Biomedical subjects

A Shafik

Publications and source records attributed to A Shafik.

At least 127 records · Page 7Linked to original sources

PubMed1997

Endoscopic pudendal canal decompression for the treatment of fecal incontinence due to pudendal canal syndrome.

Fecal incontinence resulting from pudendal canal syndrome has been treated by pudendal canal decompression (PCD) with satisfactory results. Considering the possible difficulty in exposing the pudendal canal and nerve by the open method, laparoscopic PCD was practiced in 9 women aged between 37 and 52 years. They were complaining of fecal incontinence; urinary stress incontinence was an additional complaint in 4/9 women. Neurologic, manometric, and EMG studies confirmed the diagnosis of pudendal canal syndrome. For laparoscopic PCD a 1-cm incision lateral to the anal orifice was performed. A balloon dilator was introduced in the ischiorectal fossa (IRF) to create a working space, and CO2 was insufflated. Under the guidance of a laparoscope, the IRF was entered and the inferior rectal nerve identified and followed to the pudendal canal. The latter was split open, releasing the pudendal nerve into the IRF. Fecal control was achieved in 7/9 patients and urinary control in 2/4. Fecal and urinary control were associated with improvement in perianal sensation, rectal neck pressure, EMG of external anal sphincter and levator ani muscle as well as in pudendal nerve terminal motor latency. Two women showed no improvement. Failure is suggested to be due to an advanced pudendal neuropathy. In conclusion, laparoscopic PCD is a simple, easy, and safe procedure. It allows for better exposure of the contents of the IRF than the open procedure, thus avoiding injury of the pudendal nerve and its branches during the performance of the PCD.

Adult↗

PubMed1997

Electrorenogram in renal pathologic conditions.

OBJECTIVE: A recent study in dogs has shown that the kidney generates electric waves, and a characteristic electrorenogram (ERG) pattern was found for the normal kidney. In the current communication the ERG pattern in the normal human kidney and under various pathologic renal conditions was studied. METHODS: The study comprised 12 patients with chronic renal failure, 14 with hydronephrosis, 10 with renal cell carcinoma, 10 after nephrectomy and 12 healthy volunteers. Three Beckman electrodes were applied to the loin skin and 20-min recording sessions were performed at least twice for each subject. RESULTS: Electric waves were recorded from the 3 electrodes applied to the normal kidney. They showed the same frequency and amplitude from the 3 electrodes. Chronically failing kidneys exhibited 2 ERG patterns: 'bradyarrhythmia' for early cases, and 'silent' for advanced cases. The functioning hydronephrotic kidney had a bradyarrhythmic pattern while the nonfunctioning kidney displayed a silent ERG. Malignant renal tissue revealed a 'tachyarrhythmic' pattern. Nephrectomized patients showed a silent ERG. CONCLUSION: An ERG pattern was identified for the normal human kidney. Different patterns were found under the various pathologic renal conditions. The technique, being easy, noninvasive and nonradiologic, is suggested to be included as an investigative tool in the diagnosis of renal conditions.

Adolescent↗

PubMed1997

Role of pudendal canal syndrome in the etiology of fecal incontinence in rectal prolapse.

