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Biomedical subjects

G Lose

Publications and source records attributed to G Lose.

At least 127 records · Page 7Linked to original sources
PubMed1989

Does medical therapy cure female stress incontinence?

Forty-four consecutive female patients, who were scheduled for operation for genuine stress incontinence but instead treated pharmacologically with an alpha-agonist or placebo for 3-4.5 months, were evaluated after a median observation period of 30 months. Ten patients (23%) underwent colposuspension. Fourteen patients (32%) claimed to be continent or so much improved that further treatment was considered unnecessary by the patients themselves. Of the remaining 20 patients who still claimed to have stress incontinence, 11 (25%) preferred to resume the pharmacological treatment whereas 9 patients (20%) had not decided whether they wanted further treatment. These results suggest that some operations for stress incontinence may be avoided by introduction of a standard trial of medical therapy prior to intended surgical intervention.

2-Hydroxyphenethylamine↗
PubMed1989

24-hour home pad weighing test versus 1-hour ward test in the assessment of mild stress incontinence.

Twenty-three normal volunteers and 31 women admitted for stress or mixed incontinence underwent two 24-hour home pad weighing tests. In the patients the test result was compared with the result obtained with the 1-hour ward pad weighing test. Median pad weight gain was 4 g/24-h, with an upper 99% limit of 8 g/24 h in normal women. The median urine loss was 17 g/24-h in the patients. Eighteen (58%) patients were classified as incontinent according to the result of the 1-h ward test, versus 28 (90%) according to the result of the 24-h home test. There was no significant correlation between the result of the 1-h test and the 24-h test. In the patients, test-retest analysis showed a significant variation in the result of the 24-h test. It is concluded that the better of two 24-h home tests is more sensitive for confirmation incontinence than is one 1-h ward test. Consequently, the 24-h home test is of practical use as a screening test for incontinence. The reproducibility of the test, however, seems insufficiently satisfactory to allow of its use in comparative scientific studies.

Adult↗
PubMed1988

Urinary tract infections and diurnal incontinence in girls.

To evaluate a possible relationship between urinary tract infections (UTI) and diurnal incontinence (DIC), we studied 251 girls aged 4 years or more who were referred with a history of recurrent UTI and/or DIC. During follow up (mean 35 months), 110 girls (44%) had both UTI and DIC, 50 (20%) only infections, and 41 (16%) only DIC whereas 50 (20%) had neither infection nor DIC. In 110 girls with infections occurring with intervals of at least 6 and 12 months, DIC was definitively initiated by infection on 32 (19%) occasions. Most girls were continent before the infection occurred. When the girls remained free of infection for 6 or 12 months respectively, the frequency of DIC remained unchanged. In conclusion, no support for the concept of DIC leading to UTI was obtained, whereas the reverse was found in some cases and suggested in others.

Child↗
PubMed1988

Skin reactions to urine in patients with interstitial cystitis.

Eight of 11 patients with interstitial cystitis had positive skin reactions to patch tests with urine (delayed type IV or irritant reactions). The positive reactions were seen to tests with the patients' own urine, but also, although less frequently, to tests with foreign urine as well. Immediate reactions (type I reactions; prick tests, scratch patch tests, and 20-minute patch tests) were not observed. The clinical morphology and the histology of the positive patch tests suggest a toxic rather than an allergic reaction, although the latter could not be totally excluded. The positive skin reactions may be relevant in the pathogenesis of interstitial cystitis suggesting a mucosal hyperreactivity to some component of urine.

Aged↗
PubMed1988

Pad-weighing test performed with standardized bladder volume.

The result of the one-hour pad-weighing test proposed by the International Continence Society has been demonstrated to depend on the urine load during the test. To increase reproducibility of the pad-weighing test by minimizing the influence of variation in urine load the test was done with a standardized bladder volume (50% of the cystometric bladder capacity). Twenty-five female patients with stress or mixed incontinence underwent two separate tests. Test-retest results were highly correlated (r = 0.97, p less than 0.001). Nonetheless, analysis of test-retest differences revealed a variation up to +/- 24 g between two tests. It is concluded that this setup (i.e., standardized bladder volume) of the one-hour pad-weighing test allows for a more reliable assessment of urinary incontinence for quantitative purposes.

