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)

Comprehensive treatment, including pharmacotherapy, rehabilitation, psychotherapy and ultrasound stimulation of the lymphatic system by the method of Seltzer is given to multiple sclerosis patients at the hospital department for these patients. In the first year of treatment three courses of ultrasound sessions are given with 24 sessions in each course, in the second year two such courses are given, and in the following years one course is given yearly. The present material comprised 45 patients after 7 or 8 courses of treatment in the hospital. The neurological status of each patient was evaluated before the first course and after the last one using a score scale containing the most important clinical parameters. Is was found that these therapeutic methods had only a negligible effect on paresis of the extremities, but it seems that they influenced favourably eye signs, particularly nystagmus, and cerebellar tremor. The greatest improvement was obtained in sphincter disturbances, especially in pollakiuria and urinary incontinence. The effect of ultrasound alone on the obtained results could not have been assessed. Investigations would be necessary for this purpose which are not done in this hospital.
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PMID:[Complex treatment of patients with multiple sclerosis]. 664 25

The authors report a series of 47 patients suffering from disseminated sclerosis who required neuro-urological management because of micturition disturbances. They were in general young (mean age 43 years) and had been suffering from disseminated sclerosis for 10 years (on average). The neurological disease was in general severe since it was progressive in 32 cases and pure remittent in 13 only. Two-thirds of the patients were autonomous from a locomotor standpoint. Micturition disturbances developed in the first five years of the disease in 2/ 3rds of the patients and became really troublesome only after disseminated sclerosis had been progressive for five years. Dysuria, frequency and incontinence with urgency were the commonest symptoms. Persistent or transient retention of urine remained relatively common. Nocturnal urine loss was rarer. Sphincter incompetence was marked in half of the patients but this did not necessarily go hand in hand with locomotor incapacity. Symptoms and signs were grouped as irritative, obstructive and mixed syndromes. From a urodynamic standpoint, the detrusor was sometimes normal but more often behaved pathologically, being either hyperactive or hypoactive. Hypoactivity of the detrusor was accompanied in 9 cases out of 10 by spasticity of the striate sphincter. Spasticity of the striate sphincter was the commonest type of behaviour, although normal striate sphincter electromyography was possible and; rarely, results were of peripheral neurogenic type. There was no evidence of any correlation between the type of micturition syndrome, detrusor function and striate sphincter function. Similarly, no correlation could be established between the type of detrusor dysfunction and the period for which disseminated sclerosis had been present.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:[Urinary disorders in multiple sclerosis. Apropos of 47 cases]. 672 76

Thirty women with detrusor instability (27 cases idiopathic, and three secondary to multiple sclerosis) completed a double-blind, cross-over trial of the prostaglandin synthetase inhibitor flurbiprofen and a placebo, results being evaluated by questionnaire and cystometry. Frequency, urgency, and urge incontinence were all significantly reduced with flurbiprofen (P less than 0.001, P less than 0.025, and P less than 0.025 respectively), as was the detrusor-pressure rise during bladder filling (P less than 0.01). Side effects, however, occurred in 13 patients while taking flurbiprofen compared with five while taking placebo (P less than 0.025). After the trial 19 patients wished to continue with flurbiprofen. Flurbiprofen is a useful treatment for idiopathic detrusor instability and is well tolerated by most patients.
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PMID:Evaluation of flurbiprofen in detrusor instability. 698 48

A 32-year-old female with a seven year history of multiple sclerosis was hospitalized due to an exacerbation of symptoms, and complained of a high frequency of urination and occasional urinary incontinence. A urologic consult was obtained and the patient was diagnosed as having neurogenic (spastic) bladder, resulting in a reflexive voiding whenever the accumulation of urine in the bladder reacher 100 mls. A behavioral management program using feedback and goal-setting was implemented. Whenever she voided, the patient recorded the time of day, and measured the amount by using a graduated urinal. Following a 5-day baseline the patient and experimenter, on a daily basis, established a goal specifying a minimum waiting period between voidings, even when waiting might result in incontinence. Feedback on average duration between voidings was given daily. After 13 days of treatment, the duration between voidings had increased from a baseline of 58 min to 130 min and the average amount of urine had increased from 95 ml to 160 ml. At three and six month follow-ups, the patient reported that she was able to maintain treatment gains without difficulty; however, she had been unable to increase the time between voidings beyond approximately two hours.
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PMID:Behavior therapy for urinary frequency in a patient with neurogenic bladder: a case report. 707 50

