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Query: UMLS:C0677481 (urinary frequency)
 1,126 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

The clinical effectiveness and safety of terodiline hydrochloride and clenbuterol hydrochloride were studied on 51 patients with neurogenic bladder, stress incontinence, unstable bladder and others, the chief complaints of which were urinary frequency or urinary incontinence. Overall improvement was graded as marked in 6 patients (11.8%), moderate in 20 patients (39.2%), slight in 11 patients (21.6%), unchanged in 13 patients (25.5%) and aggravated in one. The patients impression was "good" or better in 56.9%. There were a total of 13 cases (25.5%) of adverse reactions, namely, 7 cases of finger tremor, 3 cases of dry mouth and others. These reactions disappeared rapidly after the discontinuance of drug administration. The clinical efficacy in the treatment of subjective symptoms was 71.4% for urinary incontinence, 56.4% for diurnal pollakisuria. The examination of lower urethral functions demonstrated a significant (p less than 0.01) increase in bladder capacity at first desire and maximum desire to void. However, we found no significant increase in urethral clossure pressure. The findings of this study suggest that terodiline hydrochloride and clenbuterol hydrochloride are very useful for the treatment of urinary frequency and incontinence.
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PMID:[Clinical studies of terodiline hydrochloride and clenbuterol hydrochloride for urinary frequency and incontinence]. 176 84

Twenty patients suffering from urinary stress incontinence were treated by perineal reeducation. The assessment included a medical and urological questionnaire, a physical examination, a urine analysis and culture, a cystoscopy, urinary flow and cystometry, a urethral pressure profile and a subjective evaluation of the perineal musculature. The 20 patients selected had documented stress incontinence, had never been operated on for incontinence and had a stable bladder at urodynamic assessment. Treatment was identical for all patients and included 12 biofeedback and electrostimulation sessions over a 4 to 6 week period. The questionnaire, urodynamic and perineal assessment were repeated at the end of treatment. No complication occurred. Micturition frequency decreased in all patients. Clinical correction of incontinence was observed in ten patients, improvement in nine and no change in one for an overall cure or improvement rate of 95%. The urethrocystocele evaluation did not change. Perineal evaluation and urodynamic parameters were only slightly improved. At follow-up evaluation 6 to 9 months post treatment, a 75% cure or improvement rate was still present. Perineal reeducation is a non morbid and effective modality to correct urinary stress incontinence. Its long term efficacy and its use for other types of incontinence has to be demonstrated.
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PMID:[Perineal retraining in urinary stress incontinence]. 178 26

Intermittent functional electrical stimulation (FES) was employed for the control of incontinence. One FES session lasted for 30 minutes. It was repeated at intervals of 3 days to 1 week via an anal plug electrode. The success rate was 64% in 41 patients with pollakiuria, urgency and/or urge incontinence, and 43% in 7 patients with stress incontinence. Detrusor activity measured by cystometry did not correlate significantly with the effect on subjective symptoms and the urethral pressure did not increase. The remarkable clinical effect was observed in patients with overactive detrusor function. It seems that FES indirectly inhibits detrusor contraction by suppressing the intrasacral pathway for detrusor activity.
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PMID:Functional electrical stimulation in the management of incontinence: studies of urodynamics. 186 13

The clinical efficacy of a new device for treatment of female incontinence was studied in a multicenter trial. The device consists of an inflatable electrode carrier and an external stimulator unit. Forty women were treated: 10 had primary or recurrent genuine stress incontinence, 15 had urge incontinence due to idiopathic detrusor instability, not responding to drug treatment, and 15 had stress incontinence combined with detrusor instability. Twenty-five patients were improved by the treatment. Another 8 reported an excellent result of treatment and remained free of symptoms for more than six months after withdrawal of the treatment. The results were more favorable in patients with bladder hyperactivity than in genuine stress incontinence. The patients' general ratings of treatment efficacy correlated well with their recordings of urinary frequency and consumption of incontinence pads. The functional bladder capacity increased in improved patients, but normalization of urodynamic parameters was no prerequisite for clinical improvement. We found intravaginal electrical stimulation to be a valuable alternative to medical and surgical intervention in patients with detrusor instability.
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PMID:Contelle: pelvic floor stimulator for female stress-urge incontinence. A multicenter study. 351 28

A method has been developed for the measurement of sensory receptors that respond to pressure at the base of the bladder and posterior urethra. The application of force to a balloon catheter placed at that part of the bladder regularly results in an urge to urinate. People with normal voiding perceive the urge to void when 245 +/- 47 gm. (standard deviation) of force are applied. Patients with irritative symptoms (urinary frequency and urgency) perceive the urge to void when 132 +/- 50 gm. (p equals 0.0003) are applied. After enucleative prostatectomy more force is required to cause the urge to void (344 +/- 48 gm., p equals 0.0003) and even more force is required after radical prostatectomy (469 +/- 54 gm., p equals 0.0002). Patients with acute urinary retention or urinary stress incontinence were not distinguishable from the normal group. Patients with chronic urinary retention may be divided into 2 subgroups: 1 with normal sensory perception and 1 with reduced perception (526 +/- 32 gm., p equals 1.6 X 10(-9)). Three patients with urinary urgency not associated with frequency did not perceive the urge to void until 541 +/- 21 gm. (p equals 6.2 X 10(-7)) had been applied. Some elderly patients could not reproducibly report the urge to void. When lidocaine was applied topically within the bladder sensitivity was reduced by 210 +/- 114 gm. (p equals 0.003). It is suggested that pressure sensitive receptors in the mucosa or submucosa of the bladder base and posterior urethra have a role in micturition, that their activity can be quantitated and that protocols designed to manage them may have impact on the care of patients with voiding disorders.
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PMID:Measurement of trigonal sensitivity as a test of bladder function. 380 12

