Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0042024 (incontinence)
 13,409 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Twenty patients with detrusor hyperreflexia in multiple sclerosis were treated for frequency, urgency and incontinence, or catheter bypassing by interferential currents applied on the lumbosacral spinal marrow. Although the mechanism of action is not totally understood, subjective and objective improvements were registered in most patients. Further investigations are needed to confirm these results and to explain the favorable effect of interferential therapy.
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PMID:Interferential therapy for detrusor hyperreflexia in multiple sclerosis. 387 63

Hyperreflexia is the most common urological finding in patients with multiple sclerosis. A prospective randomized study was done to compare the effectiveness of 2 commonly used drugs, oxybutynin and propantheline. Of the 34 patients entered into the trial 19 were treated with oxybutynin and 15 with propantheline. The urological symptoms (frequency, nocturia, hesitancy, urgency and urge incontinence) were graded according to severity from 0 to 3. Patients with urinary infection were excluded. Urodynamic examination, consisting of cystometrography and electromyography, was performed in all patients before treatment. Both groups of patients had comparable neurological, urological and urodynamic status before treatment. In 4 patients (21 per cent) treated with oxybutynin and in 4 (27 per cent) treated with propantheline side effects were so severe that the treatment had to be discontinued. Symptomatic response to oxybutynin was good in 10 patients (67 per cent), fair in 2 (13 per cent) and poor in 3 (20 per cent). Propantheline produced good symptomatic results in 4 patients (36 per cent), fair in 1 (9 per cent) and poor in 6 (55 per cent). The mean increase in maximum cystometric capacity on cystometrography was significantly larger in the oxybutynin group than in the propantheline group (144 +/- 115 versus 35 +/- 101). Our results indicate that oxybutynin is more effective than propantheline in the treatment of detrusor hyperreflexia in patients with multiple sclerosis.
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PMID:Oxybutynin versus propantheline in patients with multiple sclerosis and detrusor hyperreflexia. 395 49

Sixty-four patients with multiple sclerosis and associated symptoms of neurogenic bladder dysfunction underwent urodynamic evaluation. The most common symptoms were urgency, incontinence, and frequency which did not correlate with urodynamic findings. Cystometrography demonstrated hyperreflexic bladders in 78 per cent and areflexic bladders in 20 per cent of patients. In those patients with hyperreflexia, voiding cystourethrography revealed poorly sustained uninhibited contractions associated with ineffective bladder emptying in 50 per cent, well-sustained contractions in 38 per cent, and detrusor-sphincter dyssynergia in 12 per cent. Therapy consisted of intermittent catheterization, pharmacologic manipulation, or transurethral resection of the external sphincter, according to urodynamic evaluation.
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PMID:Vesical dysfunction in multiple sclerosis. 398 35

First, some details about the symptoms of Multiple Sclerosis and about theories concerning pathophysiology and etiology are described. After that, results of an enquiry into psycho-social coping mechanisms of 27 male patients living with Multiple Sclerosis are shown. In detail: To 85% of these patients micturation problems were a well-know experience. "Urging need to micturate" made it impossible for these patients to participate in public life and brought social isolation for them. A feeling of helplessness and impotence was caused by the symptom of unnoticed incontinence. No patient were divorced because of Multiple Sclerosis, but it seemed that some patients did not marry because of first symptoms of the disease. Changes in sexual functioning of these male patients depended upon the way of coping with sexuality generally by them, and was not merely a constant physiological defect. An investigation was also carried out about the length of time between first symptoms and the correct diagnosis, between the time of correct diagnosis and the time the patient was informed, as well as an investigation about the mourning process itself. For a better understanding of a patient having to cope with a chronic disease it is recommend to take into consideration also his premorbid life history.
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PMID:[Psychosocial processing of disease exemplified by multiple sclerosis. Results of an empirical study of 27 males]. 398 38

Rehabilitation of the multiple sclerosis patient must be individualized because of the varied manifestations and fluctuating course of the disease. The activity schedule must be modified to compensate for muscle weakness and fatigability. Spasticity and the preventable complication of joint contractures may be treated with joint ranging, medications, motor-point blocks and surgical intervention. Mobility problems, such as foot drop, may be improved with an ankle-foot orthosis, but ultimately a patient may require a wheelchair. Measures to prevent pressure sores include position change, pressure release, incontinence management and special equipment.
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PMID:Multiple sclerosis: Part I. Common physical disabilities and rehabilitation. 405 Jun 40

