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Biomedical subjects

T Hald

Publications and source records attributed to T Hald.

At least 109 records · Page 6Linked to original sources
PubMed1982

Urodynamic evaluation after vaginal repair and colposuspension.

Eighty-six consecutive patients with urinary incontinence and/or genital prolapse were evaluated by urodynamic examination and colpo-cysto-urethrography before and after vaginal repair or colposuspension procedures. None of the patients had had a previous operation for genital or lower urinary tract disorders. The follow-up period exceeded one year. In the vaginal repair group there was a significant decrease in opening time and an increase in pre-micturition pressure and maximum flow rate. In the colposuspension group there was an increase in pre-micturition pressure, opening pressure, mean micturition pressure, post-micturition pressure, flow time and pressure time and a decrease in maximum flow and mean flow. Vaginal repair appears to reduce urethral resistance, while colposuspension tends to increase outflow resistance. Colposuspension should be avoided in patients with poor or absent detrusor function.

Adult↗
PubMed1982

The effect of prostatectomy on upper urinary tract function.

59 patients with obstructive prostatic hypertrophy (BPH) were evaluated regarding the influence of prostatectomy on upper urinary tract function by means of [51Cr]EDTA clearance and gamma camera renography measurements. 25 patients were randomly allocated to transvesical and 34 patients to transurethral prostatectomy. At the 6-month follow-up a slight decrease in glomerular filtration rate (GFR) was seen in the total patient group. Residual renal activity 20 min following injection (A20) as well as half-peak time values showed upper urinary tract obstruction in 54% of the patients preoperatively, whereas dilatation of the upper urinary tract was demonstrated at i.v. pyelography in only 15%. Patients with renographic obstruction preoperatively had low GFR values compared with patients without obstruction. In patients with upper urinary tract obstruction, prostatectomy relieved the obstruction, even in the case of normal urography. In patients with normal upper urinary tract, a clinically insignificant decrease in GFR and increase in A20 and half-peak time was observed. No differences with regard to upper urinary tract function were seen on comparing transurethral with transvesical prostatectomy.

Aged↗
PubMed1981

Monolayer cultures of cells originating from ultrasonically guided fine needle aspiration biopsies.

Explantation of small samples of tissue obtained by ultrasonically guided fine needle aspiration biopsy (0.6 mm outer diameter) from intraabdominal solid masses was performed in 25 patients. In 7 cases, the material was taken from nonmalignant tissue and in 18 from malignant lesions. Growth during 30 days or more obtained in 1 of the 7 nonmalignant cases and in 7 of the 18 malignant cases. The morphological appearance of three cultures in monolayer is demonstrated.

Abdominal Neoplasms↗
PubMed1981

Sympatholytic effect on striated urethral sphincter. A peripheral or central nervous system effect?

Effects of intravenous administration of sympatholytic drugs on urethral pressure and electromyographic activity from urethral and anal sphincter, were investigated in five normal women. Clonidine (Catapresan), which easily passes the blood brain barrier, resulted in a pronounced decrease in urethral pressure and electromyographic activity from both sphincters. Phentolamine (Regitine), which does not pass the blood brain barrier, also lowered urethral pressure but had no effect on electromyographic activity from the sphincters. Neither drug depressed reflex induced increase in urethral pressure and sphincter activity during bladder filling or during voluntary contraction of the pelvic floor muscles. Phenoxybenzamine administration to one normal female had the same effect as clonidine. It is suggested that part of the clinical effect on voiding disorders seen after treatment with sympatholytic drugs passing the blood brain barrier (e.g. phenoxybenzamine) might be due to an effect on the central part of the striated urethral sphincter innervation.

Adult↗
PubMed1981

Neuromuscular dysfunction of the lower urinary tract with special reference to the influence of the sympathetic nervous system.

