Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0234215 (discomfort)
 24,445 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

The people become elder in this time, everywhere. The number of patients with adenoma of the prostate is increasing. Most of them have other diseases, too. A retrospective study (2646 cases in 8 years, exactly specially analysed 469 cases from 1975/1976) was done, comparing the results of TUR and open surgery. Well known is the lower risk of TUR, the lower blood loss, the lower discomfort, the lower nursing in the postoperative period ect. There are not news in this study. But it is important, to recall some things, because it's more and more difficult, to classify an old man as an "inoperable case". Nobody knows, where he should stay. The family does not like him at home (his "dripping", his incontinence etc.) In the veterans house it's the same problem, and from the hospital he is removed, because he is an "inoperable case". The situation of this old man is very bad, because he feels there isn't a place for him and nobody likes him. Each man, also if it's the strongest one, will be broken psychically and physically after a short time. Concerning these aspects, must be enlarged the indication of removal the bladder neck obstruction per transurethral resection, more and more.
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PMID:[Transurethral electroresection--an alternative to the indwelling catheter of old patients with prostatic hypertrophy]. 8 44

Using a new device for intravaginal electrical stimulation (IVS), 24 women with pure stress incontinence, mixed urge and stress incontinence or urge incontinence due to detrusor instability, were treated. To minimize mechanical discomfort, the electrode carrier was made of flexible material and inflatable. Furthermore, this design facilitated fixed, constant positioning of the electrodes at individually tested sites to produce maximum response at voltage well tolerated by the patient. The stimulation frequency was adjusted to suit the cause of incontinence: 20 to 50 Hz in stress incontinence, 10 Hz detrusor instability. The electrode carrier was well accepted. Seven of the 9 patients with pure stress incontinence became continent during IVS. Three of them have so far remained continent for 2 to 8 months without IVS. The 15 patients with detrusor instability or mixed incontinence were all free from symptoms after IVS for more than 3 months. Two of them have remained cured for more than 3 months after they had stopped IVS.
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PMID:Long-term intravaginal electrical stimulation in urge and stress incontinence. 30 93

Ninety-eight patients with urinary incontinence have been treated with maximal electrical stimulation (MES) The MES method used is a modification of previously used similar methods of maximal stimulation with respect to reduced intensity of stimulation and reduced number of electrodes. Thus, discomfort to the patient during treatment is considerably lessened. Anal or vaginal MES produced temporary or sustained improvement or relief of incontinence in 47 of 98 patients.
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PMID:Maximal electrical stimulation for urinary incontinence: report of 98 cases. 31 13

The clinical results of treatment of infravesical prostatic obstruction with an intraurethral coil in 150 consecutive patients are reported. A total of 80 patients had urinary retention and 70 had severe prostatism. Median observation time was 8.2 months, with a range of 0 to 40 months. In 75 patients the spiral was removed after a median of 4 months (range 0 to 30 months) because of planned prostatectomy in 17, urinary retention in 16, incontinence in 10, local discomfort in 7, no symptomatic improvement in 13 and causes not related to the spiral (stroke and so forth) in 7. Migration occurred 55 times in 42 patients but this only led to coil removal in 5. A total of 23 patients died with the coil in situ. Voiding symptoms improved considerably in the majority of the patients. Approximately two-thirds of the patients had no or few symptoms, while a fourth had moderate symptoms, leaving only approximately 10% with severe prostatism. Chronic bacteriuria was noted in 52 patients but was not a clinical problem. Calcification on the top and inside of the coil was noted mainly after long-term treatment, and probably necessitated exchange of the coil after 2 to 3 years. We conclude that the prostatic spiral is a useful alternative to an indwelling catheter. However, life-long followup is necessary in most patients.
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PMID:The intraprostatic spiral: clinical results in 150 consecutive patients. 137 51

We reviewed our experience of the application of a new urethral stent (PROSTAKATH) for 8 patients with prostatic outflow obstruction from December 1989 to March 1990. 6 patients had required the Foley catheter for several months because of chronic urinary retention. 2 were dys-uric patients having a higher bladder residual urine volume. All were in a high risk group for surgery. 7 out of the 8 patients were treated successfully. The stent was not placed in one. All 7 patients in whom the urethral stent was placed voided freely after placement of the stent. Bladder residual urine was not detected by the ultrasound sonography except in one patient. The urethral stent used in this study was a spring-like spiral with an outside diameter of 21 Fr, it is made of gold-plated stainless steel. Under local anesthesia, it can be easily inserted using a 6-7 Fr. ureteral catheter as a guide wire under ultrasonic scanning guidance. During the follow-up period of 5-8 months, 1 patient had an episode of migration of the stent to the bladder 2 months later, which was removed endoscopically, and a new stent was placed. Side effects were observed in 2 patients; one complained of strong discomfort and the other suffered from urge incontinence. Both symptoms were ameliorated during the follow-up period. We conclude that the urethral stent is an effective device as a non-invasive treatment of prostatic outflow obstruction.
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PMID:[Application of new intraurethral stent for higher risk patients with benign prostatic hypertrophy]. 171 70

