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Query: UMLS:C1762617 (weakness)
 37,932 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Urinary incontinence is the most obvious urinary tract complication in children with myelomeningocele. Incontinence is owing to a hyperreflexic (spastic) bladder and/or pelvic floor weakness, which responds to functional electrical stimulation. Of 33 incontinent children the criteria for functional electrical stimulation were absent in 21 because of denervation of the pelvic floor muscles. Of 6 children who used functional electrical stimulation 5 had a successful result. However, incontinence recurred in 3 of the 5 patients between 6 and 18 months after functional electrical stimulation treatment was completed and they are awaiting repeat treatment.
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PMID:Electrical stimulation for incontinence in myelomeningocele. 31 Apr 76

Incontinence and frequency of voiding were present after spinal cord injuries in 18 patients. A hyperreflexic bladder and/or pelvic floor weakness was found in these patients. Functional electrical stimulation resulted in relief or improvement of symptoms in 9 of the 11 patients in whom this procedure was used. An increase in anal sphincter pressure with functional electrical stimulation was a more reliable criterion than an increase in maximum urethral pressure in the selection of patients for the procedure.
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PMID:Electrical stimulation for voiding dysfunction after spinal cord injury. 31 Apr 77

Impeded cranial migration of the spinal cord is described in five cases which initially were not recognized. The aetiology, symptomatology and differential diagnosis are presented. The clinical manifestations are signaled by skin lesions typical for dysraphic lesions, signs of urinary and rectal incontinence, deformity or weakness of the feet, impaired gait, motor reflex and sensory changes, and occasionally trophic changes. The restriction in cranial migration of the spinal cord can only be proved by myelography. The importance of early neurosurgical intervention to prevent irreversible deterioration of the motor, sensory or urinary system is particularly emphasized. Improvement after surgery can be achieved in at least 30% of the patients who already developed neurological deficits.
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PMID:[The importance of early recognition of impeded cranial migration of the spinal cord]. 32 Apr 60

This method of improving anal continence is recommended for patients with partial anal incontinence, in whom some functioning anal sphincter remains. It is particularly applicable for treating those patients who have sustained operative trauma, but is less helpful for those who have generalized sphincter weakness; however, any patient with some sphincter function may benefit. Emotionally unstable patients are less likely to benefit. Although the series was small, the results were considered sufficiently gratifying to justify a preliminary report.
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PMID:Biofeedback in the management of partial anal incontinence: a preliminary report. 44 49

There were 15 men with incontinence after prostatectomy who were assessed with a urethral pressure profile and a multichannel filling and voiding study with sphincter electromyography. Of these 15 patients 7 had sphincter weakness alone, 7 had sphincter weakness and detrusor hyperreflexia, and 1 had detrusor hyperreflexia alone. Full urodynamic assessment is essential before treatment can be recommended for incontinence after prostatectomy.
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PMID:Urodynamic assessment of incontinence after prostatectomy. 45 91

Some degree of bladder instability is common in elderly people because aging changes in the portion of the frontal cortex concerned with micturition allow uninhibited bladder contractions. Although this in itself is not a cause of urinary incontinence, it may be an important predisposing factor and must be differentiated from all other causes. Stress incontinence occurs when the bladder outlet becomes incompetent because of weakness of the supporting pelvic muscles. Incontinence also can be a symptom of atrophic urethritis, acute cystitis, chronic bacteriuria, or bladder carcinoma. Overflow incontinence results from retention of urine, which can be caused by impacted feces, prostatic enlargement, autonomic neuropathy, or anticholinergic drugs. A complete history and thorough physical examination, with special attention to neurologic signs, vulval appearance, and rectal examination often will reveal the cause of urinary incontinence. If the cause is not readily apparent, cystometrography is indicated, and if the bladder is normal, cystoscopy should be done immediately. A more limited examination is acceptable only in demented patients who may not be able to cooperate in the examination and subsequent treatment.
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PMID:Differential diagnosis of urinary incontinence. 63 64

Since 1947, we have treated 19 children with neuroblastoma whose first symptoms were paralysis or weakness of an extremity, and/or incontinence due to tumor in the spinal canal. In 18 patients, the spine tumor was part of a dumbbell tumor which was present in the adjacent paravertebral area and in one, no extraspinal tumor was found. Aggressive treatment was employed for all. In 17 children, the intraspinal tumor was treated by laminectomy and irradiation with and without chemotherapy. Radiation and chemotherapy were used for two. The extraspinal tumor was excised totally in six and partially in six. All 12 children received postoperative radiation and chemotherapy. In 6 children, the extraspinal tumor was treated only with radiation and chemotherapy. Nine of 19 children are alive without evidence of neuroblastoma. Thirteen patients showed either partial (6) or full (7) neurologic recovery. Survival was related to the child's age at diagnosis and the extent of disease. While 8 of 9 children under 1 yr of age survived, only 1 of 10 children over 1 yr survived. None of the 5 children with Stage IV disease at diagnosis could be saved. The degree and frequency of neurologic recovery were greatest in children whose neurologic symptoms had been present the shortest times and were equal among those who survived and those who died. The outlook for children who became paralyzed by neuroblastoma is not hopeless; therapy aimed at saving life or neurologic function is both worthwhile and rewarding.
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PMID:Prognosis for children with neuroblastoma presenting with paralysis. 87 30

Incontinence due to hyperreflexic bladder and/or pelvic floor weakness can be corrected by chronic functional electrical stimulation (FES). Cystometry, electromyography of pelvic floor muscles, and anal sphincter pressure measurements with and without electrical stimulation determines if chronic FES will be successful. Post-acute stimulation improvement occurred in patients with incontinence due to hyperreflexic bladder and/or pelvic floor weakness. A success rate of 92 per cent was achieved with chronic FES in incontinent patients with this method of selection.
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PMID:Electrical stimulation for incontinence. Technique, selection, and results. 108 78

The subject of occult spinal dysraphism or myelodysplasia is reviewed from standpoints of embryology, clinical manifestations, and treatment, and the management of 73 cases summarized. In general, these concealed lesions arise from developmental variants in the most distal part of the neural tube, a situation which may cause distortion or partial absence of neural tissues and also lead to damage from compression or traction. Lipomyelomeningocele and congenital dermal sinus are two exampled of the many types of such lesions, but some are more complicated and border-line myelomeningocele-like forms occur. Incontinence, deformity or weakness of the feet, impaired gait, and other difficulties may appear late and increase with growth. Surgical treatment is advised to reduce chances of delayed or progressive loss of function.
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PMID:Occult spinal dysraphism: a series of 73 cases. 109

Spastic or hyperreflex bladder dysfunction can cause frequency, urgency, and incontinence. Detrusor activity was inhibited by FES (functional electrical stimulation) applied to the anal sphincter causing decreased bladder spasticity and increased bladder capacity. FES is indicated for incontinence not only because of weakness of the pelvic floor but also because of hyperreflex bladder.
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PMID:Bladder inhibition with functional electrical stimulation. 110 26


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