BACKGROUND: The current communication investigates the role of pudendal canal syndrome in the genesis of fecal incontinence (FI) in complete rectal prolapse (CRP). METHODS: 89 patients with CRP (group A, 45 with FI, and group B, 44 without FI) were studied. Ten healthy volunteers in group C acted as controls. The subjects were assessed for rectal and rectal neck pressures, electromyographic (EMG) activity of the external anal sphincter (EAS) and levator ani, as well as for pudendal nerve terminal motor latency (PNTML). RESULTS: Group-A patients manifested perianal hypo- or anesthesia, diminished rectal neck pressure (p < 0.05) and EMG activity of EAS and levator muscle and prolonged PNTML (p < 0.05). In group B, rectal neck pressure was diminished (p < 0.05) in all patients. The EMG activity of the EAS and PNTML (p > 0.05) were normal in 34 patients, while the EMG activity was reduced and the PNTML prolonged (p < 0.05) in the remaining 10. The levator ani muscle showed diminished activity in the 44 patients of this group. CONCLUSION: The results of group A point to pudendal neuropathy as a cause of FI. In group B, 10 patients showed manifestations of subclinical pudendal neuropathy which may present later on with FI. The constant prolongation of PNTML in patients with FI postulates a relationship between the two. The cause of prolonged PNTML seems to be attributable to pudendal neuropathy due probably to pudendal nerve entrapment in the pudendal canal with a resulting pudendal canal syndrome. Therefore, pudendal canal syndrome is suggested to play a significant role in the genesis of FI in CRP.

Anal Canal↗

PubMed1997

Study of the uterine response to vaginal distension: the 'vagino-uterine reflex'.

To study the effect of vaginal distension on the uterus, the uterine pressure was measured in 20 healthy female volunteers (mean age 34.3 +/- 7.8 years; 7 nulli-, 13 multiparous) by means of a manometric tube perfused by a pneumohydraulic system. Vaginal distension was induced by a 12 F condom-ended catheter. The condom was inflated in increments of 10 ml of air. The test was repeated after anesthetizing the vagina and uterus, respectively. The uterine pressure increased upon vaginal distension; it showed more rise as the distension increased (p < 0.01). The response was momentary and the pressure returned to basal values although vaginal distension continued. It disappeared upon sustained or successive inflations of 5-7 times and was restored after a resting period of 3-5 min. There was no uterine pressure response when the vagina or uterus were anesthetized and it returned when the anesthetic effect had worn off. No significant difference was found in the pressure response between nulli- and multiparous women (p > 0.05). The aforementioned results were reproducible when repeated in the same woman with no significant difference (p > 0.05). The inflated condom looks like the erect penis, and the uterine response to the inflated condom seems to simulate that of the erect penis distending the vagina during coitus. The constant rise of uterine pressure to vaginal distension postulates a reflex relation which we call 'vagino-uterine' reflex. Uterine contractions during coitus are suggested to have a 'suction-pumping' action on the semen deposited in the vaginal fornices.

Adult↗

PubMed1997

The hypertonic rectosigmoid junction: description of a new clinicopathologic entity causing constipation.

A physiological sphincter exists at the rectosigmoid junction; this rectosigmoid sphincter (RSS) relaxes on sigmoid colon contraction and contracts on rectal contraction. Eight cases of RSS hypertonia are presented herein. Six women and two men (mean age, 44.2 +/- 10.3 years) complained of chronic constipation of 9.6 +/- 6.2 years' duration. They had had normal bowel habits before that time. Anorectal physiologic studies were performed. Intestinal transit was delayed by the accumulation of pellets in the sigmoid colon. Defecography and electromyography of the external anal sphincter and levator ani muscle were normal. The resting pressure was normal in the sigmoid colon, rectum, and rectal neck (p > 0.05) but elevated in the RSS (p < 0.01). The sigmoidorectal inhibitory and excitatory reflexes were absent. Biopsies from the sigmoid colon and rectum showed normal histologic findings, but those from the RSS were aganglionic. A diagnosis of RSS "achalasia" was made. Five of the eight patients had improvement as a result of RSS dilatation. The remaining three patients underwent sigmoidomyotomy. The eight patients are now 9 to 38 months without recurrence of constipation. Rectosigmoid junction achalasia constitutes a clinicopathologic entity that should be considered in the etiology of constipation.

Adult↗

PubMed1997

Re: Applied anatomy of the cremasteric muscle and fascia.

Explore the source record for details and available documents.

Abdominal Muscles↗

PubMed1997

Olfactory-corporeal reflex: description of a new reflex and its role in the erectile process.

