Biomedical subjects

P Thind

Publications and source records attributed to P Thind.

33 records · Page 2Linked to original sources

PubMed1992

Initial urethral pressure increase during stress episodes in genuine stress incontinent women.

The urethral and bladder pressure increments registered during a cough were investigated in 30 woman with genuine stress incontinence (GSI) and compared with those from 30 previously investigated healthy women. The pressures were measured by means of a double microtip transducer catheter with the bladder sensor uncovered and the urethral sensor covered with a water-filled rubber cylinder and placed at the bladder neck, midurethrally, or distally in the urethra. In GSI women the pressure increment preceding the pressure spike produced by coughing was significantly higher in the bladder compared with the urethra, and the pressure increment seemed to be initiated in the bladder and all along the urethra simultaneously. In healthy women the pressure increment preceding a pressure spike was significantly higher in the midurethra compared with the bladder and it seemed to be initiated in the midurethra. These findings seem to reflect a defective active closure mechanism in GSI which may be a contributing factor in its pathogenesis.

Adult↗

PubMed1992

The effect of alpha-adrenoceptor stimulation and blockade on the static urethral sphincter function in healthy females.

The influence of noradrenaline and prazosin on the urethral closure function was evaluated in 10 healthy female volunteers. Measurements of pressure at varying cross sectional areas were carried out at the bladder neck, in the high pressure zone, and in the distal urethra. Prazosin reduced the static pressure, predominantly in the midportion of the urethra, whereas noradrenaline caused no significant pressure change. The urethral resistance to dilatation and the hysteresis were unaffected by the two agents. It is suggested that the response to prazosin is related to decreased activity of the urethral smooth as well as of the striated muscles, the latter as a result of a reduced somatomotor output from the central nervous system.

Adult↗

PubMed1992

The effect of bilateral pudendal blockade on the static urethral closure function in healthy females.

OBJECTIVE: To evaluate the effect of bilateral pudendal blockade on the urethral closure function in the resting state in healthy women. METHODS: Synchronous measurements of pressure and cross-sectional area were recorded at the bladder neck, in the high-pressure zone, and in the distal urethra before and after the pudendal blockade in ten women. RESULTS: The blockade reduced the resting pressure significantly (P < .01) all along the urethra. The viscoelastic indices of elastance (reciprocal of compliance) and hysteresis (difference in pressure at a given degree of urethral dilation when this is increased and decreased stepwise) were significantly (P < .05) reduced. CONCLUSIONS: The striated muscles innervated by the pudendal nerve are of paramount importance for the closure function in the resting state all along the urethra. Urethral elastance and hysteresis seem to depend on activity in the surrounding striated muscle fibers.

Adult↗

PubMed1992

Assessment of voiding dysfunction in men with acute epididymitis.

Fifteen men with a recent attack of acute epididymitis were examined urodynamically and endoscopically after the symptoms had resolved. Thirteen of the 15 patients had abnormal voiding. Two patients had stricture formation in the posterior urethra, one had benign prostatic hyperplasia, one had bladder neck sclerosis, and 4 had detrusor-external sphincter dyssynergia. Three patients including the one with prostatic enlargement presented abdominal straining exceeding 50 cm H2O during micturition. The cause of an obstructive voiding pattern could not be established in 3 patients. The results support the theory of urethrovasal reflux due to a high hydrostatic pressure at the collicular level as a pathophysiological factor in acute epididymitis.

Adult↗

PubMed1991

How to measure urethral elastance in a simple way. Elastance: definition, determination and implications.

The elastance of a biological tube describes the resistance of the latter to dilatation. It is defined as dP/dV, where dP is the pressure increase caused by the volume increase dV. Elastance is the reciprocal of compliance. Elastance in the female urethra can be estimated from the slope of the regression line of related values of pressure and cross-sectional area. In the present study, urethral elastance was calculated by measurement of the related pressures and cross-sectional areas during stepwise dilatation by a balloon and by determination of the pressure at which inflow through side holes in catheters with increasing diameters began. There was no difference between the elastance values obtained by the two methods. Due to the linear correlation found between pressure and cross-sectional area we conclude that urethral elastance can be estimated from measurements of urethral pressure at two or more related cross-sectional areas by a simple technique using e.g., 8F, 14F, and 20F catheters.

