Vaginal cones: a conservative method of treating genuine stress incontinence.
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Female↗
Biomedical subjects
E Versi
Publications and source records attributed to E Versi.
The prevalence of variation of resting urethral pressure in women and its association with lower urinary tract function.
Variation of resting urethral pressure has been reported and it has been postulated that this is important in the genesis of lower urinary tract symptomatology in women. In order to differentiate between normal and abnormal urethral pressure variations several arbitrary values have been chosen and the prevalence of abnormality in symptomatic women reported. However, large variations in urethral pressure may be seen in healthy, asymptomatic volunteers. We have identified the prevalence of urethral pressure variation in a large group of female volunteers and have shown that "abnormal" urethral pressure variation is not associated with lower urinary tract symptomatology.
Female↗
The effect of vaginal delivery on the urethral sphincter.
To investigate the aetiological role of vaginal delivery in genuine stress incontinence we compared two groups of women who underwent full urodynamic assessment in our department. The women in the first group had competent urethral sphincter mechanisms and those in the second group had genuine stress incontinence. There were no differences between the two groups in respect of parity, number of vaginal deliveries or birthweight of the heaviest baby. The group with competent urethral sphincter mechanisms did show some evidence to implicate an increased number of vaginal deliveries in poor function of the distal part of the urethral sphincter mechanism.
Birth Weight↗
Correlation of urethral physiology and skin collagen in postmenopausal women.
Connective tissue collagen is thought to contribute to the generation of urethral pressure. It has been previously shown that skin collagen and urethral pressure are oestrogen dependent. This study demonstrates a correlation between urethral pressure measurements and skin collagen content. It is suggested that the beneficial effect of oestrogens on urethral function may be mediated by collagen.
Collagen↗
Effect of oestrogen and testosterone implants on psychological disorders in the climacteric.
In a double-blind trial oestradiol, oestradiol/testosterone, or placebo implants were assessed for their effects on psychological symptoms in women attending a menopause clinic. After two months, women receiving active treatment scored better than the placebo group on a self-rating scale of distress, on anxiety, and on depression (p less than 0.05). Postmenopausal but not perimenopausal women improved after placebo, and at 4 months the scores in the three groups no longer differed significantly.
Adult↗
Skin collagen changes in post-menopausal women receiving oestradiol gel.
Sixteen post-menopausal women who had never previously received any hormonal treatment applied Oestrogel cream 1.5 mg/day percutaneously for 1 yr. Skin biopsies were taken from the abdomen and from the lateral aspect of the thigh at 0, 3, 6 and 12 mth, and the changes in skin collagen content were noted. The abdominal skin collagen content increased significantly (P less than 0.001) over the 1-yr treatment period. The thigh skin collagen content also increased, but did not reach significant levels. There was a strong correlation between the change in skin collagen content (in both the abdomen and the thigh) and the original skin collagen content, indicating that the change in collagen content in response to oestrogen therapy is dependent on the original level. There is no further increase once an 'optimum' skin collagen level has been reached.
Administration, Topical↗
Decline in skin collagen content and metacarpal index after the menopause and its prevention with sex hormone replacement.
The thigh skin collagen content and the metacarpal index were measured in 69 untreated postmenopausal women and in 37 postmenopausal women who had been receiving oestradiol and testosterone implants for 2-10 years. There was a significant positive correlation between the skin collagen content and the metacarpal index in both groups of patients. In the untreated group, there was a statistically significant decrease both in the thigh skin collagen content and in the metacarpal index with the years since the menopause. This decrease was preventable in women who were on sex hormone replacement therapy.
Collagen↗
The short-term effect of radical hysterectomy on urethral and bladder function.
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Female↗
Skin collagen changes in postmenopausal women receiving different regimens of estrogen therapy.
Collagen is a widespread body constituent that is affected by estrogen status in women. Its decrease after menopause can be prevented and/or restored by estrogen treatment. We explored the effect of four different hormonal replacement regimens on total skin collagen content by measuring hydroxyproline in skin biopsy specimens taken from postmenopausal women. All regimens showed increases in skin collagen levels proportionate to the levels at the start of the treatment. Estrogen replacement therapy is shown to be prophylactic in women who have higher skin collagen levels and both prophylactic and therapeutic in women with lower skin collagen levels.
Administration, Cutaneous↗
Internal urinary sphincter in maintenance of female continence.
The integrity of the bladder neck was assessed in 98 continent women. Radiological and physiological evidence showed that half of these women had an incompetent bladder neck, but they were still continent. These data devalue the urodynamic finding of an incompetent bladder neck as an indication for surgery for incontinence and question the physiological importance of the internal sphincter.
Climacteric↗
Perineal pad weighing versus videographic analysis in genuine stress incontinence.