In the past 8 years at St George's Hospital, 13 women underwent urinary diversion for disabling incontinence. Seven patients had multiple sclerosis, 2 had suffered trauma to the lumbar spine and 4 had failed repeated surgery for urethral sphincter incompetence. One patient died several months postoperatively due to relapse of her multiple sclerosis. The remaining 12 were interviewed to determine the effect of the operation on their quality of life. Preoperatively, 9 patients (75%) were either housebound or only ventured out to do the shopping and none led a full social life. Postoperatively 8 patients (67%) managed a full social life and all were improved. Most managed their stomas proficiently and none regretted having the operation. The most common late complication was pyocystis. We conclude that patients with disabling incontinence can have their quality of life substantially improved by urinary diversion. The incidence of pyocystis is probably high enough to warrant vaginal vesicostomy to be performed routinely at the time of diversion, at least in those women with chronic urinary infection.
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PMID:Urinary diversion for incontinence--a beneficial procedure? 407 63

24 female patients with multiple sclerosis presented with severe urge incontinence or leakage around an indwelling urethral catheter. All had failed to respond satisfactorily to drug therapy. After subtrigonal phenol injection 83% were dry.
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PMID:Subtrigonal phenol injection therapy for incontinence in female patients with multiple sclerosis. 613 96

Cross-sectional data from 1,793 cases of definite or probable multiple sclerosis (MS) identified in an extensive population survey in King and Pierce (K-P) Counties, Washington and Los Angeles (LA) County, California, were analyzed. Compared to the U.S. population as a whole, patients were more likely to be divorced and to have more years of schooling. The prevalence of MS was higher for females, and for northern-born, regardless of sex. Reconstructed age-, sex-specific incidence rate estimates for natives of the two areas showed a much higher peak annual incidence occurring in an older age group in K-P than in LA. Earliest symptoms in both areas were numbness in the legs, double vision, and loss of vision in one or both eyes. Weakness in arms, speech difficulties, and urinary incontinence tended to be late symptoms. The overall assessment of disability levels showed more than half of the patients to be fully ambulatory at the time of the first interview, with a somewhat higher proportion of each sex severely disabled in California. The ages of onset tended to be younger in LA than in K-P. The earlier onset of disease and the higher proportion of patients with high disability in Los Angeles County suggest that the course of disease is more malignant in this low-prevalence area.
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PMID:Two populations with multiple sclerosis. Clinical and demographic characteristics. 616 3

Twelve Lewis rats were inoculated with a guinea pig spinal cord tissue preparation. They developed experimental allergic encephalomyelitis (EAE) after 12-14 days, manifested by weight loss, tail flaccidity, ataxia, hind limb paresis and incontinence. The CNS lesions are produced in this animal model on the basis of inflammatory demyelination, which provides a useful model for multiple sclerosis. Concomitantly with EAE, all animals developed vestibular hyperreactivity (VH) of otolith and canal reflexes. In surviving animals these reflexes renormalized after full clinical recovery. The major effect on the canal response was an increased duration of postrotatory nystagmus caused by an increase in time constant. These findings are similar in part to those previously reported in patients with multiple sclerosis.
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PMID:Physiological abnormalities in experimental allergic encephalomyelitis (EAE). I. Vestibular hyperreactivity (VH) in rats with EAE. 633 52

The relationship between neurological urinary symptoms and urodynamic findings in patients with multiple sclerosis was examined. The duration of multiple sclerosis was significantly longer in patients with urinary symptoms. The presence of urinary symptoms correlated with the severity of the pyramidal or sensory lesions and the total disability score. Cystometrograms revealed detrusor hyperreflexia in 67 per cent of the patients, areflexia in 21 per cent and a normal detrusor in 12 per cent. Somatic dyssynergia was found in 20 of the 39 patients whose examination revealed clear-cut results. Positive correlation was found between urge incontinence and detrusor hyperreflexia, and between hesitancy and detrusor areflexia but no relationship was found between urological symptoms and sphincter function. Analysis of the neurological lesions in relation to the cystometric findings revealed a positive correlation among pyramidal lesions, detrusor hyperreflexia and detrusor areflexia, and between cerebellar lesions and detrusor areflexia. The correlation between detrusor dysfunction and high total disability score disappeared when patients with high pyramidal scores were excluded. No correlation could be detected between somatic dyssynergia and the various neurological lesions.
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PMID:Relationship between neurological and urological status in patients with multiple sclerosis. 647 Nov 85


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