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T Hald

Publications and source records attributed to T Hald.

At least 55 records · Page 3Linked to original sources
PubMed1991

A patient weighted symptom score system in the evaluation of uncomplicated benign prostatic hyperplasia.

A new scoring system is presented for use in patients with uncomplicated benign prostatic hyperplasia. The system is based on the patients' information on the magnitude of twelve symptoms related to bladder and voiding function (symptom score), and three questions related to sexual function. Furthermore the patients are asked to grade the impact of these symptoms on their daily lives (bother score). Multiplication of the two scores related to bladder and voiding function gives the total score. The score related to sexual function is used only for comparing the situation before and after treatment. The new patient weighted total score may assist in creating a solid base for the indication for and evaluation of surgical and non-surgical treatment of uncomplicated benign prostatic hyperplasia.

Humans↗
PubMed1991

World Health Organization Consensus Committee recommendations concerning the diagnosis of BPH.

The expert committees, which met in Paris in June 1991 under the patronage of WHO to establish a consensus concerning BPH, adopted the recommendations summarised in this report. Despite certain criticisms which can be made, these recommendations offer the advantage of simplicity and uniformity, thereby constituting a "universal language". This will facilitate comparison of patients and therapeutic results, both in everyday practice and in the course of clinical trials. These recommendations will be periodically re-evaluated in the light of clinical experience and technological progress.

Clinical Protocols↗
PubMed1991

Evoked potentials from the lower urinary tract. II. The spino-cortical neuraxis. A methodological study.

Spinal and cerebral evoked potentials (EPs) on stimulation of the dorsal nerve of the penis, clitoris, bladder wall and posterior urethra were recorded in 20 normal subjects (10 females and 10 males). Responses were obtained by computer averaging of multiple potentials registered over the spinal cord (L1) and cerebral cortex. Responses from the posterior tibial nerve were also recorded. Consistent cortical responses were obtained from the pudendal nerve, bladder wall and posterior urethra, whereas spinal responses were difficult to record. The maximum responses after stimulation of the pudendal nerve, bladder wall and posterior urethra were recorded over the midline of the scalp at CZ-2 cm point. The configuration of the somatosensory evoked potentials of the pudendal nerve had a W-shape with a consistent positive peak P1 (median 42.0 msec, range 39-45 msec), whereas the responses after endovesical and endourethral stimulation mainly were M-shaped with a prominent negative peak N1 (Bladder: mean 104.0 msec, range 75-112 msec and posterior urethra: median 103.0 msec, range 78-114 msec). Conduction times within the central spinal pathways could be calculated by subtracting the latencies of the peripheral spinal potentials from the central cortical potentials.

Adult↗
PubMed1990

[Urinary incontinence. Experiences with the artificial urethral sphincter AS 800].

Since 1983, 62 patients with incontinence of urine (43 men and 19 women) were treated with an artificial sphincter model AS 800. During the period of observation, the artificial sphincters were removed in five patients on account of complications and six patients had died. In 22 patients, a total of 34 operations were required on account of complications. Out of 51 patients with artificial sphincters at the time of this review, 43 (84%) had experienced improvement: 15 (29%) were completely continent and 18 (35%) had only slight stress incotinence. It is concluded that the technical improvement which has taken place has improved the therapeutic results and approximately halved the number of complications requiring treatment.

Adolescent↗
PubMed1990

Failure of combined supratrigonal cystectomy and Mainz ileocecocystoplasty in intractable interstitial cystitis: is histology and mast cell count a reliable predictor for the outcome of surgery?

Eight women with severe intractable interstitial cystitis were treated with supratrigonal cystectomy and Mainz ileocecocystoplasty. The preoperative evaluation consisted of symptom analysis, cystometry, cystoscopy and bladder pathological findings. Seven patients had increased mast cell density. Median followup was 10 months. The symptoms resolved in 2 patients but recurred in 6 shortly after the operation. Voiding could not be established in 4 patients. Self-catheterization was difficult and painful. Ultimately, cystectomy and urinary diversion were performed in 5 patients and is scheduled in 1. The 2 cured patients had a small contracted bladder preoperatively while they were under anesthesia, while all 6 failed cases had a large bladder capacity. Postoperative biopsies from the trigone showed no difference in the amount of fibrosis, the degree of degenerative changes in the muscle and mast cell density between the 2 cured patients and the 6 who failed to improve. The mast cell density and the histological status of the trigone cannot be used as predictors of the outcome of supratrigonal cystectomy. The role of the mast cells in interstitial cystitis is reviewed. Combination of supratrigonal cystectomy and a Mainz augmentation cystoplasty cannot be recommended in patients with intractable interstitial cystitis and a large bladder capacity.