A comparison was made of the sensitivity of perineal pad testing and the videographic diagnosis of genuine stress incontinence (GSI) in postmenopausal women. The 99% upper confidence limit for pad weight gains in 90 normal women was 1.4 g. Ninety-nine women with urodynamically proven GSI were studied and 14 had false negative pad tests. There was no significant correlation between the videographic assessment and the gain in pad weight. We recommend the use of the pad test to confirm incontinence only in the absence of imaging facilities as the latter is more sensitive.
Adult↗
Long-term effects of the menopause and sex hormones on skin thickness.
Skin collagen content and skin thickness in a group of postmenopausal women who had been treated with sex hormone implants were compared with those in an untreated group of similar women. Both skin collagen content and thickness were found to be significantly greater in the treated than in the untreated group. In the untreated women skin collagen content declined in relation to menopausal age but not to chronological age. No correlation was found with menopausal age, chronological age or duration of therapy in the treated group. These data suggest that skin collagen is influenced by the sex hormone status and declines after the menopause, contributing to the increase in urinary hydroxyproline excretion that has been reported to occur at this time.
Collagen↗
Pineal influences hypothalamic Gn-RH content in the vole, Microtus agrestis.
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Animals↗
Effect of copulation on the hypothalamic content of gonadotrophic hormone-releasing hormone in the vole, Microtus agrestis.
There was a drop of 56% in the hypothalamic content of Gn-RH in female voles 5 min after mating compared with that in unmated but receptive animals. This suggests that the surge of LH in vole plasma associated with reflex ovulation is evoked by a massive release of Gn-RH.
Animals↗
Evidence for a coitally induced 'mnemonic' involved in luteal function in the vole (Microtus agrestis).
The development of luteal function in the vole is dependent on a neuroendocrine reflex which is initially activated by mating. Bromocriptine was used to destroy the CL initially induced by mating and fresh CL were induced by hormone treatment. The fate of such newly formed CL suggested that the luteotrophic effect of mating continued for about 10 days after mating, despite the destruction of the original mating-induced CL. The luteotrophic effect of mating therefore seems to be 'remembered'. A study of the fate of hormonally induced CL in females in which pregnancy had been blocked by exposure to a strange male suggested that the strange male may cause pregnancy failure by inhibiting or suppressing the luteotrophic 'mnemonic' activated by the stud mating.
Animals↗
Studies on the control of the corpus luteum in the vole, Microtus agrestis.
The lifespan of corpora lutea resulting from hormonally induced ovulations was prolonged by exogenous prolactin, concurrent lactation, or pregnancy. Treatment of mated females with bromocriptine resulted in failure of luteal function only when the drug was given before Day 6 of pregnancy. Pregnancy was dependent on the presence of the ovaries in its later stages. The results suggest that prolactin is luteotrophic in early pregnancy but that a placental luteotrophin may become effective by Day 6 of pregnancy.
Animals↗
MR imaging of the female pelvic floor in the supine and upright positions.
The goal of this study was to determine whether a .5-T open configuration magnet system could be used to evaluate the female pelvic floor support structures and their functional changes in the upright and supine positions. We evaluated five normal volunteers with full bladders in the supine and sitting positions. Multiple measurements were obtained, including distance between symphysis and urethra, bladder neck to fixed pubococcygeal line, and posterior urethrovesical angle. The pelvic floor was evaluated for integrity of the urethra, vagina, and supporting ligaments. High quality, interpretable images were obtained for all five patients in both positions. Most of the pelvic floor structures were stable, with the exception of the posterior urethrovesical angle, which increased in the sitting position. We conclude that the vertically open configuration magnet system shows promise for evaluation of the female pelvic floor, including urinary stress incontinence and prolapse.
Adult↗
Videourodynamic diagnosis of occult genuine stress incontinence in patients with anterior vaginal wall relaxation.
OBJECTIVE: To (1) utilize videourodynamics, the gold standard, to assess the prevalence of occult genuine stress incontinence (GSI) among preoperative patients with symptomatic anterior vaginal wall relaxation and (2) identify urodynamic discriminators that might help predict occult GSI. METHODS: In this prospective study, videourodynamic evaluation was performed on 48 consecutive patients presenting for preoperative urodynamic evaluation of anterior vaginal wall prolapse. Patients with occult GSI were identified by urodynamic testing with and without Gehrung pessary support of the bladder base during stress maneuvers. Variables from the history, physical examination, and videourodynamics were then analyzed. RESULTS: The overall incidence of occult GSI was 25% (22.7% in the pelvic organ prolapse [POP] group and 26.9% in the POP-UI group). Patients with occult GSI were not identifiable on history but did have a higher incidence of late first sensation, open bladder neck at rest, and hypermobility on imaging with videourodynamics. CONCLUSION: This study suggests that one quarter of women presenting with anterior wall relaxation with or without incontinence symptoms have occult GSI. Given this high prevalence, preoperative evaluation with urodynamics, possibly videourodynamics, utilizing bladder base support is justified if the data are substantiated in a larger, definitive study. Patients with a late first sensation, open bladder neck, and hypermobility may have a higher incidence of occult GSI.
Aged↗