Filling cystometry, urethral and anal sphincter electromyography, pressure-flow registration, urethral closure pressure profile at rest and after alpha-adrenoceptor blockade with phentolamine, evoked potential of the bulbocavernosus reflex and denervation supersensitivity to carbachol in a-reflexic bladders were performed in 57 consecutive patients with a localized neurological lesion, in order to evaluate the relative importance of the somatic, the parasympathetic and especially the sympathetic nervous system for the function of the lower urinary tract. In spinal lesions with detrusor hyperreflexia, dyscoordination between detrusor and striated urethral sphincter was dominant, while in cauda equina lesions and in lesions of the pelvic nerves the lack of parasympathetic bladder innervation dominated. It was not possible to identify specific spinal segments controlling sympathetic nervous regulation of the lower urinary tract. The only influence of the sympathetic nervous system was a control of urethral pressure, where a statistically significant smaller proportion of the maximal urethral pressure was affected after alpha-adrenergic blockade in patients with peripheral nerve lesions. All a-reflexic bladders exhibited denervation supersensitivity to carbachol, while carbachol did not change urethral pressure significantly indicating minimal influence of the parasympathetic nervous system on urethral pressure.

Adolescent↗
PubMed1981

Urethral denervation supersensitivity to noradrenaline after radical hysterectomy.

Urethral closure pressure profiles were registered before and during intravenous infusion of noradrenaline in 7 female patients who had undergone radical hysterectomy, and in whom a bladder denervation supersensitivity test to carbachol previously had been positive. Patients who had a completely denervated bladder had a greater rise in maximum urethral pressure during noradrenaline infusion (exceeding 20 cm H2O) than normal subjects (1 to 15 cm H2O). Urethral supersensitivity to noradrenaline may be a promising test in diagnosing damage of the sympathetic nervous innervation of the lower urinary tract.

Adult↗
PubMed1981

Accuracy in preoperative estimation of prostatic size. A comparative evaluation of rectal palpation, intravenous pyelography, urethral closure pressure profile recording and cystourethroscopy.

In a prospective study of 75 patients with prostatic hypertrophy a comparison was undertaken of the accuracy in estimates of operative prostatic weight from conventional preoperative investigations. Estimates from rectal digital palpation alone and from intravenous pyelography (prostatic impression, elevation of the bladder base as well as the configuration of distal ureters) were without significant correlation to operative weights, and were not found useful for preoperative estimation of prostatic size. Prostatic length in urethral closure pressure profile measurements as well as the distance from bladder neck to verumontanum and the weight estimated at cystourethroscopy were statistically significantly correlated to operative weights with a coefficient of correlation in the order of 0.5 and were judged useful, although not very precise in the clinical work.

Aged↗
PubMed1981

Appendico-vesical fistula and persistent urachus in a patient with hematuria.

A 35-year-old man had been treated with sulfamethizole on 6 occasions because of recurrent urinary tract infections. Furthermore, he had experienced diffuse monosymptomatic hematuria for 15 years. Cystoscopy and biopsy demonstrated irregular intestinal mucosa. Physical examination and intravenous urography were normal. Preoperative diagnosis was urachus-derived adenoma with the possibility of adenocarcinoma. At operation a typical urachus and--surprisingly--an appendico-vesical fistula was found.

Adult↗
PubMed1981

Incontinence surgery in females with motor urge incontinence.

Forty-one consecutive female patients were operated on despite the finding of motor urge incontinence; they were reinvestigated six months to two years after operation. Seventeen of the patients had associated symptomatic genital prolapse and were operated without previous pharmacological treatment. The remaining 24 patients were resistant to parasympatholytic treatment. The method of operation was based on vaginal examination and evaluation of bladder suspension defect at voiding-cystourethrography. Cure and improvement rate was 73 per cent. Cystometry was normalized in 30 per cent of all patients and in 45 per cent of patients with preoperative detrusor instability on provocation only. Disappearance of detrusor instability as well as normalization of a bladder suspension defect was associated with a good result. Motor urge incontinence should not contraindicate incontinence surgery on females selected and treated as in the present study.

Adult↗