False Negative Reactions↗
PubMed1988

Spontaneous versus intubated flow in male patients.

The spontaneous flow rate was compared with the flow rate obtained during a pressure-flow study with two 5F catheters in the urethra, in 57 male patients with various lower urinary tract disorders. Intubation caused a median decrease in maximum flow rate of 1 mL/sec (95% confidence limits 0-2 mL/sec). In patients with infravesical obstruction a significant decrease in maximum and mean flow rates was found whereas the flow rate was unchanged in the group of patients without obstruction. It seems that changes in flow rate due to intubation of the urethra is of minor importance compared with other factors and intubation may actually provide diagnostic information in diagnosing mechanical obstruction. It is concluded that the transurethral technique for pressure-flow studies offers a simple and reliable method for obtaining simultaneous pressure-flow values. It can be performed without further invasion in conjunction with cystometry. Therefore this technique is recommended in the urodynamic testing of male patients with lower urinary tract disorders.

Humans↗
PubMed1988

Terodiline, emepronium bromide or placebo for treatment of female detrusor overactivity? A randomised, double-blind, cross-over study.

In a randomised, double-blind study, 20 women with idiopathic detrusor instability and associated symptoms were treated with terodiline 25 mg bd, placebo, and emepronium bromide 200 mg tds--each drug being given for 3 weeks with placebo as wash-out period before cross-over. The results were evaluated according to drug preference, frequency charts and elimination of detrusor instability on cystometry. Serum levels of both drugs were monitored as control of tablet intake. The preference for terodiline to placebo was statistically significant: 14/3 women (P less than 0.05), and the majority of women (12/4) preferred terodiline to emepronium. Terodiline also gave a small but significant reduction in 24 h micturition frequency and eliminated detrusor instability in almost 50% of the patients (P less than 0.05). Side effects were frequent but mild in all three treatment periods. It was concluded that terodiline offers an alternative in the treatment of female detrusor instability.

Adult↗
PubMed1988

Norfenefrine in the treatment of female stress incontinence. A double-blind controlled trial.

Forty-four consecutive patients with genuine stress incontinence were treated with norfenefrine 15-30 mg t.i.d. in a 6-week, double-blind and parallel, placebo-controlled study. Subjectively, 52% were improved and 26% became continent during norfenefrine treatment. Objectively (stress test), 30% became continent and the maximum urethral closure pressure increased 10% which was statistically significant. These results, however, were not statistically different from those of placebo treatment. Simultaneously, subjective and objective improvement was seen more often in patients given norfenefrine compared to placebo (p less than 0.1). In patients with most severe incontinence according to urodynamic criteria the effect of norfenefrine was statistically significantly better than placebo. A low incidence of side effects was observed and no differences between norfenefrine and placebo were found. It is concluded that norfenefrine may be of value in the treatment of female stress incontinence.

2-Hydroxyphenethylamine↗
PubMed1988

Autorosette inhibition factor: a positive acute phase reactant in interstitial cystitis.

Autorosette inhibition factor (AIF), complement C3d and eosinophil cationic protein (ECP) in urine were determined in 28 patients with painful bladder disease. In patients with interstitial cystitis (IC), diagnosed by the demonstration of detrusor mastocytosis, a positive correlation (r = 0.73, p less than 0.01) between AIF and C3d was found, whereas no reliable correlation was found in the remaining patients. The median concentration of urinary ECP was significantly elevated in the group of patients with IC whereas the median concentration of C3d was significantly elevated in both groups. AIF seems to behave as a positive acute phase reactant in IC. It is hypothesized that AIF may play a role in the pathogenesis of IC by influencing the normal barrier function of the epithelium of the bladder.