OBJECTIVE: The dog approaches the bitch and smells the vulva. The relationship which seems to exist between a special smell in the bitch and sexual arousal in the male dog was investigated. METHODS: 12 male dogs and 25 bitches were studied. The bitches were divided into five equal groups, each representing 1 of the 5 phases of the estrous cycle. A vaginal swab that soaked in the bitches' vaginal secretions was divided into two pieces: one was sent for estradiol and progesterone determination, and the other was smelt by the male dog. The responses of the intracorporeal pressure (IP) and the electromyographic activity of the bulbo- and ischiocavernosus (BC, IC) muscles of the male dog to the smelling of bitch's vaginal odor were assessed. The pressure response was also determined 10 min and 1 h after either the nasal mucosa or the corporeal tissue was anesthetized. RESULTS: Elevated IP was recorded in 12 of 12, 10 of 12 and 8 of 12 dogs smelling vaginal swabs of bitches in metestrus (p < 0.001), estrus (p < 0.001), and diestrus (p < 0.01), respectively. No pressure response occurred when the vaginal swab was smelt while the nasal mucosa or the corporeal tissue was anesthetized. The BC and IC muscles exhibited no response to smelling of the vaginal swab of bitches in any phase of the estrous cycle. The results were reproducible. CONCLUSIONS: The study showed that the IP increased with smelling of vaginal secretions containing high progesterone levels, whereas estradiol-17 beta did not effect IP elevations. The higher the progesterone level, the greater the IP. The increased IP is not due to BC and IC muscle contraction. It is postulated that a reflex relationship exists between IP elevation and olfactory stimulation. This reflex response was reproducible and was not evoked when the two arms of the reflex were anesthetized. We call this reflex 'olfactory-corporeal reflex'. This reflex seems to prime the male dog for sexual intercourse.

Animals↗

PubMed1997

Direct measurement of intra-abdominal pressure in various conditions.

OBJECTIVE: To standardise a direct method for measuring intra-abdominal pressure (IAP), to correlate the results with intrarectal pressure, and to compare the results in various conditions. DESIGN: Prospective open study. SETTING: Teaching hospital, Egypt. SUBJECTS: 34 Subjects in 4 groups: control (n = 11), hernia (n = 8; 6 umbilical and 2 incisional), mass (n = 7; 6 enlarged spleen and 1 carcinoma of sigmoid), and obese (n = 8; a mean of 40% above expected weight). INTERVENTIONS: Measurement of IAP with a Verres needle connected to a pressure transducer with the patient at rest, straining, supine, erect, and before and after anaesthesia. Intrarectal pressure was measured simultaneously. MAIN OUTCOME MEASURES: Reproducibility and correlation between the two measurements. RESULTS: The hernia group had significantly lower IAP than controls both at rest and on straining (mean (SD) 2.7 (1.5) cm H2O compared with 7.0 (5.09) and 6.1 (2.7) compared with 20.5 (7.9), p < 0.01 in each case). Neither the mass nor the obese group differed from the controls at rest, but the pressure was higher on straining (31.2 (1.4) and 33.5 (2.07) cm H2O, respectively, compared with 21.9 (7.3), p < 0.05 in each case). There was a significant drop in IAP after anaesthesia in all groups, and no significant difference between intrarectal pressure and IAP in any group. CONCLUSION: The method of measuring IAP is reproducible. Intrarectal pressure is similar to IAP and can therefore be used instead of it.

Abdomen↗

PubMed1997

Transcutaneous electrovesicogram in normal volunteers, patients with interstitial cystitis, neurogenic bladder, benign prostatic hyperplasia, and after cystectomy.

