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Biomedical subjects

J Nordling

Publications and source records attributed to J Nordling.

At least 145 records · Page 8Linked to original sources
PubMed1980

Noradrenergic innervation of the human bladder in neurogenic dysfunction.

The purpose of this investigation has been to determine the distribution of noradrenergic nerves in biopsy samples of the urinary bladder obtained from a total of 34 patients with neurogenic bladder disorders. On the basis of clinical evaluation, 12 patients were classified as having neurological lesions of the lower motor neuron type, the remainder consisted of cases of partial or complete spinal cord injury at various segmental levels. Irrespective of the type of neurological lesion, all specimens of posterior bladder wall and trigone contained few noradrenergic nerves. The smooth muscle bundles were rarely associated with this type of nerve and those fibers which were observed usually accompanied the vascular study of the region. These findings are indistinguishable from the results obtained in normal subjects and indicate that the sparse peripheral distribution of vesical noradrenergic nerves is unaffected in cases of neurogenic bladder dysfunction.

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

Recurrent urinary incontinence treated neurosurgically.

Neurogenic bladder dysfunction can be difficult to manage and is usually impossible to cure. This case report describes neurosurgical treatment of a case of recurrent urinary incontinence in a 56 years old woman who was previously treated on four occasions with vaginal repair operations with no beneficial effect. Cystometry revealed detrusor hyperreflexia (supranuclear bladder paresis). Myelography demonstrated cervical spinal cord compression. She was treated with spondylodesis of the cervical spine with complete relief of incontinence. 18 months postoperative cystometry was normal and after three years she was free of symptoms.

Female↗
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

Prostatism. II. The correlation between cysto-urethroscopic, cystometric and urodynamic findings.

The cysto-urethroscopic findings in 93 out of 107 consecutive patients referred for symptoms of bladder outlet obstruction were assessed and graded with special reference to bladder wall trabeculation, patency of the bladder neck, prostatic occlusion of the urethra, the estimated prostatic weight and the bladder neck-verumontanum distance. The cysto-urethroscopic findings of trabeculation and prostatic enlargement were not statistically significantly correlated to the cystometric demonstration of detrusor hyperreflexia. However, urodynamic parameters of infravesical obstruction judged by the opening pressure, maximum flow rate and the calculated urethral resistance were statistically significantly correlated to the cysto-urethroscopic findings of prostatic occlusion of the urethra, increased bladder neck-verumontanum distance and an increased prostatic weight estimated at cystoscopy. It is concluded that cysto-urethroscopy gives good information of as well the site as the hydrodynamic severity of organic infravesical obstruction.

Adult↗
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

Dilatation of the resting posterior urethra in spinal cord injury patients.

In 26 patients with detrusor-sphincter dyssynergia after a spinal cord injury the resting posterior urethra at cystography was found either closed as in normal subjects or open to a varying degree. Highest intravesical pressure measured at cystometry during uninhibited detrusor contraction was statistically significantly related to the degree of dilatation of the resting posterior urethra. An even higher correlation coefficient was found between the dilatation of the resting posterior urethra and an arbitrary score calculated on the basis of highest cystometric pressure and duration of disease since spinal cord injury. The possible importance of this finding in relation to incontinence after urethral sphincterotomy is discussed.

Adult↗
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↗
PubMed1979

Prostatism. I. The correlation between symptoms, cystometric and urodynamic findings.

One hundred and seven consecutive patients referred with symptoms of bladder outlet obstruction were studied using cystometry and combined pressure-flow-electromyographic investigation. The symptoms of infravesical obstruction were not statistically significantly correlated to the hydrodynamic documentation of increased bladder outlet resistance as judged by maximum flow rate and the calculated urethral resistance. Irritative symptoms such as frequency, nocturia, urgency and urgeincontinence were statistically significantly correlated to the presence of detrusor hyperreflexia. The functional disorder bladder neck dyssynergia was encounterd in 5% of the patients (95% confidence limits 1-10%). This diagnosis cannot be made by conventional urological investigations. It is concluded that objective demonstration of infravesical obstruction is mandatory in the selection of patients with symptoms of lower urinary tract dysfunction for surgery on the prostate or the bladder neck.

Adult↗
PubMed1979

Bladder function in urologically normal middle aged females. A urodynamic and radiological investigation.

The bladder function was studied in 15 urologically normal females over 40 years of age. They volunteered for this study which consisted of urodynamic studies and lateral micturition cystourethrography. The data are presented in tables. There are only small differences in the urodynamic parameters between this material and a material of women under 40 years of age. It is clearly demonstrated that a gynaecological cystocele tells little or nothing about the bladder function or bladder support. None of the cystometrograms showed uninhibited detrusor contractions. It is underlined to repeat the micturition studies several times in order to obtain a voiding event which the subject recognizes as normal.

Adult↗
PubMed1979

Effects of clonidine (Catapresan) on urethral pressure.

Effects of clonidine (Catapresan) on urethral closure pressure profile were investigated in five patients with minor urologic complaints. Plasma norepinephrine was measured as an index of sympathetic nervous activity. Intravenous injection of clonidine resulted in a pronounced fall in maximum urethral pressure. Plasma norepinephrine concentration decreased as expected. There was a statistically significant correlation between changes in plasma norepinephrine and urethral pressure after clonidine. These findings are discussed in relation to the known effects of alpha-adrenoceptor blocking drugs on urethral pressure. Clonidine may be useful in the treatment of some patients with functional infravesical obstruction.

Adult↗
PubMed1978

Sympathetic innervation of the urinary bladder and urethral muscle in the pig.

The sympathetic innervation of the lower urinary tract was studied in the female and male pig using a specific histochemical technique for visualization of noradrenaline containing nerves. In smooth muscle from the detrusor few evenly distributed adrenergic nerve terminals were found. A greater number of terminals were observed in the trigone, bladder neck and urethra. There was no sex difference. In smooth muscle specimens from pig detrusor and trigone sympathetic nerve terminals were more abundant than in corresponding tissue from humans.

Animals↗