Acute-Phase Proteins↗
PubMed1988

Epidermal growth factor in urine from patients with urinary bladder tumors.

Epidermal growth factor (EGF) concentration and 24-hour excretion in urine were measured with a radioimmunoassay in 18 patients previously treated for various types of urinary bladder tumors and a comparable control group of 18 normals. The median concentration of EGF in urine from the patients was 1.50 nmol/l and from normals 3.03 nmol/l. The median 24-hour excretion of EGF in urine from the patients was 1.96 nmol and from normals 3.33 nmol. These differences between patients and normals were statistically significant (p less than 0.05 and p less than 0.005) although there was an overlap in individual values of EGF concentration and excretion in urine from patients and normals. This study suggests that urothelial neoplasia is related to a low concentration and excretion of EGF.

Aged↗
PubMed1987

Chronic cystitis: excretion of epidermal growth factor (EGF)/urogastrone (URO).

To investigate the role of epidermal growth factor (EGF)/urogastrone (URO) in the cytoprotection of the urothelium in the urinary bladder we measured the concentration of EGF/URO by radioimmunoassay in urine from patients with chronic cystitis. The series comprised 12 patients with classical interstitial cystitis, 10 young females with recurrent bacterial cystitis and 12 children with recurrent cystitis together with sex- and age-matched controls. The results showed no variation in the substance concentration of EGF/URO in urine from cystitis patients and control groups. A negative correlation was found between 1) the urinary concentration of EGF/URO and increasing age, and 2) the excretion of EGF/URO per mol creatinine. The present study did not show a decreased output of EGF/URO in patients with chronic cystitis. Further studies are necessary in the evaluation of the physiological role of EGF/URO in the urinary tract.

Adolescent↗
PubMed1987

Excretion of urinary Tamm-Horsfall glycoprotein in girls with recurrent urinary tract infections.

Tamm-Horsfall glycoprotein (THG) might constitute a bacteria-fixing mucus which contributes to the non-immunological anti-infectious mechanisms of the lower urinary tract. To evaluate the role of THG in girls with idiopathic recurrent lower urinary tract infections, the THG excretion and concentration in 24-h urine were measured by a radial immunodiffusion method in 16 patients with a median age of 9 years and in 14 healthy age-matched girls. The results showed no significant differences in the THG excretion or concentration between the patients and the controls. Transiently decreased THG excretion rates as well as functional changes in the ability and/or capacity to trap bacteria, however, may leave girls periodically prone to colonization of the bladder. Thus, further studies are warranted to evaluate the importance of THG in the bladder defence mechanism.

Adolescent↗
PubMed1987

Painful bladder disease: clinical and pathoanatomical differences in 115 patients.

The diagnostic criteria for interstitial cystitis considered as a subgroup of painful bladder disease (that is sensory bladder disease and chronic abacterial cystitis) are not well established. Some urologists rely on symptoms, while others rely on cystoscopic appearance or pathological findings. Among 115 patients with painful bladder disease we compared symptoms, and cystoscopic and urodynamic findings in those with and without detrusor mastocytosis (28 or more mast cells per mm.2) and attempted to elucidate possible differences between the groups. We chose the pathological anatomical criterion of detrusor mastocytosis to be diagnostic for interstitial cystitis. A total of 43 patients had detrusor mastocytosis and other pathological anatomical signs of interstitial cystitis, and 72 had no mastocytosis but the pathological diagnoses of chronic unspecific cystitis, fibrosis of the bladder, detrusor myopathy, intestinal metaplasia and normal findings. When the 2 groups of patients were compared we found no differences in regard to symptoms (pain, dysuria, frequency, nocturia and urgency), frequency of allergy and hysterectomy, duration of symptoms, petechial bleeding during cystoscopy with bladder distension and cystometric findings. The patients with mastocytosis differed from those without mastocytosis in that they were older, and had a higher frequency of hematuria, a higher frequency of a red, scarred and richly vascularized bladder at cystoscopy before distension, and a smaller cystoscopic bladder capacity. We conclude that by dividing patients with painful bladder into 2 groups according to the mast cell counts in the detrusor, certain differences in the clinical findings in the groups can be ruled out. However, in individual patients one cannot note with certainty to which pathological anatomical group the patient belongs, since great overlapping between the groups exists. Whether only patients with detrusor mastocytosis have interstitial cystitis depends on definitions and still remains an open question.