Recordings of the vesical electric activity (electrovesicogram = EVG) were carried out in 22 healthy volunteers (12 male, 10 female: mean age 41.6 years), 9 women with interstitial cystitis (IC: mean age 44.6 years), 24 patients with neurogenic bladder (NB: 16 male, 8 female; mean age 48.3 years), 26 patients with benign prostatic hyperplasia (BPH: mean age 66.8 years), and 9 cystectomy patients (6 men, 3 women: mean age 37.6 years). Four Beckman type silver-silver chloride electrodes were applied to the abdominal skin: one above and lateral to each pubic tubercle, one above symphysis pubis, and a reference electrode to the thigh. Normal EVG manifested as regular slow waves or pacesetter potentials (PPs) which had the same frequency, amplitude and regular rhythm when the test was repeated in the individual subject. Mean frequency was 4.8 cycle/minute (cpm), amplitude 1.7 mV and velocity 4.6 cm/sec. IC manifested with "vesicoarrhythmia" (increased irregular PPs). NB patients exhibited a "dysrhythmic" EVG (irregular PPs) in upper motor neuron lesions and a "silent" EVG in lower motor lesions. In BPH, the compensated bladder showed "tachyvesica" (regular increased PPs) and the decompensated "bradyarrhythmia" (irregular decreased PPs) or "silent" EVG. Cystectomy patients showed a "silent" EVG. In conclusion, transcutaneous EVG may be a useful investigative method in the diagnosis of vesical disorders. It is safe, simple, without complications and cost-effective.

Adult↗

PubMed1997

Homohemodialysis: a technique of dialysis for the uremic animal.

As an alternative to kidney transplantation in conditions of renal failure, an in situ kidney of a healthy individual may be used. The present study utilizes the kidney of a healthy rabbit as a hemoperfusion unit for another, uremic, animal. The study comprised 17 experimental models, each of which consisted of 2 adult New Zealand rabbits. One animal of each model was rendered uremic by means of bilateral nephrectomy. The blood chemistry (urea, creatinine, sodium, potassium, pH and base deficit) was examined pre- and 4-hourly post-operatively. When after 48 hours post-nephrectomy, the blood chemistry had reached a level sufficient to endanger the animal's life, homohemodialysis was performed. The anticoagulated blood was circulated from the uremic animal to the normal one and then back to the uremic animal through the femoral vessels using a tube system. The blood chemistry was determined every 10 minutes and pH and base deficit every 30 minutes. All animals died or were sacrificed within 21 hours after shunting was started, and autopsy was done. Serum sodium was the first to normalize within the first 10 minutes post-shunting, followed by serum potassium and pH in 30 minutes. Blood urea and creatinine reached normal levels in 40 minutes and base deficit in 60 minutes post-shunting. The pathologic examination of specimens from the vital organs of both the normal and uremic animals showed different degrees of cellular damage probably due to hypotension or acute effects of the unbalanced animal homeostasis. The cellular damage was much less in the normal than in the uremic animals. In conclusion, homohemodialysis proved to be effective in normalizing the concentrations of the different substances retained in the blood of uremic animals within only 60 minutes of dialysis.

Animals↗

PubMed1997

The use of the tunica vaginalis sac as a dialyser for the uremic animal model.

The tunica vaginalis (TV), being part of the peritoneum, can be used for dialysis. The present study explores the possibility of using the TV sac as a dialyser in 21 male adult New Zealand rabbits which had been rendered uremic by ligation of both ureters. 4 animals acted as controls and another 4 as sham controls. Blood chemistry including blood urea, creatinine, sodium and potassium was assessed pre- and 12 hourly post-ureteric ligation. Intratunical dialysis was started 48 hours after ureteric ligation when a high uremic state had been achieved. Blood chemistry was determined 4 hourly post-dialysis. Dialysate was replaced by a fresh one when the blood chemistry was no further improving. After blood chemistry normalization, the animals were sacrificed and autopsied. Blood chemistry improved after TV dialysis in all rabbits and normalized in 13. Eight animals, in spite of showing improvement in blood chemistry, died before normalization. Blood chemistry normalization necessitated dialysate replacement by a fresh one more than once (3 times in 11 rabbits and 4 times in 2). Autopsy showed degenerative changes in kidneys, liver, spleen, lungs and small intestine which were less marked in the animals whose blood chemistry had normalized. In conclusion, intratunical dialysis succeeded in normalizing the blood chemistry of uremic animals.