Cecum↗
PubMed1990

Upper urinary tract deterioration after implantation of artificial urinary sphincter.

The preoperative urodynamic evaluations of twenty patients with myelomeningocele who had had artificial sphincter implantation because of urinary incontinence were reviewed. Four patients developed hydronephrosis and severe impairment of renal function between two and six years after implantation of the artificial sphincter. The condition was partly reversible after removal of the artificial sphincter. The urodynamic evaluation prior to implantation revealed in the four mentioned patients compared to the 16 patients with normal upper urinary tract, a tendency to lower bladder compliance, lower bladder capacity and more severe detrusor hyperreflexia, but it was not possible to make a clear discrimination between the two groups. Attention is drawn to this unfortunate combination of effects after artificial sphincter implantation. Periodic control of the upper urinary tract by urography is recommended.

Adolescent↗
PubMed1989

Urodynamics in benign prostatic hyperplasia: a survey.

Urodynamic investigations have been used in the diagnosis of prostatic obstruction for the last 30 years. The methods have changed, and the emphasis is now more on diagnosing borderline cases and ruling out obstruction than actually demonstrating the obstruction. The philosophy surrounding the clinical management of benign prostatic hyperplasia (BPH) is changing. Three concepts are useful in this context: the presence of actual prostatic enlargement, the symptomatology, and the presence of urodynamic obstruction. These items are not always present together. It is of extreme importance for our understanding of BPH to realize the way these concepts interrelate. The paper stresses the importance of detrusor-related phenomena in the symptomatology and urodynamics.

Aged↗
PubMed1989

Standardized evaluation of erectile dysfunction in 95 consecutive patients.

We investigated 95 patients referred for erectile dysfunction by penile blood pressure measurement, the intracavernous papaverine test and Doppler investigation of the penile arteries. Furthermore, penile cutaneous perception threshold, bulbocavernosus reflex latency and somatosensory cortical evoked potentials of the pudendal nerve were measured. In selected cases cavernosometry, cavernosography and corpus cavernosum electromyography were performed. Doppler investigation of the cavernous arteries after papaverine injection was more reliable than penile blood pressure measurement in the diagnosis of arteriogenic erectile dysfunction. Decreased sensibility of the penis may be the sole factor responsible for inability to sustain an erection. Erectile dysfunction may be provoked by impaired function of the pudendal nerve. Penile cutaneous perception threshold measurement and corpus cavernosum electromyography are mandatory in the evaluation of neurogenic etiology. Cavernosometry and cavernosography are reliable methods in the determination of abnormal drainage from the corpus cavernosum.

Adult↗
PubMed1989

Polyamines and other accessory sex gland secretions in human seminal plasma 8 years after vasectomy.

In 56 males, vasectomized 8 years previously, and in 56 age-matched non-vasectomized controls, a number of secretory products of prostatic, seminal vesicular and epididymal/testicular origin were used to monitor post-operative changes in accessory sex gland function. Significant reductions were observed in seminal plasma volume (3.0 vs 4.9 ml, P less than 0.01), and the total ejaculate contents of zinc (5.1 vs 9.7 mumol, P less than 0.01), magnesium (10.6 vs 26.5 mumol, P less than 0.01), PAP (371 vs 1260 IU, P less than 0.005) and citric acid (76.7 vs 127.9 mumol, P less than 0.05), indicating a major impact on secretions of prostatic origin. Unaltered PGE-1 (54.3 vs 53.2 micrograms, P less than 0.95) and fructose (3.9 vs 4.5 mumol, P greater than 0.1) indicated no effects on the secretory function of the seminal vesicles. A marked reduction was demonstrated in the ejaculatory contents of the polyamines, spermidine (366 vs 650 nmol, P less than 0.005) and spermine (5435 vs 11 804 nmol, P less than 0.05) but not their acknowledged precursor, putrescine, which is also of prostatic origin.

