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Biomedical subjects

J Nordling

Publications and source records attributed to J Nordling.

At least 91 records · Page 5Linked to original sources
PubMed1991

A patient weighted symptom score system in the evaluation of uncomplicated benign prostatic hyperplasia.

A new scoring system is presented for use in patients with uncomplicated benign prostatic hyperplasia. The system is based on the patients' information on the magnitude of twelve symptoms related to bladder and voiding function (symptom score), and three questions related to sexual function. Furthermore the patients are asked to grade the impact of these symptoms on their daily lives (bother score). Multiplication of the two scores related to bladder and voiding function gives the total score. The score related to sexual function is used only for comparing the situation before and after treatment. The new patient weighted total score may assist in creating a solid base for the indication for and evaluation of surgical and non-surgical treatment of uncomplicated benign prostatic hyperplasia.

Humans↗
PubMed1991

Evoked potentials from the lower urinary tract. II. The spino-cortical neuraxis. A methodological study.

Spinal and cerebral evoked potentials (EPs) on stimulation of the dorsal nerve of the penis, clitoris, bladder wall and posterior urethra were recorded in 20 normal subjects (10 females and 10 males). Responses were obtained by computer averaging of multiple potentials registered over the spinal cord (L1) and cerebral cortex. Responses from the posterior tibial nerve were also recorded. Consistent cortical responses were obtained from the pudendal nerve, bladder wall and posterior urethra, whereas spinal responses were difficult to record. The maximum responses after stimulation of the pudendal nerve, bladder wall and posterior urethra were recorded over the midline of the scalp at CZ-2 cm point. The configuration of the somatosensory evoked potentials of the pudendal nerve had a W-shape with a consistent positive peak P1 (median 42.0 msec, range 39-45 msec), whereas the responses after endovesical and endourethral stimulation mainly were M-shaped with a prominent negative peak N1 (Bladder: mean 104.0 msec, range 75-112 msec and posterior urethra: median 103.0 msec, range 78-114 msec). Conduction times within the central spinal pathways could be calculated by subtracting the latencies of the peripheral spinal potentials from the central cortical potentials.

Adult↗
PubMed1990

[Urinary incontinence. Experiences with the artificial urethral sphincter AS 800].

Since 1983, 62 patients with incontinence of urine (43 men and 19 women) were treated with an artificial sphincter model AS 800. During the period of observation, the artificial sphincters were removed in five patients on account of complications and six patients had died. In 22 patients, a total of 34 operations were required on account of complications. Out of 51 patients with artificial sphincters at the time of this review, 43 (84%) had experienced improvement: 15 (29%) were completely continent and 18 (35%) had only slight stress incotinence. It is concluded that the technical improvement which has taken place has improved the therapeutic results and approximately halved the number of complications requiring treatment.

Adolescent↗
PubMed1990

Functional assessment of the bladder.

The urinary bladder has two functions: to store and to empty. A frequency-volume chart completed by the patient provides useful information about voiding intervals, possible factors provocative for incontinence, functional bladder capacity and daily urine volume. Filling cystometry is used primarily to evaluate reflex function in the storage phase, giving information about the presence or absence of detrusor instability and (in combination with urethral EMG) about detrusor-sphincter coordination. Information is also obtained about bladder sensation, bladder capacity and bladder compliance. Detrusor function during emptying is closely related to outflow conditions and therefore demands simultaneous registration of detrusor pressure and urinary flow rate. An inverse relation exists between detrusor pressure and flow rate, which means that reduced flow rate causes increased detrusor pressure for the same detrusor power. Underactive detrusor function will result in low detrusor pressure and low flow rate. The finding of a non-contractile detrusor may indicate psychogenic inhibition or a neurogenic lesion. Sacral evoked potentials and denervation supersensitivity tests may help to distinguish between these conditions.

Humans↗
PubMed1990

Urethral stricture following transurethral prostatectomy.

Urethral stricture is the most common late complication of transurethral prostatectomy. Uroflowmetry is recommended as the routine screening procedure for strictures postoperatively. If maximal urinary flow rate (Qmax) is below 10 mL/second the patients should be investigated further. The etiology of urethral stricture is still unclear. Further studies are necessary to evaluate the possible etiologic role of infected urine pre- and/or postoperatively, urethral catheterization pre- and postoperatively, catheter material, and the type and size of the resectoscope. A narrow urethra is probably a predisposing factor for stricture formation, but this is not definitively clarified. Only few randomized studies have been performed to evaluate the different prophylactic methods against development of strictures postresection. Resection via perineal urethrotomy, perhaps preceded by urethral calibration, seems to be a way to avoid anterior urethral strictures. The effects of internal urethrotomy preoperatively on stricture formation are conflicting. Further randomized studies are necessary.

