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

There were 17 spinal cord injury men with drug-resistant pain who were treated with transcutaneous nerve stimulation. Bladder and sphincter dysfunctions were evaluated by gas cystosphincterometry and rectal sphinctero-electromyography with the patient in 2 different positions. With the use of transcutaneous nerve stimulation for pain we noted no demonstrable urodynamic changes in acute and chronic paraplegics and chronic quadriplegics. However, there was an increase in the urethral pressures and in the rectal electromyogram spike potentials in acute and recent (less than 2 years post-injury) quadriplegics with postural detrusor-striated sphincter dyssynergia. Therefore, caution is necessary when transcutaneous nerve stimulation is used in this particular group of patients since it might be detrimental to the genitourinary tract.
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PMID:Effects of transcutaneous nerve stimulation on the vesicourethral function in spinal cord injury patients. 31 32

The authors report a series of 100 consecutive patients with spinal metastases causing cord or cauda equine compression, who were treated with surgical decompression. Of these, 30% (all women) had breast cancer. The most common primary neoplasm in man was prostatic carcinoma. Pain was the earliest and most prominant symptom, followed by weakness. Bladder dysfunction was recorded in 40 patients. The thoracic region was the most common site of cord compression (76 patients). Surgical treatment involved urgent and extensive laminectomy decompression. Concomitant spinal stabilization was required in 10 cases, involving posterior rib graft fusion in seven and Harrington rod instrumentation in three. At last follow-up review, 29 of these patients were living with an average postoperative survival of 2.3 years; 71 patients had died with an average survival of 8.8 months. Surgical decompression produced effective pain relief in 70% of the patients. Postoperatively, 58 patients could walk; of these, 40 were walking and continent of urine 6 months following surgery (including five patients who were totally paraplegic on admission). Positive approach and aggressive management in this problem can achieve results superior to those generally reflected in the literature.
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PMID:The neurosurgical management of spinal metastases causing cord and cauda equina compression. 73

Endometriosis is defined as the presence of endometrial tissue outside the cavity of the uterus. The urinary tract is rarely affected, only 1 to 11%. Bladder is the most frequent urinary localization while the ureteral involvement is rare. We report a case of intrinsic ureteral endometriosis in a woman with left hydronephrosis, lumbar pain and septic fever. Instrumental and laboratory investigations can hardly lead to a reliable diagnosis of ureteral endometriosis. A final diagnosis is feasible only by histologic examination, which obviously implies surgery.
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PMID:[Intrinsic endometriosis of the ureter. Clinical case]. 146 62

Twelve patients with end-stage interstitial cystitis and intractable symptoms resistant to conservative measures underwent supratrigonal cystectomy and colocystoplasty, comprising 7 right colocystoplasties and 5 open-loop sigmoidocystoplasties. Mean follow-up was 4.7 years. Ten patients had complete relief of pain and a decrease in frequency, while 2 patients required cystectomy and urinary diversion because of persistent symptoms or infection and incontinence. Bladder function was evaluated urodynamically in 11 patients. The bladder capacities in the right colocystoplasties were between 325 and 800 ml (mean 495), compared with 180 and 500 ml (mean 345) in the sigmoideocystoplasties. Two patients suffered from mild urge incontinence. All the patients retained their sensation of bladder fullness and voided without difficulty. In only 3 cases was a procedure needed to lower the bladder outflow tract resistance. Most patients did not need long-term antibiotics. No impairment in renal function was noted. In view of the good results achieved colocystoplasty can be recommended more often for the treatment of interstitial cystitis, detubularized right colocystoplasty being the operation of choice.
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PMID:Colocystoplasty for the treatment of severe interstitial cystitis. 202 72

Twenty-one patients with stable effort angina pectoris were randomized in a crossover study to 4 weeks traditional Chinese acupuncture or placebo tablet treatment. The patients had at least five anginal attacks per week in spite of intensive treatment. Acupuncture was given three times per week at main points Neiguan (Pericardium 6), Tongli (Heart 5), Xinshu (Urinary Bladder 15), Pishu (Urinary Bladder 20) and Zusanli (Stomach 36). Previous antianginal treatment remained unchanged during the whole study. During the acupuncture period, the number of anginal attacks per week was reduced from 10.6 to 6.1 compared with placebo (P less than 0.01). Accordingly, the performance before onset of pain during exercise test increased from 82 W to 94 W (P less than 0.05). However, maximal performance did not increase after acupuncture. Intensity of pain at maximal workload decreased from 1.4 to 0.8 (scale 0-4, P less than 0.01). Further, ST-segment depressions at maximal comparable load decreased from 1.03 to 0.71 mm after acupuncture (P less than 0.01). A life quality questionnaire confirmed improved feeling of well-being. Thus, acupuncture showed an additional beneficial effect in patients with severe, intensively treated angina pectoris.
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PMID:Effect of acupuncture in patients with angina pectoris. 204 50

