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Biomedical subjects

T Hald

Publications and source records attributed to T Hald.

At least 127 records · Page 7Linked to original sources
PubMed1980

Extraperitoneal pelvioscopy: a new aid in staging of lower urinary tract tumors. A preliminary report.

A new technique to obtain biopsy specimens from the pelvic lymph nodes is presented. A mediastinoscope introduced through a small incision in the abdominal wall allows the identification of the pelvic nodes. A series of 12 patients with prostatic or bladder carcinoma is presented and the feasibility of the method is documented. There was no morbidity associated with the endoscopic node biopsy. Suggestions for modification of the instrument are made. The method is now under further scrutiny to establish its place among other available methods to study lymphogenous spread of pelvic malignancies.

Aged↗
PubMed1980

Neurogenic bladder.

A survey of the innervation of the bladder and urethra is presented. Based on the defects of innervation the main types of neurogenic bladder disorders are classified and described. The principal diagnostic procedures, cystometry and sphincter-electromyography, are reviewed in detail. The findings at voiding cysto-urethrography are depicted. It is important to be able to distinguish between voiding disorders of non-neurogenic and neurogenic origin. The specific treatment of the various types of neurogenic disorders of the lower urinary tract is described.

Autonomic Nervous System↗
PubMed1980

Anterior bladder suspension defects in the female. Radiological classification with urodynamic evaluation. Anatomically corrective operations.

Colpo-cysto-urethrography, urodynamic and cystometric examinations were performed in 420 patients from the departments of urology and gynecology. One hundred and ninty-eight patients displayed displacement of the urethro-vesical junction in the anterior and inferior direction. Three grades of displacement were established. The mildest form, grade 1, was visible only during a cough. The intermediate form, grade 2, was present even at rest. The severest form, grade 3, involved a displacement of the anterior vaginal wall, resulting in anterior bladder descent during cough and/or micturition. Stress incontinence was a complaint in 82 per cent of the women. The pathology is shown to be laxity of the arcus tendineus fasciae pelvis, which normally exerts a pull on the bladder neck in a postero-cranial direction. In seven cases anatomically corrective operations on this ligament were performed, resulting in a normal bladder base in an anatomically correct position. The operation is complicated and not suited for routine use.

Female↗
PubMed1980

Recurrent urinary incontinence treated neurosurgically.

Neurogenic bladder dysfunction can be difficult to manage and is usually impossible to cure. This case report describes neurosurgical treatment of a case of recurrent urinary incontinence in a 56 years old woman who was previously treated on four occasions with vaginal repair operations with no beneficial effect. Cystometry revealed detrusor hyperreflexia (supranuclear bladder paresis). Myelography demonstrated cervical spinal cord compression. She was treated with spondylodesis of the cervical spine with complete relief of incontinence. 18 months postoperative cystometry was normal and after three years she was free of symptoms.

Female↗
PubMed1980

Functional bladder neck obstruction. Late results after endoscopic bladder neck incision.

The effect of endoscopic bladder neck incision for functional bladder neck obstruction was assessed in 28 consecutive patients with a follow-up period of up to 50 months. The operation had excellent effect on the patients' symptoms consisting mainly of weak stream and/or recurrent urinary infections. Uroflowmetry at the postoperative follow-up study showed a statistically significant increase in as well maximum flow rate as mean flow rate. The bladder neck incision carried very few complications, and the average postoperative stay in hospital was 2.8 days. It is important to be aware of the condition functional bladder neck obstruction, and the diagnosis should be based upon uroflowmetry and voiding cystourethrography. In borderline cases with only slightly reduced urinary flow rate, additional pressure-flow studies should be applied to demonstrate infravesical obstruction.

Adult↗
PubMed1979

Dilatation of the resting posterior urethra in spinal cord injury patients.

In 26 patients with detrusor-sphincter dyssynergia after a spinal cord injury the resting posterior urethra at cystography was found either closed as in normal subjects or open to a varying degree. Highest intravesical pressure measured at cystometry during uninhibited detrusor contraction was statistically significantly related to the degree of dilatation of the resting posterior urethra. An even higher correlation coefficient was found between the dilatation of the resting posterior urethra and an arbitrary score calculated on the basis of highest cystometric pressure and duration of disease since spinal cord injury. The possible importance of this finding in relation to incontinence after urethral sphincterotomy is discussed.

Adult↗
PubMed1979

Evoked response of the bulbocavernosus reflex.

The bulbocavernosus reflex can be elicited either by penile or urethral stimulation. The mean signal transit time after electrostimulation of the dorsal penile nerve to evoked response in the anal sphincter (35 msec) was only half the signal transit time after stimulation in the posterior urethra (60 msec). Thus, the modified bulbocavernosus reflex elicited either by squeezing the glans penis or by pulling a urethral balloon catheter represents two different reflexes with differenct afferent and probably different intraspinal pathways. In the clinic it is therefore important, when testing the bulbocavernosus reflex, to report how it is elicited.

Adult↗
PubMed1979

Bladder function in urologically normal middle aged females. A urodynamic and radiological investigation.

The bladder function was studied in 15 urologically normal females over 40 years of age. They volunteered for this study which consisted of urodynamic studies and lateral micturition cystourethrography. The data are presented in tables. There are only small differences in the urodynamic parameters between this material and a material of women under 40 years of age. It is clearly demonstrated that a gynaecological cystocele tells little or nothing about the bladder function or bladder support. None of the cystometrograms showed uninhibited detrusor contractions. It is underlined to repeat the micturition studies several times in order to obtain a voiding event which the subject recognizes as normal.

Adult↗
PubMed1979

Bladder denervation procedures.

Bladder denervation can provide useful rehabilitation of bladder function when other measures have failed. Idiopathic hyperactivity may respond best to hyperbaric distension or bladder transection. Procedures performed close to the bladder seem, at present, to be more effective than those near the central nervous system. Procedures have little morbidity, apart from transection. On the average a 50 per cent improvement may be expected, but in all cases it is most important to consider the length of follow-up in reported series.

Denervation↗
PubMed1978

Are doctors able to assess prostatic size?

The between-observer variation was evaluated through three independent estimates of preoperative prostatic weight in each of 40 patients. Error in the estimates was of considerable magnitude irrespective of size of prostates. Experienced urologists did not attain a more reliable estimate than unexperienced doctors. Only about 2/3 of estimates were correct within a range of +/- 25 g. However, there was a statistically significant correlation between estimated and actual operative prostatic weight.

Clinical Competence↗