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Biomedical subjects

S L Stanton

Publications and source records attributed to S L Stanton.

At least 109 records · Page 6Linked to original sources
PubMed1984

Long-term follow-up of surgery for urinary incontinence in elderly women.

This study reviews the 3- to 5-year follow-up of 35 elderly women treated by colposuspension for incontinence due to urethral sphincter incompetence (genuine stress incontinence). All patients had pre- and post-operative urodynamic studies and were followed up annually by clinical assessment and Urilos test. Thirty-two patients were subjectively cured and 31 objectively cured. Cystocele was corrected by the colposuspension. Rectocele and enterocele were frequently encountered at follow-up and prophylactic closure of the pouch of Douglas or posterior repair were recommended. Although the peak urine flow rate measurements at follow-up were reduced, no patient encountered difficulty in bladder emptying. The low operative and post-operative morbidity rate was due to careful pre-operative medical selection.

Aged↗
PubMed1983

Urethral pressure measurement by microtransducer: the results in symptom-free women and in those with genuine stress incontinence.

Urethral pressure measurements were recorded at rest and during stress by a microtransducer technique in 20 women without urinary symptoms and 120 women with urodynamically proven genuine stress incontinence. In the symptom-free women the resting profile values were largely maintained during stress, as a consequence of 100% transmission of intra-abdominal pressure rises to the proximal three-quarters of the functional urethral length. Whilst the majority maintained continence at the bladder neck level, 25% of these controls showed evidence of bladder neck opening during stress. The stress-incontinent patients showed a deficiency of pressure transmission ratios which appeared to have an 'all or none' character in the determination of symptoms. The amplitude and stability of the maximum urethral closure pressure at rest, the extent of urethral closure pressure lost in response to stress, and the extent of intrabdominal pressure rises interact to determine the severity of symptoms or 'margin to continence'.

Adult↗
PubMed1983

A clinical and urodynamic assessment of the Burch colposuspension for genuine stress incontinence.

Twenty-five women having a Burch colposuspension operation were assessed before and after the operation by urodynamic investigations including urethral pressure measurements at rest and on stress. After 3 months, the objective cure rate was 88%. An increase in voiding difficulty and urodynamic evidence of outflow obstruction was seen after the operation. The operation does not induce any significant change in resting urethral profile variables. The stress profile showed accentuation in pressure transmission ratios, most marked in the proximal urethra. These changes are likely to be mechanical in origin and may be responsible for voiding difficulties in those women who initiate voiding by straining.

Adult↗
PubMed1983

The use of intravaginal oestrogen cream in genuine stress incontinence.

Ten women presenting with symptoms of post-menopausal urogenital oestrogen deficiency, including atrophic vaginal changes and a variety of urinary symptoms, were studied urodynamically and shown to have genuine stress incontinence. Their urethral function was assessed by resting and stress pressure profiles before and after treatment with an intravaginal oestrogen cream. A reduction in the severity of symptoms of stress incontinence, urgency and voiding difficulties was found. No significant changes were induced in the resting urethral pressure profile although the maximum urethral closure pressure on stress was significantly increased as a consequence of improved pressure transmission in mid-urethra. The distribution of pressure transmission suggests that the effect of oestrogen therapy may be due to improved efficiency of urethral closure by the pelvic floor in response to stress.

Aged↗
PubMed1983

The use of desmopressin (DDAVP) for nocturia in women with multiple sclerosis.

Sixteen women with multiple sclerosis who complained of nocturia completed a double-blind cross-over trial of Desmopressin (DDAVP) and placebo. Nocturia was reduced from a mean of 2.55 voids to 2.01 with placebo and to 1.28 with Desmopressin (p less than 0.01, for the difference between placebo and Desmopressin). Side effects were minor, and equally distributed between treatment and placebo.

Arginine Vasopressin↗
PubMed1983

Voiding difficulties in the female: prevalence, clinical and urodynamic review.

The urodynamic questionnaires of 600 consecutive female patients attending a urodynamic clinic with a variety of urologic symptoms were reviewed. Investigations consisted of independent uroflowmetry and either twin-channel subtracted cystometry or videocystourethrography with synchronous bladder pressure and urine flow recordings. Urodynamic evidence of voiding difficulty was defined as a repeated peak flow rate of less than 15 ml/sec or more than 200 ml of residual urine. One hundred ninety-five patients complained of voiding difficulties; this was substantiated in only 87. An additional 12 patients had no symptoms suggestive of impaired voiding, but had urodynamic evidence of voiding difficulty. Symptoms of voiding difficulty were found to be unreliable. Neurologic disease was a significant etiologic finding. Uroflowmetry was advised for patients who were to undergo suprapubic surgery for incontinence or radical pelvic surgery.

Adult↗
PubMed1982

The use of desmopressin (DDAVP) in nocturnal urinary frequency in the female.

Twenty-five patients complaining of nocturia completed a double-blind cross-over trial using desmopressin (DDAVP) and placebo. All had failed to respond to treatment with antispasmodic agents and evening fluid restriction. The drugs were given as a single intranasal dose on retiring. Nocturnal urinary frequency was reduced from a mean of 3.2 episodes to 2.6 with placebo and 1.9 with DDAVP (0.01 greater than P greater than 0.001). Diurnal urinary symptoms were not significantly affected and side effects were minimal. This drug seems to have a place in the treatment of nocturia, where more conventional therapies have failed.

Administration, Intranasal↗
PubMed1982

Clinical and urodynamic effects of anterior colporrhaphy and vaginal hysterectomy for prolapse with and without incontinence.

The clinical and urodynamic effects of anterior colporrhaphy and vaginal hysterectomy were studied in 73 patients, of whom 29 had incontinence due to urethral sphincter incompetence. Pre-and post-operative urodynamic assessment was made and follow-up continued for 2 years. Symptoms of urge incontinence, stress incontinence and prolapse were significantly reduced following surgery. Urodynamic data showed no significant change. The incidence of detrusor instability and voiding difficulties was not increased.

Female↗
PubMed1981

Algorithmic method for assessing urinary incontinence in elderly women.

In young patients the assessment of urinary incontinence is based increasingly on the results of complex urodynamic investigations. The value of such techniques in the elderly, however, is as yet unproved. Based on the clinical and urodynamic findings in 100 incontinent elderly women an algorithmic method for managing such patients was devised. A retrospective study comparing the algorithmic outcome with the results of standard urodynamic assessment showed that 60% of invasive investigations could be avoided by this method with minimal loss of diagnostic accuracy.

Aged↗
PubMed1981

Detection of urinary incontinence.

Thirty patients complaining of stress incontinence were investigated by clinical examination, videocystourethrography and Urilos device. The latter was the most effective method of confirming the history. Standing and lying made no difference to detection of incontinence on clinical examination. A scheme for use of these investigations was proposed.

Adolescent↗