Humans↗
PubMed1990

The urethral plug: a new treatment modality for genuine urinary stress incontinence in women.

A new modality, the urethral plug, was used to treat 22 women with genuine urinary stress incontinence. The plug is made of thermoplastic elastomer (Kraton G), and consists of a meatal plate, a soft stalk and 1 or 2 spheres along the stalk. The spheres were located according to the result of the urethral pressure profile. The midpoint of the proximal sphere was placed at the bladder neck and the distal sphere was placed just above the maximum urethral pressure point. At voiding the plug was removed and afterwards a new plug was inserted. The plug with 2 spheres was tested in week 1 (period 1) and the plug with only the distal sphere was tested in week 2 (period 2). A total of 22 patients completed period 1. Eight patients did not complete period 2, mostly due to either unchanged incontinence during period 1 or a repeated loss of the plug with 1 sphere. In periods 1 and 2, 73 and 79% of the patients were subjectively and objectively continent or improved. A total of 14 patients completed both periods. Eight patients preferred the plug with 2 spheres, 1 preferred the other plug and 5 had no preference. The side effects were few. This preliminary study shows that the urethral plug seems to be a promising alternative treatment for female genuine urinary stress incontinence.

Equipment Design↗
PubMed1990

Voiding patterns in men evaluated by a questionnaire survey.

A questionnaire on obstructive and irritative voiding symptoms was sent to 572 men aged between 20 and 79 years, selected at random from the National Register; 337 questionnaires were completed. None of the responders had consulted a doctor because of voiding symptoms. There was a significant increase in voiding symptoms and in the obstructive, irritative and total symptom scores between the sixth and seventh [corrected] decades, whereas the increases in the other decades were small. Only the prevalence of terminal dribbling was uniform. The prevalence of single obstructive and irritative voiding symptoms in men aged 60 to 79 years without subjective prostatism was the same as in patients admitted with prostatism, although most of the men had milder symptoms. Only nocturia and urge incontinence were more prevalent in patients admitted with prostatism. About 20% of men in the oldest decades had symptoms equal in severity to those found in men undergoing prostatectomy; 29% and 11% of men in the eighth decade [corrected] had nocturia twice and 3 times or more respectively; 19% complained of urge incontinence. More information on possible treatment is needed.

Adult↗
PubMed1990

The intraprostatic spiral. New treatment for urinary retention.

In a series of 45 consecutive patients with acute or chronic urinary retention, 41 were treated by insertion of an intraprostatic spiral using ultrasonic guidance under local anaesthesia. Insertion was successful in 35 patients and in 6 the spiral was inserted endoscopically. During a follow-up period of 12 months 8 patients died, all with a functioning spiral. The device was removed in 16 patients; in 6 cases the reasons for removal were related to the spiral and in 10 they were not. The spiral remained in situ in 17 patients and all had satisfactory voiding. This device is a good alternative to an indwelling catheter in patients awaiting prostatic surgery and also in those who are either unfit or unwilling to undergo prostatectomy.

Aged↗
PubMed1990

Voiding patterns and prevalence of incontinence in women. A questionnaire survey.

A detailed questionnaire on the occurrence of irritative and obstructive voiding symptoms, incontinence and the number of childbirths was sent out to 600 women aged between 20 and 79 years, randomly selected from the National Register; 432 (72%) returned the questionnaire and 414 (69%) were evaluable. The frequency of obstructive symptoms such as hesitancy, intermittency and decreased stream was low. Diurnal frequency with voiding intervals less than 3 h were recorded by more than 50% of the women and about 10% voided more frequently than every second hour. Nocturia increased significantly with age; 54 (13.6%) voided at least twice per night. About 40% complained of incontinence but this was troublesome in only 6%; 15.3, 13.3 and 11.5% had stress, urge and mixed incontinence respectively. More than 8% wore nappies or sanitary towels every day to protect against urinary leakage. Although the tendency to wear nappies or sanitary towels increased with age, the increase was not statistically significant. There was a positive correlation between the occurrence of stress incontinence and childbirth in the group as a whole.

Adult↗
PubMed1990

Xenon tissue/blood partition coefficient for pig urinary bladder.

In four landrace pigs the tissue/blood partition coefficient (lambda) for xenon (Xe) for the urinary bladder was calculated after chemical analysis for lipid, water and protein content and determination of the haematocrit. The coefficients varied from bladder to bladder owing to small differences in both the haematocrit and tissue composition. In Xe washout studies of the blood flow of the urinary bladder, we recommend calculating the lambda for Xe from the actual haematocrit and from the median value of tissue composition found in the present study.

