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Biomedical subjects

M Borzyskowski

Publications and source records attributed to M Borzyskowski.

26 records · Page 2Linked to original sources
PubMed1985

Sphincter behaviour in myelomeningocele.

Four hundred and two videourodynamic studies were performed on 207 children with neuropathic vesicourethral dysfunction due to myelomeningocele. The children were divided into three groups (contractile, intermediate and acontractile) according to the urodynamic behaviour of their bladders, and the behaviour of the bladder neck and distal sphincter mechanism was assessed in each group. The bladder neck may be competent or incompetent in children with contractile bladders but is never obstructive, and is always incompetent in children with either intermediate or acontractile bladders at their usual bladder volumes. The distal sphincter mechanism is nearly always dynamically obstructive (detrusor-sphincter dyssynergia) in children with contractile bladders but is rarely if ever incompetent, whereas in children with intermediate or acontractile bladders, both (static) distal sphincter obstruction and sphincter weakness incontinence exist to some degree, although the predominance of one of these may mask the existence of the other unless it is specifically looked for or some therapeutic manoeuvre unmasks it. The main conclusion from this study is that, with the possible exception of those few children with more minor partial cord lesions, dysfunction of one or both sphincter mechanisms is the rule in congenital cord lesions.

Adolescent↗
PubMed1982

Neuropathic vesicourethral dysfunction in children. A trial comparing clean intermittent catheterisation with manual expression combined with drug treatment.

Forty-three children with overt neurological disease and neuropathic vesicourethral dysfunction were entered into a trial comparing clean intermittent catheterisation (CIC) with manual expression combined with drug treatment (non-CIC). The 22 children in the CIC group showed a significantly greater improvement in continence than the 21 children in the non-CIC group (P less than 0.001) without a significant increase in the incidence of urinary tract infections. Neither form of treatment is effective in reducing the risk of deterioration of renal function due to the combination of detrusor-sphincter dyssynergia and vesicoureteric reflux. Neither form of treatment improves continence in the presence of gross sphincter weakness or gross impairment of bladder compliance.

Bethanechol Compounds↗
PubMed1982

Videourodynamic evaluation of neuropathic vesicourethral dysfunction in children.

The findings of the videourodynamic (VUD) assessment of the vesicourethral dysfunction of 103 children with neurological disease are described. Detrusor-sphincter dyssynergia was the main determinant of voiding efficiency and the most important cause of impaired renal function. Storage efficiency was mainly determined by the behaviour of the bladder neck during the filling phase. The response to treatment of the child's incontinence was largely determined by the detrusor compliance. Detrusor contractility was found to be of 2 types distinguishable by several physical and functional characteristics rather than by amplitude alone. This may be of more than just academic and semantic importance. VUD studies are essential if conservative treatment modalities are to be rationally and selectively employed.

Adolescent↗
PubMed1981

The congenital varicella syndrome.

Two children, aged 18 months and 3 years, with the congenital varicella syndrome are described. Neuropathic bladder and lax abdominal wall musculature were present in one case. In the other, paralysis and marked hypoplasia of one arm, and an ipsilateral Horner's syndrome, were the main abnormalities. Extensive skin scarring corresponding to a dermatome distribution was present in both children. This constellation of abnormalities, which may best be explained on the basis of a developmental radiculopathy, emphasises the neuropathic effects on the fetus of varicella zoster (VZ) infection in early pregnancy.

Abnormalities, Multiple↗
PubMed1981

Neuropathic bladder and spinal dysraphism.

The association between spinal dysraphism and a neuropathic bladder is well known, but the diagnosis of the spinal lesion and the associated renal problems is often delayed. Four children referred with orthopaedic problems and in whom the bladder abnormally proved to be the major disability are described. Despite widely differing vertebral involvement, all had lower motor neurone neurological deficits confined to lumbar and upper sacral segments. All had unstable, variably thickened, small bladders, and it is proposed that the bladder abnormality is the result of a partial lesion of lumbosacral innervation, and not of an upper motor neurone lesion.

Child↗