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Biomedical subjects

H H Meyhoff

Publications and source records attributed to H H Meyhoff.

At least 73 records · Page 4Linked to original sources
PubMed1981

Sympatholytic effect on striated urethral sphincter. A peripheral or central nervous system effect?

Effects of intravenous administration of sympatholytic drugs on urethral pressure and electromyographic activity from urethral and anal sphincter, were investigated in five normal women. Clonidine (Catapresan), which easily passes the blood brain barrier, resulted in a pronounced decrease in urethral pressure and electromyographic activity from both sphincters. Phentolamine (Regitine), which does not pass the blood brain barrier, also lowered urethral pressure but had no effect on electromyographic activity from the sphincters. Neither drug depressed reflex induced increase in urethral pressure and sphincter activity during bladder filling or during voluntary contraction of the pelvic floor muscles. Phenoxybenzamine administration to one normal female had the same effect as clonidine. It is suggested that part of the clinical effect on voiding disorders seen after treatment with sympatholytic drugs passing the blood brain barrier (e.g. phenoxybenzamine) might be due to an effect on the central part of the striated urethral sphincter innervation.

Adult↗
PubMed1981

Influence of sympathetic tonus and plasma noradrenaline on urethral pressure.

The relative influence of circulating noradrenalin and sympathetic tonus on urethral pressure was investigated by intravenous administration of noradrenalin and clonidine. Raising circulating noradrenalin concentrations by noradrenalin infusion had only a relatively minor effect on urethral pressure, indicating that urethral pressure is not controlled by circulating noradrenalin. Besides depression of sympathetic tonus and urethral pressure, clonidine reduced striated anal sphincter activity.

Adult↗
PubMed1981

Neuromuscular dysfunction of the lower urinary tract with special reference to the influence of the sympathetic nervous system.

Filling cystometry, urethral and anal sphincter electromyography, pressure-flow registration, urethral closure pressure profile at rest and after alpha-adrenoceptor blockade with phentolamine, evoked potential of the bulbocavernosus reflex and denervation supersensitivity to carbachol in a-reflexic bladders were performed in 57 consecutive patients with a localized neurological lesion, in order to evaluate the relative importance of the somatic, the parasympathetic and especially the sympathetic nervous system for the function of the lower urinary tract. In spinal lesions with detrusor hyperreflexia, dyscoordination between detrusor and striated urethral sphincter was dominant, while in cauda equina lesions and in lesions of the pelvic nerves the lack of parasympathetic bladder innervation dominated. It was not possible to identify specific spinal segments controlling sympathetic nervous regulation of the lower urinary tract. The only influence of the sympathetic nervous system was a control of urethral pressure, where a statistically significant smaller proportion of the maximal urethral pressure was affected after alpha-adrenergic blockade in patients with peripheral nerve lesions. All a-reflexic bladders exhibited denervation supersensitivity to carbachol, while carbachol did not change urethral pressure significantly indicating minimal influence of the parasympathetic nervous system on urethral pressure.

Adolescent↗
PubMed1981

Urethral denervation supersensitivity to noradrenaline after radical hysterectomy.

Urethral closure pressure profiles were registered before and during intravenous infusion of noradrenaline in 7 female patients who had undergone radical hysterectomy, and in whom a bladder denervation supersensitivity test to carbachol previously had been positive. Patients who had a completely denervated bladder had a greater rise in maximum urethral pressure during noradrenaline infusion (exceeding 20 cm H2O) than normal subjects (1 to 15 cm H2O). Urethral supersensitivity to noradrenaline may be a promising test in diagnosing damage of the sympathetic nervous innervation of the lower urinary tract.

Adult↗
PubMed1981

Accuracy in preoperative estimation of prostatic size. A comparative evaluation of rectal palpation, intravenous pyelography, urethral closure pressure profile recording and cystourethroscopy.

In a prospective study of 75 patients with prostatic hypertrophy a comparison was undertaken of the accuracy in estimates of operative prostatic weight from conventional preoperative investigations. Estimates from rectal digital palpation alone and from intravenous pyelography (prostatic impression, elevation of the bladder base as well as the configuration of distal ureters) were without significant correlation to operative weights, and were not found useful for preoperative estimation of prostatic size. Prostatic length in urethral closure pressure profile measurements as well as the distance from bladder neck to verumontanum and the weight estimated at cystourethroscopy were statistically significantly correlated to operative weights with a coefficient of correlation in the order of 0.5 and were judged useful, although not very precise in the clinical work.