Animals↗

PubMed1996

Transcutaneous electrosigmoidography. Study of the myoelectric activity of sigmoid colon by surface electrodes.

The purpose of this study was to determine the feasibilty of performing transcutaneous electrosigmoidography (TC-ESG). The study involved 19 healthy volunteers (11 men, 8 women; mean age 38.2 +/- 14.8 years). To validate the results of TC-ESG, the latter was performed simultaneously with intra-sigmoid ESG. TC-ESG was done also in five patients who underwent sigmoidectomy. The optimal position of the electrodes was determined after several trials. Two electrodes (Beckman) were applied, each 2-3 cm away from the middle of a line drawn from the umbilicus to the symphysis pubis. A third electrode was placed just above the symphysis pubis. A reference electrode was applied to one of the lower limbs. For intra-sigmoid IS-ESG, two silver-silver chloride electrodes were introduced from the anal orifice into the sigmoid colon and were attached to the mucosa by suction. Pacesetter potentials (PPs) were recorded as regular negative deflections. They had constant amplitude, frequency and velocity when recordings were obtained in the same subject. The PPs registered transcutaneously had the same amplitude, frequency and velocity as those recorded intrasigmoidally. Action potentials could be registered only intrasigmoidally and not transcutaneously. No electric waves could be recorded by TC-ESG in 5 patients who had undergone sigmoidectomy. In conclusion, TC-ESG is a simple, non-invasive and non-radiologic technique that can substitute intra-sigmoid ESG and potentially can be used in the diagnosis of various pathologic conditions of sigmoid colon.

Action Potentials↗

PubMed1996

Sigmoido-rectal junction reflex: role in the defecation mechanism.

The presence of a sphincter at the rectosigmoid junction (RSJ) is debated. This investigation studies the presence or absence of a sphincter and its possible role in sigmoid colon storage and rectal evacuation. Eighteen healthy volunteers (10 males, 8 females) with a mean age of 36.6 +/- 14.8 years (range 21-53) were studied. The pressure response of the sigmoid colon, RSJ, and rectum to sigmoid and rectal distension, respectively, was determined before and after anesthetizing either the sigmoid colon or the rectum. The RSJ length was evaluated by the station pull-through technique. Sigmoid distension with balloon volumes of up to 80.6 +/- 4.4 ml of H2O effected no sigmoid, RSJ or rectal pressure changes (P > 0.05). At a mean sigmoid distension of 88.6 +/- 4.1 ml of H2O, the sigmoid colon showed a significant pressure increase (P < 0.001), a RSJ pressure decrease (P < 0.05), and insignificant pressure changes in the rectum (P > 0.05); the balloon was dispelled into the rectum. Rectal distension of 94.6 +/- 5.8 ml of H2O produced rectal (P < 0.001) and RSJ (P < 0.05) pressure increases. Distension of the anesthetized sigmoid and rectum did not produce pressure changes in the RSJ (P > 0.05). This study demonstrated a high pressure zone at the RSJ of 3.8 +/- 0.7 cm in length. This suggests that the RSJ might act as a functional sphincter. It opens reflexly upon sigmoid contraction, by a reflex we call "rectosigmoid inhibitory reflex," and closes upon rectal contraction, a reflex we call "rectosigmoid excitatory reflex." The former allows the stored feces in the sigmoid colon to pass to the rectum, and the latter reflex prevents stool reflux to the sigmoid upon rectal contraction.

Administration, Topical↗

PubMed1996

Electroureterogram in the obstructed ureter and vesicoureteral reflux.

