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Biomedical subjects

J Nordling

Publications and source records attributed to J Nordling.

At least 109 records · Page 6Linked to original sources
PubMed1988

Sensitivity of 131I-hippuran diuresis renography and pressure flow study (Whitaker test) in upper urinary tract obstruction.

Diuresis renography and pressure flow studies were performed in 14 patients with unilateral hydronephrosis. Based upon the results of intravenous pyelography, typical symptomatology, and the outcome of surgical treatment, all patients were found to have upper urinary tract obstruction. It was therefore possible to calculate the sensitivity of the two tests. Obstruction was found at the pressure flow studies in 7 of 14 patients (50%), while an obstructive pattern was found at diuresis renography in 12 of 13 patients (92%). Due to a very low glomerular filtration rate, diuresis renography was equivocal in 1 case. Based upon these results, diuresis renography seems to be superior to pressure flow studies in cases with upper urinary tract obstruction.

Adult↗
PubMed1986

Long term results of transurethral and transvesical prostatectomy. A randomized study.

The long term result of transurethral (TURP) versus transvesical (TVP) prostatectomy was evaluated in a randomized study of 75 patients with clinically benign, medium sized, obstructive prostatic hyperplasia. Follow-up investigation including evaluation of symptoms and urinary flow rate was undertaken every 6 months the first 2 years as well as 5 years postoperatively. Thirteen patients died during follow-up. However, the remaining 64 patients were representative for the total series of patients. More than 90% in both groups had a satisfactory subjective result throughout follow-up. A significant and persistent relief in obstructive and irritative symptoms were seen in both groups. Nocturia was the predominant follow-up symptom being present in more than 50% of the patients 5 years postoperatively. During observation a slight decrease in sexual activity and retrograde ejaculation was reported by TVP and TURP patients. About 25% of the patients in both groups with benign histology had secondary operations during follow-up. Maximum as well as average flow rate values remained stable throughout the period of observation with small differences between the two groups. The incidence of urinary tract infections was reduced significantly by the surgical procedures. Only minor and clinically insignificant differences were observed between the results of the two operative procedures.

Follow-Up Studies↗
PubMed1986

The AMS artificial urinary sphincter on the bulbous urethra.

An artificial sphincter with the cuff on the bulbous urethra was implanted in 29 patients with urinary incontinence. After a median observation time of 3 years, 19 patients were continent, four others were improved and the system had been removed in six cases. Urethral erosion occurred in only two cases, both due to infection. Use of low-pressure systems is recommended.

Adolescent↗
PubMed1985

Functional bladder neck obstruction. Results of endoscopic bladder neck incision in 131 consecutive patients.

Endoscopic diathermy incision of the bladder neck was carried out as a routine procedure in 131 consecutive male patients with an established diagnosis of functional bladder neck obstruction. Follow-up after 3 months revealed excellent symptomatic and urodynamic results. Morbidity was low and the post-operative stay in hospital short (median 2 days). Patients must be informed of the risk of retrograde ejaculation associated with the procedure and objective evidence of the diagnosis is essential.

Adult↗
PubMed1985

Economy in transurethral prostatectomy.

The economy in transurethral (TURP) versus transvesical (TVP) prostatectomy was evaluated in a prospective randomized study. Forty-three patients were allocated to TURP and 32 to TVP. All patients had clinically benign, medium-sized prostatic hyperplasia. Median postoperative ward time was 15 1/2 days following TVP, compared with 7 days following TURP. Statistically significant differences between the two groups in favour of TURP were also seen in the duration of anaesthesia for prostatectomy, in the amount of antibiotics and i.v. infusions used, as well as in number of postoperative outpatients visits. No difference was observed in number of patients readmitted to hospital within 6 months due to sequelae of the prostatectomy. Postoperative sick-leave was 4 weeks following TVP, compared with 2 weeks for TURP patients. However, in the present study the patients' own expenses related to the operation were small and revealed minor differences in favour of TURP. It is stressed that increasing application of TURP in medium-sized prostatic hyperplasia may imply a substantial reduction in the waiting lists as well as an estimated retrenchment for the Danish community of US $3400 (34000 D.kr.) per patient or at least $4.5 million (45 million D.kr.) per year.

