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Biomedical subjects

A Martan

Publications and source records attributed to A Martan.

At least 55 records · Page 3Linked to original sources
PubMed1997

[Does maximum short-term electric stimulation cause contraction of the pelvic floor muscles?].

Electric stimulation is successfully used in the treatment of the stress and urgent type of incontinence. Electric stimulation of the muscles of the pelvic floor causes reflex contraction of the striated peri- and paraurethral muscles and is associated with concurrent reflex inhibition of the detrusor muscle. The therapeutic results depends greatly on the total or at least partially preserved innervation of the muscles of the pelvic floor by the pudendal nerve. One of the possible stimuli of the pelvic floor muscles is maximal electric stimulation (MES) and the objective of our study was to evaluate the effect of MES on the muscles of the pelvic floor or to detect possible changes by US and urodynamic examination. The study comprised women with the stress type of incontinence (GSI). The group was formed by 40 women with GSI, 20 were subjected to US examination and urodynamic examination (n = 20). The group of subjects subjected to urodynamic examination was extended to 40 (n = 40). For electrostimulation a Conmax apparatus was used. The applied frequency was 20 Hz, the amplitude from 0 to 90 mA (grades 0.6), pulse duration 0.75 ms. During the cystometric examination the authors recorded a significant increase of the maximal urethral closure pressure (MUCP), prolongation of the functional (FUL) and anatomical length (AUL) of the urethra during MES. During US examination the authors recorded a significant diminution of the gamma angle, a reduction of the mobility of the UV junction and prolongation of the anatomical length of the urethra during MES. From the investigation ensues that the pelvic floor muscles are contracted during MES and those changes contribute to an increase of the muscular tonus and contracting capacity of the muscles of the pelvic floor and thus cause among other things elevation of the neck of the urinary bladder. The elevation contributes to the normalization of the intraabdominal transmission of pressure to the proximal urethra and thus to treatment of the stress type of urinary incontinence.

Electric Stimulation Therapy↗
PubMed1997

[Tolerance and effectiveness of propiverine hydrochloride in 752 patients with symptoms of detrusor hyperactivity and increased sensitivity and irritability of the urinary bladder: results of a study monitoring drug utilization].

In a post-marketing surveillance study of 752 patients suffering from urgent incontinence, mixed urgent-stress incontinence, reflex incontinence, urgency and enuresis were treated with propiverine hydrochloride. Clinical efficacy of propiverine hydrochloride was verified by the improvement of symptoms related to detrusor hyperactivity, hypersensitivity and hyperreflexia during a 12-week surveillance period: daytime and overnight urinary incontinence, as well as the frequency, nocturia, urgency in day time and at night decreased. These results are well demonstrated by decreased pad use and statistically significant decrease of Gaudenz urgency score during treatment, confirming the efficacy of propiverine hydrochloride already proved in clinical trials. The safety profile of propiverine hydrochloride displayed characteristic anticholinergic symptoms (dry mouth, accommodation disorders, constipation, tiredness, dizziness) with decreasing incidence during the 12-week treatment period. The residual urine volume decreased also. Serious adverse events were observed rarely and could be explained by the lack of consideration of contraindications, warnings and interactions with other drugs. The positive risk-benefit relationship of propiverine hydrochloride in the treatment of detrusor hyperactivity, hypersensitivity and hyperreflexia was reconfirmed in this post-marketing drug surveillance study.

Adolescent↗
PubMed1997

[Ultrasound imaging of the urethral sphincter].

The integrity and functional capacity of the urethral sphincter is one of the important prerequisites of urinary incontinence in women. Urodynamic investigations revealed repeatedly that the maximum closure pressure in the median portion of the urethra corresponds to the maximal thickness of the external urethral sphinctor (rhabdosphincter urethrae). This striated muscle is adapted to maintain a relatively steady tonus which assists the closure mechanism of the urethra [4]. In the submitted study the authors focused attention on the ultrasonic visualization of the internal urethral sphincter in order to assess the relationship between the size of this sphincter and the stress type of incontinence (genuine stress incontinence-GSI). The investigation comprised thirty women with confirmed GSI and a control group of thirty asymptomatic volunteers. During perineal ultrasonic examination of women in a supine position by means of an ACUSON 128 XP 10 apparatus using a convex probe with a frequency of 5 MHz the authors recorded statistically significant differences in the areas and maximal thickness of the urethral sphincter in women with stress incontinence and symptom-free women. From the results ensues that the size of this muscle is much smaller in women suffering from GSI.

Adult↗
PubMed1996

[Changes in the position of the urethra and bladder neck during pregnancy and after delivery].