BACKGROUND: An electroureterogram (EUG) was identified for the normal ureter (A. Shafik, 1996). It was postulated that the EUG might change under pathologic ureteric conditions. This communication studies the EUG pattern in the obstructed ureter and in the ureter with vesicoureteral reflux. MATERIAL AND METHODS: 11 patients with stricture of the lower end of ureter (all men; mean age 36.6 +/- 6.2 years) were studied. Urography showed a hugely dilated ureter. Nineteen patients with vesicoureteral reflux (13 women and 6 men; mean age 32.8 +/- 5.6 years) had moderately dilated ureters. All patients were scheduled for operative correction in the course of which the current study was done. A monopolar silver-silver chloride electrode was applied to each of the upper, middle, and lower third of the ureter. The EUG activity and intraureteric pressure were recorded before and immediately after ureteric reconstruction. RESULTS: The obstructed ureter showed a "silent" EUG. The refluxing ureter revealed three EUG patterns: silent, bradyureter (diminished frequency and amplitude of slow waves or pacesetter potentials, PPs), and ureteroarrhythmia (irregular PP frequency and amplitude). These patterns were reproducible when the tests were performed before or immediately after ureteric reconstruction. The intraureteric pressure in the strictured ureters was high and dropped after ureteric stricture resection. It recorded normal values in the refluxing ureter. CONCLUSIONS: It appears that ureteric dilatation interferes with the electric ureteric activity. The most dilated ureters showed a silent EUG while the least dilated exhibited bradyureter. The results have shown that the dilated ureter may display an abnormal EUG and that with the development of a noninvasive technique in the future, the EUG may be of diagnostic significance in ureteric disorders.

Adult↗

PubMed1996

Electrovasogram in patients with obstructive azoospermia and absent vas deferens.

The electric activity of the vas deferens (electrovasogram, EVG) was studied in 22 patients with obstructive azoospermia (OA), in 9 patients with bilaterally absent vasa deferentia, in 10 patients who had undergone epididymovasostomy for OA, and in 12 healthy volunteers (controls). Two electrodes were applied to the posterior aspect of the upper scrotum. EVG in normal subjects showed pacesetter potentials (PPs) that had the same frequency, amplitude, and velocity of conduction from both electrodes and were consistent in the individual subject on all test days. The PPs were followed randomly by action potentials (APs). The EVG in OA exhibited "bradyvasa," i.e., diminished PP frequency, amplitude, and velocity, in 14 patients and a silent EVG in 8. Eight of the ten patients in whom azoospermia persisted after epididymovasostomy had a silent EVG. The remaining two patients, whose semen character had normalized after epididymovasostomy, revealed a normal EVG. A "silent" EVG was recorded for the nine patients with absent vasa deferentia. The electric activity is believed to be responsible for vasal motility. The bradyvasa or silent EVG encountered in OA might be attributable to the arrested function of the vas deferens and resultant vasal inertia. The latter may persist after epididymovasostomy and be responsible for the failure of the semen to normalize, as occurred in eight patients. In conclusion, EVG is a simple, easy, noninvasive, and nonradiologic technique that might be used as a diagnostic tool in the investigation of vas deferens disorders and infertility.

Adult↗

PubMed1996

Intraesophageal Polytef injection for the treatment of reflux esophagitis.

BACKGROUND: In view of the unsatisfactory results of medical and surgical treatment of reflux esophagitis, a treatment modality with polytetrafluoro-ethylene injection in the lower esophagus is presented. METHODS: Twenty-one patients (13 men, 8 women; mean age 47.7 years) presented with a lower esophageal sphincter (LES) pressure which was significantly lower than normal (mean 5.3 +/- 1.1 SD cm H2O) (P < 0.001). Four to 6 ml Polytef was injected submucosally into the lower esophagus at 3 and 9 o'clock. Patients were followed up for 18-24 months. RESULTS: No complications were encountered. In the first 3 postinjection months, symptoms disappeared and LES pressure was elevated (mean 24.2 +/- 6.6 SD cm H2O) (P < 0.001). At the 6th month, LES pressure dropped in nine patients (P < 0.05), of whom three had become symptomatic again and were reinjected. Endoscopically, esophageal hyperemia and erosion disappeared in 16 patients. At the 12th month, LES pressure was normal in 10 patients; the remaining 11 showed a significant LES pressure drop (P < 0.01) with reflux manifestations and were reinjected. At the 18th month, LES pressure was normal in all patients; endoscopically, there was mild lower esophageal hyperemia in five patients. The nine patients who were followed for 24 months had normal LES pressure and endoscopic findings and were symptom-free. CONCLUSIONS: Polytef injection achieved LES competence through elevation of LES pressure and restoration of lower esophageal rosette. Pressure drop could be due to implant egress. The technique is simple and easy, has no complications, and is performed on an outpatient basis.