Adult↗
PubMed1987

A prospective double-blind clinically controlled multicenter trial of sodium pentosanpolysulfate in the treatment of interstitial cystitis and related painful bladder disease.

Painful bladder disease, sensory bladder disease, chronic abacterial cystitis and interstitial cystitis are ill-defined conditions of unknown etiology and pathogenesis, and, therefore, they are without any rational therapy. Pathogenetic theories concerning defects in the epithelium and/or mucous surface coat (including glycosaminoglycans) of the bladder, and theories concerning immunological disturbances predominate. Sodium pentosanpolysulfate (Elmiron) acts by substituting a defective glycosaminoglycan layer and inhibits complement reactions in inflammatory processes. We compared sodium pentosanpolysulfate versus placebo in a prospective double-blind, clinically controlled multicenter trial of 115 patients with painful bladder disease. Two protocols were used. Protocol A included 43 patients with clinically and pathologically anatomically verified interstitial cystitis (28 or more mast cells per mm.2), and protocol B included 72 patients with a painful bladder and unspecific histological findings. The patients were randomized to receive either sodium pentosanpolysulfate (200 mg. twice daily) or placebo capsules for 4 months. Before and after the trial the patients were evaluated with symptom grading, urodynamics and cystoscopy with distension and deep bladder biopsies. The results showed no difference between the pre-trial and post-trial values in the sodium pentosanpolysulfate and placebo groups in both protocols in regard to symptoms, urodynamic parameters, cystoscopic appearance and mast cell counts. A significant increase in the cystoscopically determined bladder capacity in the sodium pentosanpolysulfate group in protocol A was found. We conclude that no statistically or clinically significant effect of sodium pentosanpolysulfate was found compared to placebo in patients with painful bladder disease.

Adult↗
PubMed1987

A disposable anal plug electrode for pelvic floor/anal sphincter electromyography.

During the last year we developed a disposable anal plug electrode for pelvic floor/external anal sphincter electromyography. The electrode consists of 2 disposable silver chloride surface electrodes mounted on a trochlear-shaped sponge. Testing of the new electrode with simultaneous registration of external anal sphincter electromyography using a coaxial needle electrode showed synchronous electromyographic patterns. In clinical urodynamic studies, including 48 cystometry studies with anal sphincter electromyography and 48 pressure-flow electromyographic studies, the electrode provided technically good and reliable electromyograms. The electrode design secures good contact to the recording surface and a safe fixation of the electrode during recording. The compressibility of the electrode might circumvent the problem of possible detrusor reflex inhibition induced by conventional hard anal plug electrodes. We recommend this technique for anal sphincter electromyography, since it is simple, reliable and without discomfort, and it does not require sterilization of the electrode.

Adolescent↗
PubMed1987

Disposable vaginal surface electrode for urethral sphincter electromyography.

During the last 2 years we have developed a disposable vaginal surface electrode for electromyographic (EMG) recording from the urethral striated sphincter. We describe the design of the electrode and report the results of laboratory testing, including directional selectivity of the electrode, electrode impedance, testing for movement artefacts and stability of position. Clinical studies which included 138 cystometries with sphincter EMG, 133 pressure-flow EMG studies and four urethral pressure profile studies with sphincter EMG, demonstrated that the electrode gave technically good and reliable electromyographic data. The registration caused no discomfort to the patient and did not disturb the act of micturition. We recommend this technique for the evaluation of urethral striated muscle activity during urodynamic studies in women, since it is simple, inexpensive and reliable.

Adult↗