Aged↗
PubMed1985

Transurethral versus transvesical prostatectomy. Physiological strain.

The present randomized study evaluated the physiological strain in transurethral (TURP) versus transvesical (TVP) prostatectomy in 75 patients with clinically benign, medium-sized prostatic enlargement. In both groups 5 patients had coincidental prostatic carcinoma. During TURP a suprapubic trocar was inserted for irrigation with 1.5% glycine. Antibiotics were given to patients with preoperative urinary tract infection and postoperatively tranexamic acid was administered to all patients. Coexisting diseases which might increase the operative risk were equally present in TURP and TVP patients. No patient died in connection with the operative procedures. Median duration of anaesthesia for TVP was 95 min and for TURP 60 min (p less than 0.001). Almost identical operative blood loss was seen in the two groups. However, more blood transfusion were given to TVP patients. Following discharge, more episodes of bleeding were registered in the TURP group, but no significant difference was observed in number of secondary operations for bleeding. In the TVP group, more patients had pulmonary complications, elevated rectal temperature as well as antibiotic treatment and 34% of these patients developed wound infection. Secondary operations before discharge were also more frequently undertaken in TVP patients. No differences between the two groups were seen pre- or postoperatively with respect to electrolyte, protein, creatinine and haemoglobin values. In the patients with incidental prostatic carcinoma a TURP was the most gentle procedure. With respect to physiological strain a TURP is clearly to be preferred over a TVP for obstructive clinically benign, medium-sized prostatic hyperplasia.

Aged↗
PubMed1984

Urinary incontinence in the female. A long-term study of the effect of anticholinergics on overactive detrusor function.

The long-term effect of anticholinergic medication in female patients with overactive detrusor function was studied in a group of 73 patients. The definition of overactive detrusor function is in accordance with the terminology and definition of the International Continence Society. The patients were mailed a questionnaire about the medication, its effect on the continence situation, the side effects, and whether they still used the drugs. The duration of observation was more than 12 months. A satisfactory effect of the treatment was found in 43% while 50% reported no effect or severe side effect. Only 5% stopped the medication because of side effects, 18% because of lack of effect, while 42% had resigned themselves to their voiding disorders. Twenty-nine claimed to be cured or were still using the drug with beneficial effect. Nevertheless the treatment had continued for 6 months in both the group with no effect and in the group with good effect. The anticholinergic medication is of some value because it helps the patient to accept the bladder dysfunction, to alter the micturition habits and to assist in re-establishing inhibition of the micturition reflex.

Adult↗
PubMed1984

Clinical evaluation of transurethral versus transvesical prostatectomy. A randomized study.

The present randomized study gives an evaluation of clinical results 6 months following transurethral (TURP) and transvesical (TVP) prostatectomy in 75 patients with clinical benign medium-sized obstructive prostatic hyperplasia. Following treatment of postoperative urethral stricture, urinary tract infection and residual bladder stones no statistically significant differences could be demonstrated in the effects of TURP and TVP on a calculated total symptom score nor on the individual obstructive and irritative prostatic symptoms. In both groups the obstructive symptoms were best relieved whereas rather high incidences of irritative symptoms were seen at follow-up. The median duration of incontinence following TURP was 10 weeks compared to 6 weeks following TVP but the difference, however, was insignificant. At follow-up also more patients in the TURP group had urinary incontinence although only one patient in this group with benign histology had daily urinary urge incontinence. Stress incontinence was observed in two patients with malignant histology. Persistent detrusor instability was suggested partly responsible for the follow-up irritative symptoms. In both groups and especially in the TVP group a small decrease in frequency of sexual activity was seen 6 months postoperatively. Seventy per cent of TVP patients and 57% of TURP patients reported retrograde ejaculation at follow-up. More urinary tract infections were seen in the TVP group, however, the differences were insignificant. Twenty-five per cent of TVP patients and 17% of TURP patients developed urethral strictures postoperatively and judged from flowmetry most strictures were obstructive.(ABSTRACT TRUNCATED AT 250 WORDS)

Aged↗
PubMed1984

Urodynamic evaluation of transurethral versus transvesical prostatectomy. A randomized study.