Ten patients (4 boys and 1 girl, 4 adult women and 1 man) were operated upon for incontinence due to epispadias (5 children and 2 women), or the result of multiple operations for stress incontinence (2 women), or of a transurethral bladder neck resection (the adult man), using Leadbetter's technique, which is described. In 4 patients with a sufficiently long trigonum, it was not considered necessary to perform ureterovesical reimplantation. Interesting results were obtained as they were assessed as very good in 4 and good in 2 of the 7 cases of epispadias, good in 1 of the 2 cases of sphincter lesions following surgery, and poor after endoscopic resection of the bladder neck in the man. All patients retained a normal upper urinary tract. In those patients who became continent, the new urethra measured 3.3 to 5 cm in length, whereas it was too short and dilated in cases remaining incontinent. Initial pollakiuria improved in the children after several months. These findings suggest that the ureter should be reimplanted in all cases, to allow the formation of a muscular, newly formed urethra of sufficient length. This operation appears to be effective for treating incontinence due to epispadias and traumatic sphincter lesions in women. It gives poor results in incontinence after prostate surgery and from neurological bladder. Reeducation of the child is as important as selection of patients for operation and a strict operative technique.
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PMID:[Surgical treatment of total urinary incontinence based on Leadbetter's technic]. 649 47

Stress urinary incontinence (SUI) in women is more frequent in the multiparous patient, especially in those postmenopausal after withdrawal of hormonal stimulation of the pelvic supportive tissues. With loss of support of the vesical neck and urethra, sphincter incompetence may result. A patient whose symptoms are purely irritative (urinary frequency, nocturia, urgency, or urge incontinence), without a significant degree of stress incontinence, should not benefit from any operation.
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PMID:Practical approach to stress urinary incontinence. 668 93

A lot of drugs can increase or decrease bladder activity or urethral sphincter activity. Some of them are used for treatment of incontinence or chronic retention. In case of severe pollakiuria or urge incontinence secondary to bladder instability, numerous medications can be used: anticholinergic agents, musculotropic relaxants, calcium antagonists, prostaglandin inhibitors, beta-adrenergic agonists, tricyclic antidepressants. Anticholinergic agents are regularly used on first choice. When stress incontinence is present, alpha agonists administered with estrogen and perineal reeducation represent the first stage before surgery. For medical treatment of retention, if there is not outlet obstruction, one can increase detrusor activity with betanechol chloride. In case of outlet obstruction, alpha-blockers or 5 alpha-reductase inhibitors can be used, if there is benign prostatic hyperplasia. Pygeum africanum can be used, but to date there is no clinical study proving its efficacy.
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PMID:[Medical treatment of disorders of the bladder sphincter]. 772 39

Micturitional disturbance has attracted little attention in myotonic dystrophy, but detailed micturitional histories revealed that two out of six patients (33%) had micturitional symptoms. One had difficulty urinating and the other had urinary frequency, urgency and stress incontinence. Urodynamic studies were performed in all patients and the results were as follows: Two had low maximum urethral closure pressure, two had large and three had small bladder capacities, one had detrusor hyperreflexia and one had atonic cystometrogram. Urethral sphincter electromyography revealed a decreased bulbocavernosus reflex in one, and an absent anal reflex in two. Motor unit analysis of external sphincter was performed with one patient and showed polyphasic potentials. Dystrophic changes of the lower urinary tract muscles, as well as supranuclear type of pelvic nerve dysfunction, could cause micturitional disturbance in patients with myotonic dystrophy.
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PMID:Micturitional disturbance in myotonic dystrophy. 778 66

Medications to treat lower urinary tract dysfunction in older adults are selected to alter specific physiologic parameters. Pharmacotherapy alone results in modest clinical improvement. Because of the high prevalence of adverse drug reactions and polypharmacy in the geriatric population, medication should be used for those conditions that do not respond sufficiently to behavioral therapy. For stress incontinence, medications with alpha-adrenergic agonist properties are the mainstay of pharmacotherapy because they increase outlet resistance. Pharmacotherapy of urinary frequency and urge incontinence aims to decrease detrusor irritability and increase bladder capacity by inhibiting cholinergic stimulation of the bladder. In addition to these medications, in postmenopausal women, estrogen seems to have an additive effect for both urge and stress incontinence. More randomized, placebo-controlled, double-blinded clinical trials are needed that compare various pharmacologic agents and combinations, as well as pharmacotherapy with other forms of treatment for lower urinary tract dysfunction.
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PMID:Pharmacologic treatment of lower urinary tract dysfunction in geriatric patients. 933 66


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