Treatment using a metallic spiral was attempted on 22 patients. They had urinary retention in 16 cases and dysuria in 6. In 21 of them, the spiral was successfully placed under transrectal ultrasound control. In all 21 patients, voiding was possible immediately after placement of the spiral. As for urodynamic study, urine volume was 100-230 ml (mean: 172 ml), maximum flow rate was 13-21 ml/sec (mean: 17.3 ml/sec), and average flow rate was 4-12 ml/sec (mean: 8.2 ml/sec). Residual urine volume was less than 30 ml in 20 patients and 200 ml in one. As for complications, proximal migration of the spiral was observed in 6 patients. In 4 of them, the new spiral was placed. Perineal discomfort was seen in 3 patients, in 2 the spiral was removed. Pyuria associated with bacterial infection did not continue after the treatment in patients having a catheter. Severe urge incontinence and encrustation were never seen. The above findings suggest that, though a longterm study has not done, this treatment could be an effective treatment particularly for the elderly patients with general complications and/or who require removal of an indwelling catheter for clinical or social reasons.
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PMID:[Clinical study of a metallic prostatic stent]. 172 35

Urinary incontinence in the geriatric population is prevalent, morbid, and costly. Despite the high prevalence and adverse effects, many incontinent geriatric patients do not undergo any type of diagnostic evaluation. Assessment of incontinence in this patient population should focus on identifying reversible factors that may contribute to the incontinence, determining whether the patient should be referred for further evaluation before initiating treatment, and pinpointing the cause(s) of the incontinence so that appropriate treatment can be instituted. Many different therapeutic modalities can be helpful for geriatric urinary incontinence, including behavioral, pharmacologic, and surgical approaches. Chronic catheters and diapers should generally not be used as the initial treatment, and be reserved for patients who fail more specific treatment approaches. Although it may not be possible to cure the incontinence, it is almost always possible to ameliorate the problem, and prevent discomfort, complications, and excessive costs.
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PMID:Urinary incontinence in the geriatric population. 194 28

Stenosis of the rectum after surgery is a rare complication of low anastomosis. Infection, ischemia, foreign body reaction, technical faults or recurrence of neoplasms are the most important causes. Dilatation is attempted either manually or by instrument, if the stenosis causes discomfort and in particular if diarrhea results. Rarely resection of the stenosed segment is necessary. Stenosis in conjunction with incontinence is the most feared complication of anorectal surgery. It develops exceptionally after scarring of a large mucocutaneous defect after hemorrhoidectomy, correction of an anal fistula, a mucosal prolapse, electro-resection, infection or trauma. Anal stenosis leads to increasing constipation, a reduction of stool volume, abdominal cramps and rectal bleeding.
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PMID:[Postoperative anorectal stenosis]. 236 80

Twelve patients presented with symptomatic internal intussusception of the rectum between 1979 and 1987. All were women with a mean age of 55.5 years. Ten patients had symptoms of obstructed defaecation and only three were completely continent. Polyvinyl alcohol sponge abdominal rectopexy was performed in each patient. Over a mean follow-up period of 26.9 months there was no recurrence of internal intussusception. The functional results, however, were mixed but only one patient remained incontinent for solid stool. Rectal discomfort and defaecatory difficulties persisted; six patients continued to strain at stool and in three this was worsened by the operation. Abdominal rectopexy can be recommended for those with associated incontinence, significant rectal bleeding or solitary rectal ulcer but may not benefit those who have obstructed defaecation.
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PMID:Rectopexy for internal rectal intussusception. 238 28

The author describes the therapeutic results in 48 patients with chronic anal fissure by means of internal lateral sphincterotomy (ILS). He operated patients where the complaints did not recede after conservative treatment supplemented by divulsion of the anus. In 43 patients (89.58%) in the course of two to three weeks the anal fissure healed. Only four patients (8.33%) experienced after operation a slight discomfort such as itching in the perianal region. A relapse after temporary improvement occurred in one patient (0.49%). ILS is a simple and safe operation performed under general anaesthesia after precise differentiation of the internal sphincter. The results of surgical treatment are very satisfactory the marked painfulness recedes immediately after operation, the fissure heals rapidly after relaxation of the spasm of the internal sphincter. Postoperative treatment is simple, the percentage of complications is small. None of the patients operated in the authors' department developed incontinence.
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PMID:[Personal experience with the treatment of chronic anal fissures using internal lateral sphincterotomy]. 281 87


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