Animals↗
PubMed1990

Upper urinary tract deterioration after implantation of artificial urinary sphincter.

The preoperative urodynamic evaluations of twenty patients with myelomeningocele who had had artificial sphincter implantation because of urinary incontinence were reviewed. Four patients developed hydronephrosis and severe impairment of renal function between two and six years after implantation of the artificial sphincter. The condition was partly reversible after removal of the artificial sphincter. The urodynamic evaluation prior to implantation revealed in the four mentioned patients compared to the 16 patients with normal upper urinary tract, a tendency to lower bladder compliance, lower bladder capacity and more severe detrusor hyperreflexia, but it was not possible to make a clear discrimination between the two groups. Attention is drawn to this unfortunate combination of effects after artificial sphincter implantation. Periodic control of the upper urinary tract by urography is recommended.

Adolescent↗
PubMed1989

[The prostate coil. A new form of treatment of urinary retention in men. Clinical experiences during a 6-month observation period].

A prostate spiral developed in Denmark may be introduced with a special catheter under local anaesthesia under the guidance of transabdominal ultrasonic scanning. Forty-four consecutive patients with retention of urine were treated with the prostate spiral. Ultrasonic-guided introduction was successful in 33 patients (73%). Cystoscopy proved necessary for introduction of the spiral in six patients and, in two cases, it was introduced over a ureteric catheter. In four patients the spiral could not be introduced on account of pronounced curving of the prostatic urethra. On follow-up examination after six months, eight patients had died with spirals which functioned well. The spiral had been removed in 12 patients and, in six of these, the problems could be attributed to the spiral. Nineteen out of 21 patients with the spiral in situ had subjectively satisfactory miction. The median maximal flow was 9.4 ml/s (range 1.0-21.3 ml/s). Ultrasonically-guided introduction of the prostate spiral under local anaesthesia is an easy and rapid procedure. The spiral is a good alternative to urethral indwelling catheter, also during the waiting time before prostatectomy.

Aged↗
PubMed1989

The intraprostatic spiral: a new device for insertion with the patient under local anesthesia and with ultrasonic guidance with 3 months of followup.

Acute or chronic urinary retention (median retention volume 1,000 ml.) was relieved successfully in 41 of 45 consecutive patients by insertion of an intraprostatic spiral with the patient under local anesthesia and with ultrasonic guidance. Insertion guided by ultrasound was successful in 35 patients (77 per cent). In 6 patients the spiral was inserted via the traditional endoscopic technique. During 3 months of followup the spiral remained in situ in 27 patients and in 6 it was repositioned. These 33 patients had free voiding with a median maximum flow rate of 13.6 ml. per second. Residual urine volume 1 month after insertion of the spiral was low (median 27 ml.). In 8 patients the spiral was removed during the observation period due to urinary incontinence or retention. The intraprostatic spiral is a favorable alternative to an indwelling catheter in patients awaiting an operation and in those with a high operative risk.

Aged↗
PubMed1989

Standardized evaluation of erectile dysfunction in 95 consecutive patients.

We investigated 95 patients referred for erectile dysfunction by penile blood pressure measurement, the intracavernous papaverine test and Doppler investigation of the penile arteries. Furthermore, penile cutaneous perception threshold, bulbocavernosus reflex latency and somatosensory cortical evoked potentials of the pudendal nerve were measured. In selected cases cavernosometry, cavernosography and corpus cavernosum electromyography were performed. Doppler investigation of the cavernous arteries after papaverine injection was more reliable than penile blood pressure measurement in the diagnosis of arteriogenic erectile dysfunction. Decreased sensibility of the penis may be the sole factor responsible for inability to sustain an erection. Erectile dysfunction may be provoked by impaired function of the pudendal nerve. Penile cutaneous perception threshold measurement and corpus cavernosum electromyography are mandatory in the evaluation of neurogenic etiology. Cavernosometry and cavernosography are reliable methods in the determination of abnormal drainage from the corpus cavernosum.

Adult↗
PubMed1989

Relationship between detrusor pressure and urinary flow rate in males with an intraurethral prostatic spiral.

Six patients with acute urinary retention and 2 with prostatic obstruction and urge incontinence were treated with an intraurethral prostatic spiral and underwent pressure-flow studies 51 days (median) later. Evaluation of pressure-flow parameters and pressure-flow plots by different methods gave conflicting results regarding the presence of infravesical obstruction; 6 patients showed no voiding symptoms and in 2 patients only moderate irritative symptoms remained. The spiral allowed unobstructed voiding and is a good alternative to an indwelling urethral catheter. We recommend insertion of a spiral in patients with urinary retention if the waiting period for TURP is long or if the patient is unfit for surgery.

Aged↗