In a randomized study of transurethral prostatectomy (TURP) versus transvesical prostatectomy (TVP) in 75 patients a urodynamic evaluation was undertaken before and 6 months following operation. In the TURP group a resection to the surgical capsule was attempted in each case. Operative specimen weights in the two groups did not differ statistically significantly. 5 patients in each group had unexpected prostatic carcinoma. Rapid fill CO2 cystometry did not show any significant differences in bladder function between TURP and TVP patients 6 months following operation. In both groups a high incidence of detrusor instability was observed at follow-up. However, the incidence as well as the severity of the instability had decreased significantly following the two operative procedures. As judged from flowmetry and pressure flow investigation, relief of infravesical obstruction was almost complete in both groups. However, following treatment of postoperative strictures the patients with benign histology in the TVP group compared to the TURP group had higher maximum flow rate values and lower detrusor pressure values. Confidence limits for the differences between the two groups in detrusor pressure and maximum flow rate at follow-up did, however, hardly suggest clinically significantly differences. At urethral closure pressure profile measurement a statistically significantly shorter profile length was measured in TVP patients. The marginal differences in relief or infravesical obstruction might be due to differences in the amount of apical prostatic adenoma following operation.

Aged↗
PubMed1983

Placebo--the drug of choice in female motor urge incontinence?

In a randomised double-blind cross-over trial of 19 females with motor urge incontinence but without bladder suspension defect, the effects of 14 days' treatment with emepronium bromide 200 mg qid, flavoxate chloride 200 mg qid or placebo qid were compared by means of micturition charts, the patients' drug preferences and evaluation of side effects. Placebo was the only drug giving rise to a statistically significant decrease in the frequency of voidings, incontinence and nocturia. Forty-seven per cent of the patients preferred placebo and side effects were less frequent during treatment with this medication. No differences could be demonstrated between the effects of emepronium bromide and flavoxate chloride. Perhaps detrusor instability is not always the main reason for the voiding dysfunction in these patients, in whom the effect of placebo was equal or superior to the effect of "active drugs" and superior to no treatment at all.

Adult↗
PubMed1983

Incontinence surgery in female motor urge incontinence.

Conventional incontinence surgery was performed in 41 consecutive female patients despite the finding of motor urge incontinence. The patients were reinvestigated 6 months to more than 2 years after operation. Twenty-eight of the patients also had the symptom stress incontinence. Seventeen patients had coexisting symptomatic genital prolapse and were operated on without prior pharmacological treatment. The remaining 24 patients were all resistant to parasympatholytic treatment. The choice of operative procedure was based on vaginal examination as well as bladder suspension defect as demonstrated on voiding-colpo-cysto-urethrography. Subjective cure and improvement rate was 73%. At follow-up, 30% of the patients had normal detrusor reflex control, and a significant improvement in urge incontinence as well as frequency of micturition and nocturia was observed. Probably the primary treatment in females with motor urge incontinence should be pharmacological. However, in patients with symptomatic genital prolapse as well as in patients with ineffective medical treatment, conventional incontinence surgery seems to be well indicated in the absence of neurological disease-providing the patient has an associated bladder suspension defect.

Adult↗
PubMed1982

Urinary incontinence in old age. A controlled clinical trial of emepronium bromide.

The effect of the anticholinergic agent, emepronium bromide (Cetiprin), was studied in a double blind crossover study of a group of elderly patients with urinary incontinence and uninhibited bladder contractions during cystometry. There was no statistically significant difference between the subjective effect of emepronium bromide and that of placebo, and no change in the cystometric parameters. The overall subjective cure or improvement rate was 79%. The effect of anticholinergic drugs in the treatment of urinary incontinence in elderly patients with uninhibited bladder contractions might to some extent be due to an improvement in the patients' understanding and acceptance of the bladder disorders.

Aged↗