Adult↗

PubMed1991

Method for evaluation of the urethral closure mechanism in women during standardised changes of cross-sectional area.

A method for evaluation of the closure mechanism in the female urethra during forced opening has been developed and tested. The cross-sectional area (CA) of the tube and the intraluminal pressure were measured simultaneously by a specially designed balloon catheter. The method enables induction of standardised changes of CA at different rates. Applied in the female urethra the induction results in a distinct pressure response which increases with increasing rate of change of CA as well as size of the induction. The inflation of the balloon simulates a forced opening of the urethra and hence leakage. Obviously, urinary incontinence takes place at forced opening of the urethra. Accordingly, this novel method can give important information on the pathophysiology of stress urinary incontinence in particular and the physiology of sphincter functions in general.

Catheterization↗

PubMed1990

Is micturition disorder a pathogenic factor in acute epididymitis? An evaluation of simultaneous bladder pressure and urine flow in men with previous acute epididymitis.

We evaluated 22 men 22 to 70 years old with previous acute epididymitis by pressure-flow study 3 to 12 months after the inflammation had resolved. Nine healthy men 20 to 62 years old were evaluated as controls. The patients had no symptoms from the lower urinary tract except for 2 men with slight prostatism. The maximum intravesical and maximum voiding pressures were elevated significantly in the patients compared to the controls (p less than 0.05). In most patients and in all of the controls the maximum urinary flow rates were within the normal range according to age. Because of the frequency of high voiding pressures in patients with previous acute epididymitis, this condition may be a pathogenic factor by promoting urethrovasal reflux. The high voiding pressures may be transmitted to the proximal urethra or in cases of a narrow and rigid bladder neck they may produce increased turbulence in the urine stream.

Adult↗

PubMed1990

Variations in urethral and bladder pressure during stress episodes in healthy women.

Pressure variations in the urethra and bladder during stress episodes and their time separations were investigated in 30 healthy female volunteers. The pressure was measured by means of a double microtip transducer catheter with the distal sensor in the bladder and the proximal sensor at the bladder neck, the mid-urethra and the distal urethra. In advance of the pressure spike during cough a pressure rise was demonstrated in the bladder and at all 3 sites of measurement in the urethra. The urethral pressure increments preceding and following the pressure spike were statistically significantly higher in the mid-urethra than the corresponding bladder pressures. This active urethral pressure generation in the mid-urethra and distal urethra was initiated 200 ms before the bladder pressure began to rise. The pressure in the urethral high pressure zone was higher than the bladder pressure in all cases. Passive pressure transmission to the urethral high pressure zone can take place only insignificantly due to a continuous higher pressure inside the urethra than in the bladder and due to the location of the high pressure zone in the demarcation of the abdominal cavity. It was concluded that the urethral pressure rise in the high pressure zone during stress episodes is mainly generated actively by intra- and/or peri-urethral structures.

Adult↗

PubMed1988

The analgesic effect of indomethacin in the early post-operative period following abdominal surgery. A double-blind controlled study.

Patients undergoing major intra-abdominal operations were randomly allocated to receive either 100 mg indomethacin (n = 26) or placebo (n = 20), both given as suppositories, 3 times a day for 3 days. The analgesic effect of indomethacin was measured during the first 5 post-operative days by grading the experience of pain on a closed visual analogue pain scale and further by registration of the amount of narcotics requested. Patients receiving indomethacin had significantly lower pain scores and received significantly fewer doses of narcotics (p less than 0.01). There were only minor side effects which were equally frequent in the 2 groups. These results indicate that indomethacin is an effective analgesic drug in the early post-operative period.

Abdomen↗

PubMed1987