Acid Phosphatase↗
PubMed1989

The artificial sphincter in the treatment of congenital incontinence.

From 1974 to 1988 the available AMS artificial sphincter models (AS 721, AS 761, AS 742, AS 791, AS 792 and AS 800) were implanted in 40 patients with congenital incontinence using a total of 75 prostheses. Despite mechanical problems with the earliest models 82.5% of all patients obtained a good result. The definitive failure rate due to urethral erosion was 2.5% and due to infection of the prosthesis 7.5%. The remaining failures were due to upper urinary tract deterioration in four patients.

Adolescent↗
PubMed1988

The long-term influence of vasectomy on prostatic volume and morphology in man.

During the past two decades several papers have described the changes in prostatic secretory capacity following vasectomy. Based upon results indicating a reduction of secretory function, it was suggested that even prostatic size and the incidence of benign prostatic hyperplasia (BPH) might be altered after the operation. In this study, which included 56 males who had been vasectomized 8 years previously and 56 age-matched control persons, transrectal ultrasonic scanning of the prostate was used for exact measurements of the prostatic volume and for the investigation of intraprostatic echo pattern. The total prostatic volume, the volume of the periurethral gland, and the volume of the peripheral zone were not influenced by the vasectomy; nor was the growth rate of these zones affected. In the vasectomy group, the frequency of adenomatous prostates was 19.6%, whereas 30.3% of prostates in the control group had ultrasonic signs of BPH. However, this is not a statistically significant difference. Subdividing the material according to age did not reveal altered BPH frequency in any age group when vasectomized and controls were compared.

Humans↗
PubMed1988

Bladder tumor staging by transurethral ultrasonic scanning.

To determine tumor stage, 115 bladder cancer patients with cystoscopic suspicion of invasion underwent transurethral ultrasonic scanning. Seventeen patients who had received radiotherapy were excluded because it proved impossible to differentiate between tumor and irradiation sequelae. Of the remaining 98 examinations, 4 (4.1%) were inconclusive, 73 tumors (74.5%) were correctly staged, 16 tumors (16.3%) were overstaged and 5 tumors (5.1%) understaged. Transurethral ultrasound is regarded a useful supplement to cytoscopy and biopsy in staging of bladder tumors suspected of invasion.

Biopsy↗
PubMed1988

Partial cystectomy for the myogenic decompensated bladder with excessive residual urine. Urodynamics, histology and 2-13 years follow-up.

Partial cystectomy was performed for myogenic decompensated bladder with excessive residual urine in 11 patients, in whom training instructions and pharmacological treatment were unsuccessful. Postoperatively, the patients were followed for 2-13 years (median 4 years). Both symptoms and residual urine were reduced permanently. Urodynamic testing had demonstrated underactive detrusor function in all. The supposed etiology was infravesical obstruction in 4, overdistension due to sensory bladder paresis in 3 and unknown in 4. Histological examination of the resected bladders showed focal degeneration of the smooth muscle cells (detrusor myopathy) in 7, transmural edema and vast deposits of collagen in 8, mastocytosis in 3 and eosinophilic cystitis in 1. In conclusion we regard partial cystectomy an alternative to clean intermittent self-catheterization in selected patients with excessive residual urine.

Adult↗
PubMed1987

Implantation of a pressure cuff around the subphrenic oesophagus.

The possibility of implanting a pressure cuff around the subphrenic oesophagus as a barrier to reflux was tested in six pigs. The oesophagus tolerated cuff pressures from 48 to 95 cmH2O, corresponding to intra-oesophageal pressures from 27 to 75 cmH2O. The pigs with the perioesophageal cuff swallowed a solid diet without difficulty. However, dysphagia occurred in pigs kept alive for more than a month and the main reason was malfunction of the device because of surrounding fibrosis. This problem should be solved before implantation of the device in humans is attempted.

Animals↗