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Biomedical subjects

J Nordling

Publications and source records attributed to J Nordling.

At least 127 records · Page 7Linked to original sources
PubMed1982

The effect of prostatectomy on upper urinary tract function.

59 patients with obstructive prostatic hypertrophy (BPH) were evaluated regarding the influence of prostatectomy on upper urinary tract function by means of [51Cr]EDTA clearance and gamma camera renography measurements. 25 patients were randomly allocated to transvesical and 34 patients to transurethral prostatectomy. At the 6-month follow-up a slight decrease in glomerular filtration rate (GFR) was seen in the total patient group. Residual renal activity 20 min following injection (A20) as well as half-peak time values showed upper urinary tract obstruction in 54% of the patients preoperatively, whereas dilatation of the upper urinary tract was demonstrated at i.v. pyelography in only 15%. Patients with renographic obstruction preoperatively had low GFR values compared with patients without obstruction. In patients with upper urinary tract obstruction, prostatectomy relieved the obstruction, even in the case of normal urography. In patients with normal upper urinary tract, a clinically insignificant decrease in GFR and increase in A20 and half-peak time was observed. No differences with regard to upper urinary tract function were seen on comparing transurethral with transvesical prostatectomy.

Aged↗
PubMed1982

Cysto-urethrographic appearance of the bladder and posterior urethra in neuromuscular disorders of the lower urinary tract.

Cysto-urethrography in the straight lateral projection with simultaneous intravesical pressure recording was performed in 57 patients with localized neurological lesions at different levels. All patients were previously extensively evaluated urodynamically. Bladder trabeculation was not related to level of neurological lesion or reflex pattern of the detrusor. Serration of the bladder wall was a reliable sign of a contracting detrusor in bladders without severe trabeculation. Open bladder neck at rest was related to lesion of the peripheral parasympathetic nervous system, while supposed insufficient bladder neck opening during voiding could be related neither to pressure-flow parameters nor to site of neurological lesion. No specific configuration of bladder or urethra could be related to lesion of the sympathetic nervous system.

Adult↗
PubMed1981

Clinical experience with the saphena loop arteriovenous fistula on the thigh.

The increasing number of patients on regular dialysis treatment (RDT) for many years produces a number of problems, one of which is the vascular access procedure. When the internal subcutaneous fistula cannot be used either as the first procedure or after some years of treatment, alternative methods are necessary. We present here clinical experience with the saphenous vein arteriovenous fistula placed on the upper thigh in 8 patients. The function was insufficient with a flow rate of about 125 ml/min and the complication rate was very high with development of 5 haematomas, 1 thrombosis and 1 case of severe oedema. Far more serious, however, the recording of 2 fatal external bleeding episodes. According to the literature, clinical experience with this procedure is very limited in other centres. From our experience we would not recommend this procedure and from the 2 fatal bleeding episodes we would question the placement of any fistula on the upper thigh unless absolutely necessary.

Arteriovenous Shunt, Surgical↗
PubMed1981

Different cystometric types of deficient micturition reflex control in female urinary incontinence with special reference to the effect of parasympatholytic treatment.

The effect of 4 weeks' treatment with emepronium bromide in 20 incontinent female patients with detrusor hyperreflexia was compared to the effect in 20 patients who did not have uninhibited detrusor contractions during filling cystometry but who were unable to suppress a voluntarily induced detrusor contraction. In both groups, 65% benefited from the drug and no statistically significant differences were seen in the decrease in frequency of voiding and incontinence episodes during treatment. There were no differences between the groups for age, type and degree of urinary incontinence, and radiological findings of bladder suspension defects. In these patients it is important to perform cystometry, including detrusor reflex activation procedures and the testing of their ability to suppress a voluntarily induced detrusor contraction.

Adult↗
PubMed1981

Does antibacterial ointment applied to urethral meatus in women prevent recurrent cystitis?

In a double-blind placebo controlled clinical trial the preventive value of the antibacterial ointment povidone-iodine 10% (Isodine, Betadine) applied to urethral meatus was evaluated in 17 females suffering from recurrent urinary tract infections (UTI). The patients applied povidone-iodine respectively placebo ointment twice daily and before sexual intercourse in two 6-month periods in a cross-over design. No difference was observed in number of UTI during povidone-iodine and placebo prophylaxis. A decrease in the incidence of UTI was seen during application of any ointment. The antibacterial properties of povidone-iodine ointment is unimportant in the prophylaxis of reinfections as also indicated from urethral and periurethral cultures during the study revealing no change in pathogenic bacterial flora. An improved perineal hygiene in the context of application of ointment may be responsible for the reduction in UTI incidence in females with recurrent cystitis.

Administration, Topical↗
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↗