Aged↗
PubMed1981

Incontinence surgery in females with motor urge incontinence.

Forty-one consecutive female patients were operated on despite the finding of motor urge incontinence; they were reinvestigated six months to two years after operation. Seventeen of the patients had associated symptomatic genital prolapse and were operated without previous pharmacological treatment. The remaining 24 patients were resistant to parasympatholytic treatment. The method of operation was based on vaginal examination and evaluation of bladder suspension defect at voiding-cystourethrography. Cure and improvement rate was 73 per cent. Cystometry was normalized in 30 per cent of all patients and in 45 per cent of patients with preoperative detrusor instability on provocation only. Disappearance of detrusor instability as well as normalization of a bladder suspension defect was associated with a good result. Motor urge incontinence should not contraindicate incontinence surgery on females selected and treated as in the present study.

Adult↗
PubMed1980

Neurogenic bladder.

A survey of the innervation of the bladder and urethra is presented. Based on the defects of innervation the main types of neurogenic bladder disorders are classified and described. The principal diagnostic procedures, cystometry and sphincter-electromyography, are reviewed in detail. The findings at voiding cysto-urethrography are depicted. It is important to be able to distinguish between voiding disorders of non-neurogenic and neurogenic origin. The specific treatment of the various types of neurogenic disorders of the lower urinary tract is described.

Autonomic Nervous System↗
PubMed1980

Functional bladder neck obstruction. Late results after endoscopic bladder neck incision.

The effect of endoscopic bladder neck incision for functional bladder neck obstruction was assessed in 28 consecutive patients with a follow-up period of up to 50 months. The operation had excellent effect on the patients' symptoms consisting mainly of weak stream and/or recurrent urinary infections. Uroflowmetry at the postoperative follow-up study showed a statistically significant increase in as well maximum flow rate as mean flow rate. The bladder neck incision carried very few complications, and the average postoperative stay in hospital was 2.8 days. It is important to be aware of the condition functional bladder neck obstruction, and the diagnosis should be based upon uroflowmetry and voiding cystourethrography. In borderline cases with only slightly reduced urinary flow rate, additional pressure-flow studies should be applied to demonstrate infravesical obstruction.

Adult↗
PubMed1980

Pulmonary atelectasis following upper urinary tract surgery on patients in the 25 degrees and 45 degrees 'jack-knife' position. A sequential analysis.

The development of pulmonary atelectasis following upper urinary tract surgery in patients positioned either in the 25 degrees or the 45 degrees 'jack-knife' position was evaluated in a randomized clinical trial with sequential analysis. Atelectasis was diagnosed from chest radiographs and/or from a decrease in arterial oxygen tension during the first three postoperative days. 32.1% of 78 patients developed atelectasis, but no statistically significant differences was found between the two positions.

Adolescent↗
PubMed1979

Dissociation of urethral and anal sphincter activity in neurogenic bladder dysfunction.

In 53 patients with suspected neurogenic bladder dysfunction carbon dioxide cystometry was done in combination with urethral and anal sphincter electromyography. Complete dissociation between the reflex activity of the 2 sphincters was found in 25 per cent of the patients and only 58 per cent of the patients had identical reflex activity. It is concluded that anal sphincter electromyography is highly unreliable in the diagnosis of urethral sphincter dysfunction.

Adolescent↗
PubMed1979

Urinary incontinence in the female. The value of detrusor reflex activation procedures.

One hundred consecutive female patients with urinary incontinence were investigated with CO2 cystometry including detrusor reflex activation procedures such as postural change and ability to suppress self-induced detrusor contractions. Detrusor hyperreflexia was seen in 20 patients during bladder filling in the supine position, and in an additional 35 patients after detrusor reflex activation procedures. Four different types of detrusor hyperreflexia are described based on the cystometric findings. In 38 patients treated with parasympatholytics, 66% showed a good result independent of the type of detrusor hyperreflexia.

Carbon Dioxide↗
PubMed1979

Evoked response of the bulbocavernosus reflex.

The bulbocavernosus reflex can be elicited either by penile or urethral stimulation. The mean signal transit time after electrostimulation of the dorsal penile nerve to evoked response in the anal sphincter (35 msec) was only half the signal transit time after stimulation in the posterior urethra (60 msec). Thus, the modified bulbocavernosus reflex elicited either by squeezing the glans penis or by pulling a urethral balloon catheter represents two different reflexes with differenct afferent and probably different intraspinal pathways. In the clinic it is therefore important, when testing the bulbocavernosus reflex, to report how it is elicited.

Adult↗