Adult↗

PubMed1996

Ureterovesical junction inhibitory reflex and vesicoureteral junction excitatory reflex: description of two reflexes and their role in the ureteric antireflux mechanism.

The purpose of this study was to investigate the response of the ureterovesical junction (UVJ) to ureteric distension and to bladder filling with the aim of elucidating the mechanism of UVJ antireflux. The study was performed on 13 healthy volunteers [age 41.4 +/- 10.2 (SD) years; nine men, four women]. A ureteric catheter connected to a pressure transducer was introduced into the ureter proper. After recording the ureteric pressure, the catheter was withdrawn to the bladder, and the resting pressures in the UVJ and bladder were registered. The catheter was positioned in the UVJ and a 3F balloon-tipped ureteric catheter was introduced into the ureter proper and filled saline in increments of 1 ml. The pressure response of the ureter and UVJ to ureteric distension was recorded. The bladder was then filled with 400 ml saline at two rates, slow (10 ml/min) and rapid (150 ml/min), and UVJ pressure response was registered. The aforementioned tests were repeated after anesthetizing the UVJ, the bladder musculature surrounding the UVJ and the ureteric wall at the site of the ureteric distension, respectively. Ureteric distension of the lower 2-3 cm effected ureteric pressure elevation (P < 0.05) and a UVJ pressure drop (P < 0.05); no pressure response of the UVJ occurred upon ureteric distension above this level. Slow bladder filling induced an increase in the UVJ (P < 0.01) and vesical (P < 0.01) pressures only when vesical filling reached a mean of 219.6 +/- 79.4 ml and above. Upon rapid vesical filling the pressure response occurred at a smaller volume (136.6 +/- 52.3 ml). The pressure response did not occur when the UVJ was anesthetized. The study showed that lower ureteric distension was associated with a UVJ pressure drop. This reflex relationship, which we call the "ureterovesical junction inhibitory reflex," was reproducible and disappeared on anesthetizing the UVJ or ureter. Vesical filling above a certain volume induced a UVJ pressure increase which was reproducible and disappeared on anesthetizing the UVJ; we call this reflex relationship the "vesicoureteral junction excitatory reflex." These two reflexes seem to regulate the entry of urine from the ureters to the bladder and prevent ureteric reflux during bladder filling. In conclusion, two reflexes are identified that might contribute to the mechanism of UVJ antireflux.

Adult↗

PubMed1996

Electrovesicogram in stress urinary incontinence: a preliminary study.

Electrovesicograms (EVG) were studied in 20 women with stress urinary incontinence (SUI) and 12 healthy female volunteers with a mean age of 44.8 and 48.2 years, respectively. Recordings were performed by means of three electrodes applied to the skin in the hypogastric area and one reference electrode to the lower limb. In the 12 healthy women pacesetter potentials (PPs) were recorded as regular triphasic waves. Of the 20 SUI patients 16 showed normal EVG, and the remaining 4 exhibited 'tachyvesica', i.e. increased PP frequency. These 4 patients proved to have combined urge and stress incontinence with detrusor hyperreflexia. It was concluded that SUI patients have normal EVG unless there is an associated pathology.

Adult↗