It is estimated that some 30-50% women suffer occasionally from urinary incontinence. At the end of pregnancy these complaints are more marked. In the author's group of 44 women 55% suffered from stress incontinence. The psychosocial impact of impaired function of the lower urinary pathways in women on different spheres of the patient's life is so serious that it calls for a qualified approach of a specialist. The increased mobility of the UV junction in incontinent women has been described by several authors [6, 12, 13]. It was also proved in the author's investigation closely before delivery and 3-5 days after delivery. Six weeks after delivery no differences were found in the mobility of the UV junction in continent and incontinent women. If the difference of the gamma angle (formed by the axis of the symphysis and the connecting line between the UV junction and the lower margin of the symphysis) during contraction of the muscles of the pelvic floor and Valsalva's manoeuvre (intraabdominal pressure raised by 30 cm H2O) is more than 30 degrees during the 40th week of gestation or 3-5 days after delivery (when this mobility is even greater), then the woman is liable to develop the stress type of incontinence and the authors recommend to use Kolpexin after the puerperium for exercise and strengthening of the muscles of the pelvic floor. Changes in the length of line p and angle beta are not statistically significant and cannot assess the disposition for development of urinary incontinence.

Adult↗
PubMed1996

[Manometric measurement of contraction capability of pelvic floor muscles].

The objective of our investigation was to introduce manometric assessment of the force of contraction of pelvic floor muscles as one of the examination methods for confirming the diagnosis of assessment of the degree of urinary incontinence in women; also to assess the relationship between MUCP (maximal urethral closure pressure), PWT (pad weight test) and results of manometric assessment. The trial comprised 10 healthy premenopausal and 10 postmenopausal women who did not suffer from incontinence. The authors investigated also 20 premenopausal women with the stress type of incontinence and 20 postmenopausal ones. In all manometric assessments with a WISAP apparatus were made. The maximal increase of pressure was recorded during contraction of the entire pelvic floor and when the pressure in the balloon was set at 50 and 75 mm Hg. During this assessment the authors recorded also a statistically significant difference between the group also a statistically significant difference between the group of continent and incontinent women before the menopause. No relationship between MUCP, PWT and the maximal contraction capacity of the pelvic floor muscles was found. The disadvantage of the manometric apparatus WISAP is the calibration of the apparatus in mm Hg (1 mm Hg = 13.5 cm water), i.e. the low sensitivity of the apparatus and the shape of the balloons which leads to irregular expression from the vagina during contraction of the pelvic floor muscles. From absolute values of the contraction force of the pelvic floor muscles we cannot draw any conclusions on urinary incontinence or its grade. The authors recommend this method only as a supplementary one, in particular to evaluate the results of exercise of the pelvic floor muscles.

Adult↗
PubMed1994

[Urogynecologic follow-up after conservative therapy of stress incontinence with a vaginal cone (Femcon)].

The conservative treatment of women suffering from stress incontinence is very often highly successful. Vaginal cones (Femcon) are widely used for training the pelvic floor muscles. We investigated 60 women (mean age 50.7 years). After an exercise course with cones of 3 to 4 months, 75% of these patients reported good results with respect to pelvic floor function and stress incontinence. We found no differences between the parameters of cystometry and urethrocystometry at rest. The uroflow is also not affected. Objectively, we could only determine a statistically significant increase of the transmission ratio. This fact can be explained by the active contraction of the pelvic floor muscles, which are trained by means of the cones.

Exercise Therapy↗
PubMed1994

[Antibiotic prophylaxis in cesarean section].

Childbirth by Caesarean section is associated with 7-10x more complications than spontaneous childbirth [28] whereby the second place is held by infection. One of the possible ways how to prevent these infectious complications is antibiotic prophylaxis. Views on the latter still differ as regards selection of the antibiotic, its effectiveness, onset of administration, dosage, period of administration etc. Prophylaxis should meet the following demands; it should be aimed, of short-term character, bactericide and non-toxic-these demands are met by cephalosporins of the second generation [11]. The objective of the present work was to evaluate the contribution of the prophylactic administration of antibiotics, i.e. a cephalosporin of the second generation-Zinacef (Cefuroxime). The group was formed by 23 women to whom a dose of Zinacef was administered after childbirth by Caesarean section and subsequently twice after 8-hour intervals (1.5-0.75-0.75 i.m.). The control group (23 women) did not have this prophylaxis. In both groups the authors compared the indication of s.c., time of loss of amniotic fluid before s.c., results of cultivations from the cervix, vagina, amniotic fluid, lochiae and sutures. The authors evaluated the postoperative course where they were interested in infectious complications, the temperature curve, period of hospitalization, the necessity to administer another antibiotic or to proceed with the antibiotic therapy after the prophylactic dose. The results are clearly in favour of the prophylactic administration of antibiotics to the risk group of patients delivering by Caesarean section.

