both patients underwent placement of a syringomyelia-peritoneal shunt with complete resolution of symptomatology. Postoperative MRI revealed a complete collapse of the syringomyelia cavity. In those children presenting with bowel or bladder disturbances, associated or not with intermittent pain, flexion attacks, or cramping in the lower extremities, the differential diagnosis of a syringomyelia of the distal cord should be part of the clinical considerations.
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PMID:Syringomyelia of the distal spinal cord in children. 754 56

Adequate measures of diarrheal disease are important to assess severity for clinical use and outcomes research. We developed a questionnaire to assess diarrhea severity and complications, and administered it to 205 HIV positive patients with diarrhea, fever, or weight loss. Noteworthy variations in stool form were reported by individuals and across subjects. Self-reported diarrhea correlated with the occurrence of any stool pictured without form. However, verbal descriptors "loose" and "semiformed" had little value in assessment of diarrheal disease. Both verbal and pictorial stool descriptors correlated well with diarrhea complications (pain, urgency, tenesmus, incontinence, and nocturnal diarrhea). By factor analysis, discomfort and nondiscomfort diarrhea complications loaded on different factors, consistent with clinical experience that discomfort is a distinct problem in diarrheal disease. In summary we have developed an instrument to precisely characterize diarrhea severity that correlates well with clinically important events such as incontinence and abdominal pain.
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PMID:Validation of a new measure of diarrhea. 755 36

We report a case of prostate cancer showing a complete remission after LH-RH agonist neoadjuvant therapy. A 69-year-old man was referred to our department complaining of pain on urination and urge incontinence. The serum prostate specific antigen (PSA) level was 41.6 ng/ml. Needle biopsy specimens from both lobes revealed moderately differentiated adenocarcinoma. Chest X-ray, computed tomographic (CT) scan, and bone scintigraphy demonstrated neither distant metastasis nor local invasion. LH-RH agonist was administered on a monthly basis as neoadjuvant therapy. After 4 injections, pelvic lymph node dissection and radical prostatectomy were performed on January 11, 1993. Thorough examination did not reveal any cancer cells in the removed specimen. The patient was discharged 30 days after the operation and has shown no evidence of distant metastasis or local recurrence as long as 19 months later.
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PMID:[Complete remission of prostate cancer after LH-RH agonist neoadjuvant therapy: a case report]. 764 58

The technique of appendicocaecostomy produces a continent catheterizable channel through which colonic washouts are given. This procedure was performed on six women of mean age 33.5 years with severe idiopathic constipation (mean stool frequency less than 1 per week) resistant to medical therapy. All patients had prolonged colonic transit times, three had evidence of obstructed defaecation and all had reduced or absent voluntary anal squeeze pressure. Patients found the appendicocaecostomy and catheterization acceptable, and symptoms of abdominal distension and pain resolved. All patients were able to initiate defaecation and evacuate the colon within 1 h of irrigation, and no patient had appreciable incontinence. Irrigation was necessary every 48-72 h. Adults with intractable constipation and pelvic floor weakness would be at risk of faecal incontinence after ileorectal anastomosis; it is in these patients that appendicocaecostomy has potential for the greatest benefit.
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PMID:Antegrade enemas for the treatment of severe idiopathic constipation. 761 13

Spinal cord lipomas are rare lesions, accounting for approximately 1% of all spinal cord tumors. True intramedullary spinal cord lipomas are extremely rare and are represented in the literature as scattered, single case reports. The authors present a series of six patients with intramedullary spinal cord lipomas managed at our institution from July, 1985 to July, 1993. The patients' ages ranged from 8 to 45 years. Four patients presented with newly diagnosed tumors and two had undergone previous surgery. Patients usually presented with long histories of disability followed by rapid progression of their symptoms. Most patients were in poor neurological condition on presentation. Presenting symptoms included spinal pain, dysesthetic sensory changes, gait difficulties, weakness, and incontinence. Three patients had cervical tumors, two had cervicothoracic tumors, and one patient had a thoracic tumor. Diagnostic studies, including magnetic resonance imaging, were obtained in all patients. No patient exhibited any form of spinal dysraphism or had a dural defect. All patients underwent decompressive, subtotal resections of 40% to 70% of their lesions. Follow-up times ranged from 12 to 96 months. All patients had resolution of their pain, but they generally showed no neurological improvement. As of their most recent follow-up visit, none of the patients was neurologically normal; three can function independently, although with neurological deficits. The other three patients cannot function independently and have severe neurological deficits. The authors conclude that patients with intramedullary spinal cord lipoma who present with significant neurological compromise have a very poor prognosis with regard to neurological function and generally show no improvement with surgical resection.
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PMID:Intramedullary spinal cord lipomas. 786 Dec 16