A chronic, progressive form of experimental allergic encephalomyelitis was produced by immunization of rabbits with bovine brain white matter proteolipid apoprotein. Clinical signs appeared 4 to 13 months after sensitization, and were characterized by ataxia and limb paresis which progressed to flaccid paralysis and incontinence. Light and electron microscopic observations showed both acute and chronic nonsuppurative myelitis or encephalomyelitis accompanied by primary demyelination. Myelin damage was most evident in the spinal cord but was also present in the optic nerve and brain. The neuropathology was consistent with lesions of chronic experimental allergic encephalomyelitis produced by central nervous system tissue, and resembled lesions of multiple sclerosis as well. These observations suggest that protein may be involved in the pathophysiology of demyelinating diseases. A mechanism for the chronic course of the disease is discussed.
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PMID:Chronic experimental allergic encephalomyelitis induced in rabbits with bovine white matter proteolipid apoprotein. 710 65

We investigated the management of urinary incontinence in 50 patients with multiple sclerosis (MS) in two London boroughs. Only seven appeared to be satisfied with the management of their bladder problems. A total of 51 suggestions was made for improving management in 33 of the patients. Most of these suggestions involved services which were available though not being used. The management of urinary incontinence in patients with MS should be tailored to the requirements of the individual. Alternative forms of management may often not be reaching patients who might benefit from them.
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PMID:Management of urinary incontinence in patients with multiple sclerosis. 731 Jul 60

Multiple Sclerosis (MS) cases found at autopsy in patients who had died from other diseases and in whom no sign or symptom could be related to MS are called "asymptomatic". Three cases are reported. The first patient was a 62 year old man who presented with a slowly progressive disturbance of gait, incontinence and deterioration of intellectual function. A falx meningioma was surgically removed. The patient died 3 years later with an acute respiratory illness. Examination of the brain disclosed evidence of the operation and numerous old plaques disseminated through the cerebral hemispheres (centrum semi-ovale, periventricular regions, internal thalamus and junction between cortex and white matter) and in the brain stem. The second case, a 77 year old woman with diabetes mellitus and hypertension, presented with cortical blindness and disturbances of memory of acute onset. She died one year later. Examination of the brain showed multiple infarcts involving the territories of both posterior cerebral arteries and the left middle cerebral artery. Numerous old plaques were seen in the periventricular regions, in the corpus callosum and in the left middle cerebellar peduncle. The third case, a 60 year old woman with mitral and aortic stenosis, presented with cortical deafness and transient right hemiparesis. She died 5 years later. Brain examination showed infarcts involving both middle cerebral artery territories. There was also many old plaques in the periventricular areas, thalamus, internal capsule, centrum semi-ovale, brain stem and right nucleus dentatus. In the 3 cases, the optic tracts were normal. The spinal cord, examined only in the first case, was also normal. The asymptomatic character of these MS cases can be explained first by the location of the plaques and the lack of spinal cord and optic tract involvement. It could also be due to the small size of the plaques and to axonal preservation. Such features are rare since our 3 observations have been selected from a pathological collection of 125 MS cases and 9,300 general neuropathological records. Six other cases have been previously reported by other authors.
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PMID:[Asymptomatic multiple sclerosis - 3 cases (author's transl)]. 733 73

Patients with multiple sclerosis may have two fundamental, related problems in the lower urinary tract, i.e., urinary retention and/or urinary incontinence. Forty-six patients were assessed by urodynamic testing. Evidence of detrusor overactivity was seen in 40 patients (86.9%), elevated resting urethral pressures in 39 patients (84.8%), a positive bethanechol chloride (Urecholine) stress test in 24 patients (63.2%), and a significant residual urine in 26 patients (56.5%). Data were analyzed in an attempt to explain retention and incontinence in these patients.
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PMID:Urodynamic studies in female patients with multiple sclerosis. 746 94

Generalised ventricular dilatation with or without cerebral atrophy is common in longstanding multiple sclerosis. This has been widely assumed to be due to periventricular white matter atrophy rather than true communicating hydrocephalus although it can be difficult to distinguish between these on radiological grounds. Here we report 2 chronic MS patients who had progressive dementia, gait disturbance and urinary incontinence and in whom neuroimaging, and in one case CSF infusion studies, suggested hydrocephalus. Both significantly improved following shunting procedures. We suggest that further study is required to investigate whether a significant proportion of patients with chronic MS and dilated ventricles have shunt-responsive hydrocephalus.
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PMID:Apparent hydrocephalus and chronic multiple sclerosis: a report of two cases. 771 24

Urinary troubles are common in patients with multiple sclerosis. The management of these troubles requires an accurate analysis. Urodynamic assessment was preformed in 117 patients with urinary symptoms positively diagnosed as suffering from multiple sclerosis. Urinary symptoms are not always correlated to urodynamic patterns. We have studied the correlation between urinary symptoms and urodynamic findings. Urodynamic results are similar to most of previous series: detrusor hyperreflexia is the most frequent abnormality, detrusor sphincter dyssynergia is diagnosed in 50% of the patients. There is some correlations with symptoms, but there are insufficient for an accurate diagnosis. Postvoid residue for urinary tracts infectious diseases, and sphincter incompetence for urinary incontinence are the main risk factors.
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PMID:[Urination disorders in multiple sclerosis: value of urodynamic assessment]. 774 58


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