Forty-nine patients with complete and incomplete injuries of the spinal cord or cauda equina who had undergone anterior decompression at a minimum of 3 months after injury were examined. Follow-up was from 12 months to 19 years. Postoperative neurologic improvement occurred in 46.5% of patients with incomplete injuries. If the surgery was performed less than 2 years after injury, neurologic improvement occurred in 68% with an improvement in Frankel grade of 32%. Bladder function improved in 27% of patients and if operated on less than 2 years after injury improvement occurred in 43%. Conus medullaris decompression resulted in a 50% improvement. There was an 83% improvement in the pattern of pain after decompression. Of 23 patients with preoperative spasticity, 10 improved but 6 were worse after surgery.
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PMID:Delayed anterior decompression in patients with spinal cord and cauda equina injuries of the thoracolumbar spine. 225 87

In this work we study a case of eosinophilic cystitis induced by the ingestion of some specific foodstuffs (tomatoes, coffee, carrots) and strong smells (petrol) in a female patient with clinical history of extrinsic permanent rhinitis and Quincke's oedema. Skin tests and RAST showed specific antibodies against Dermatophagoides Pteronyssimus, Farinae, Alternaria and Cladosporium. These antigens were related to the rhinosinusitis and facial oedema. Provocative tests were used to make the definitive diagnosis. They were carried out when the patient was symptomless and the following parameters were taken into account: the time elapsed estil the appearance of the symptoms, the intensity of urinary symptoms, polakiuria, urgency and prepubic pain, cystoscopy, bladder histology, urine volume and pre-and post-test histaminuria in 24 hours. Bladder histology subsequent to the intake of tomato showed capillary congestion and severe inflammatory infiltration with a clear predominance of eosinophils. The histaminuria values after the ingestion of tomatoes, carrots and coffee were superior to basal determinations, amounting to a maximum of 1229 mcg./l. in 24 hours. The allergic origin of these eosinophilic cystitis is proved by the appearance of urologic symptoms and eosinophilic infiltration of the bladder subsequent to provocative tests, which subside when the antigens which bring them about are removed.
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PMID:Eosinophilic food-induced cystitis. 652 53

Two patients with eosinophilic cystitis are presented in this report. The first case was a 39-year-old man who was admitted to our clinic with complaints of pollakisuria, pain on urination and hematuria for a month, which had not been relieved by antibiotic therapy. He had both a family and a personal past history of allergy. Excretory urograms showed a mild bilateral hydroureter and small bladder with irregular filling defects. Cystoscopic examination revealed velvety, ulcerated areas in the bladder mucosa, and we diagnosed these changes as eosinophilic cystitis after bladder biopsy. Steroid and antihistaminic therapy improved these symptoms. The second case was a 67-year-old woman who visited our clinic complaining chiefly of hematuria for 2 months. There was no predisposition to allergy, but she had a past history of uterine cancer which had been treated with irradiation. Cystoscopic examination disclosed a large amount of intravesical coagula, and erythematous and edematous areas with petechiae of the bladder mucosa. Bladder biopsy revealed hemangioma and eosinophilic cystitis. There was no recurrence of cystitis after the removal of the coagula without any other treatment.
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PMID:[Eosinophilic cystitis: a report of 2 cases]. 668 7

Two definite and 2 probable cases of anogenital herpes simplex and sacral radiculitis are described. Symptoms were typical and consisted of paraesthesia and neuralgic pain in the perineum and legs, urinary retention and constipation occurring within several days to a week after an anogenital herpetic eruption. However, at presentation only 1 case had an obvious history of anogenital herpes simplex. Neurological signs were not striking and consisted of a reduced appreciation of light touch and pin prick over the sacral dermatomes and in 2 cases reduced anal sphincter tone. CSF examination in 3 patients showed a lymphocytosis. Bladder catheterisation was required for up to 2 weeks in 2 patients. The paraesthesia persisted for weeks to months. It should be more widely recognised that anogenital herpes simplex, with sacral radiculitis, is probably the commonest cause of acute retention of urine in young sexually active people.
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PMID:Retention of urine and sacral paraesthesia in anogenital herpes simplex infection. 692 84

The majority of bladder ruptures (80-90%) are caused by major blunt abdominal trauma. Penetrating injuries account for the rest. Bladder rupture is seen most often in patients with pelvic fracture. More seldom, the rupture can be caused by energetic blunt abdominal trauma. The rupture can either be intraperitoneal or extraperitoneal. The symptoms are macroscopic haematuria, suprapubic pain and, in some patients, an inability to avoid. Retrograde cystography is the diagnostic procedure of choice. An intravenous infusion pyelogram does not provide adequate examination of the bladder. The rupture is treated by operative closure and drainage by catheter. Extraperitoneal rupture may be treated with only catheter drainage and close clinical evaluation. We describe two patients with intraperitoneal bladder rupture after low energetic abdominal trauma.
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PMID:[Bladder rupture. Diagnosis, etiology and treatment]. 757 Apr 96


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