Interstitial cystitis, a sterile bladder condition, is characterized by urinary frequency, urgency, burning and suprapubic pain. Increasing evidence indicates that interstitial cystitis is a heterogeneous syndrome that reflects an immune response to a variety of triggers. More than 50% of the patients have allergies, 30% have the irritable bowel syndrome and almost 20% suffer from migraine headaches. Increased numbers of mast cells have been reported in interstitial cystitis. Mast cell activation, which is critical if these cells were to be implicated in this syndrome, has been investigated by electron microscopy, which definitively shows mast cell secretion. Recently, methylhistamine, the major metabolite of histamine, and the specific mast cell marker, tryptase, were shown to be significantly elevated in urine of interstitial cystitis patients. Bladder biopsies from 53 patients were analyzed blindly for the number and degree of activation of mast cells using 4 different stains for light microscopy, as well as electron microscopy. Controls included 16 patients with incontinence and chronic bacterial cystitis. Mast cells in controls were less than 10/mm.2 and were all nearly intact. Surprisingly, mast cells from 11 cancer patients averaged 50/mm.2 but almost all were intact. In contrast, mast cells from 26 interstitial cystitis patients averaged 40/mm.2 and more than 90% were activated to various degrees. Therefore, bladder mast cell activation is a characteristic pathological finding in at least a subset of patients with interstitial cystitis.
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PMID:Activation of bladder mast cells in interstitial cystitis: a light and electron microscopic study. 786 1

A classic feature of interstitial cystitis is the development of glomerulations during bladder distention while the patient is under anesthesia, which is thought to be a sign that the bladder was chronically under filled before distention. The cause for under filling is pain or sensory urgency in interstitial cystitis, and glomerulations have also been associated with conditions of decreased functional bladder capacity. Two cases of bladder glomerulations associated with severe intrinsic urethral sphincter deficiency (type 3 incontinence) are reported. Neither patient had symptoms of interstitial cystitis before or after anti-incontinence surgery. A likely explanation is that severe stress incontinence chronically prevented the bladder from filling to capacity before cystoscopy. Thus, these cases support the premise that glomerulations are a response to distending a previously under filled bladder [corrected].
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PMID:Glomerulations in women with urethral sphincter deficiency: report of 2 cases [corrected]. 786 22

Literature reports experience using a transurethral prosthetic stent for the treatment of neurogenic bladder in males with spinal cord injury who also have detrusor-external sphincter dyssynergia (DESD). The Urolume prosthesis, a cylindrical wire mesh stent, was inserted in the membranous urethra of 25 spinal cord injured males with DESD and elevated voiding pressure. Patient education regarding care of external condom urine collecting devices was an important preoperative requirement ensuring long-term success. One-year post-stent placement subjects showed a statistically significant decrease in voiding pressure and residual urine volume. Bladder capacity remained constant. All subjects were able to achieve spontaneous reflexive voiding without constant dribbling. There were no complications of bladder stone formation, tissue overgrowth within the stent, untoward effects on renal or erectile function, or pain. Patients reported decreased autonomic dysreflexia symptoms and significant psychosocial benefits such as decreased incontinence and freedom from indwelling catheters. Patient satisfaction, ease of placement, and minimal associated morbidity make sphincter stent placement an effective alternative to external sphincterotomy.
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PMID:Transurethral placement of external sphincter wire mesh stent for neurogenic bladder. 786 17

A multicenter study of the patients in whom the Urolume has been implanted has been among the actions undertaken by the Italian Club of Minimally Invasive Urology (UMICLUB). For each patient, a computer information format has been prepared containing evaluation data related to the preoperative period, the endoscopic procedure, and follow-up. The collected data were computerized through unifunctional and multifunctional analysis. Of the 82 patients recruited, 76 were followed for a period ranging from 1 to 40 months. Urinoflow results dramatically improved after implantation of the endoprosthesis: peak flow rates increased by 310%, while mean flow rates increased by 294%. Incontinence and dribbling were found in 4% and 20% of the patients, respectively, and were independent of the distance between the external sphincter and the Urolume prosthesis and of the stent number and length. The cross-data elaboration seems to indicate a statistically significant relation between urethral preparation before Urolume implantation and stricture recurrence, with recurrence being more frequent after dilation. Significant correlations have not been noticed between stenosis etiology, urinary infection, type of anesthesia, and recurrence; between the type of anesthesia, stent length, and duration of hospitalization; or between stent number and position and pain. The impact of the Urolume prosthesis on sexual activity was marginal by all three measures considered (pain during erection, coitus, and ejaculation).
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PMID:Urolume in urethral stenosis: Italian Club of Minimally Invasive Urology experience. 798 41


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