Adult↗
PubMed1994

[Ultrasound of the bladder neck-urethra transition before and after pelvic floor training with Kolpexin].

In this study we examined sonographically the position of the bladder neck in healthy control persons and patients suffering from stress incontinence before and after pelvic floor exercises supported by Kolpexin. 14 of the 20 patients are satisfied after performing the Kolpexin exercises. We found by using perineal sonography a significant decrease of the angle gamma after the pelvic floor training. The perineal sonography allows good informations about the position of the bladder neck after conservative treatment, too.

Exercise Therapy↗
PubMed1994

[Ultrasound of the urinary bladder neck: changes before and after pelvic floor muscle exercise].

It was repeatedly reported that training of pelvic floor muscles in the treatment of the stress type of urinary incontinence produced favourable results [1, 4, 6, 7, 8, 10]. The objective of the present study was to examine by ultrasound, using the transperineal route, the influence of exercise of pelvic floor muscles in the treatment of the stress type of incontinence on the position of the internal reproductive organs and the vesicourethral system. For exercise and strengthening of the muscles of the pelvic floor the intravaginal aid Kolpexin [7] was used. The authors investigated two parameters--the angle formed by the median axis of the symphysis with the imaginary line connecting the apex of the lower margin of the symphysis with the urethrovesical junction (angle U). The second parameter is the distance of the apex of the lower margin of the symphysis from the urethrovesical junction (line P). The authors recorded statistically significant changes of angle U before and after exercise of the pelvic floor muscles which were confirmed by ultrasonic examination. Changes in the length of line P were not statistically significant. Strengthening of the pelvic floor muscles was confirmed also by manometric examination. From a group of 20 patients 14 (70%) improved markedly after two months' exercise of the pelvic floor muscles and thus are free from complaints. Ultrasonic urogynaecological examination provides information on a change in the position of internal reproductive organs and the vesicourethral system and is one of the many methods which can confirm the effect of conservative or surgical treatment.

Adult↗
PubMed1993

[Personal experience with the modified pad-weight test].

Subjective evaluation of urinary incontinence cannot assess the degree of abnormality. Objective assessment of the escape of urine is essential for assessment of the degree of incontinence or for evaluation of the therapeutic results. Therefore a simple standard test was elaborated which can be used for the objective measurement of urinary losses in all patients. The International Continence Society (I.C.S.) recommended in 1983 a one-hour test for objective assessment of escape of urine. The latter assesses the loss of urine by weighing pads or dispers before and after standard activities. The authors tried in their clinical department to assess the significance of a modified 40-minute test in women with urinary incontinence--it was only 44%. They also compared the results of the PWT and Puraclo,max and compared these results with the number of women operated on account of incontinence. In the group of patients with a positive PWT a neg-puraclo,max was recorded in 88.2%. Conversely in patients with a neg-puraclo,max the PWT was positive only in 50%. Surgery was used in neg-puraclo,max in 75% and in positive PWT in 76.6% women. In a negative PWT a neg-puraclo,max was recorded in 65% of the patients of whom 61.5% were operated and two refused operation. In the conclusion the authors emphasize that PWT alone provides only basic objective information on the patient's complaints. The reliability of evaluation of the patient's complaints is increased by complete urodynamic examination.

Female↗
PubMed1993

[Drug therapy of urge incontinence in the female].

In this study we urodynamically examined 105 women suffering from urge incontinence before and 4 weeks after treatment with various drugs. The subjective and objective findings in the 3 patients' groups are compared. The results showed that the patients treated by spasmolytics (Oxyphenonium bromatum/Hexasonium jodatum/Papaverin) had the lowest rate of side effects in comparison with the women treated by calcium channel blockers and spasmolytics (Diltiazem/Oxyphenonium bromatum) and those with imipramine therapy. But the success rate of the first group was the lowest, too.

Adult↗
PubMed1992

Pregnancy complicated by malaria, precipitate labor and uterine rupture.

A case of Plasmodium falciparum malaria is reported in a 25-year-old pregnant woman with a history of three previous cesarean sections. She developed premature precipitate labor which was complicated by stillbirth, uterine rupture, bladder and vaginal tears necessitating hysterectomy.

Adult↗
PubMed1992

Pregnancy complicating irradiation-induced constrictive pericarditis.

A case is reported of a 24-year-old primigravida who had severe effusive constrictive pericarditis secondary to mediastinal irradiation following chemotherapy for Hodgkin's disease. Pregnancy was threatened by serious maternal cardiovascular complications, and a non-viable fetus was born spontaneously and prematurely. Patient was completely asymptomatic before pregnancy.

Adult↗