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Biomedical subjects

U Jonas

Publications and source records attributed to U Jonas.

At least 253 records · Page 14Linked to original sources
PubMed1981

Telemetric urodynamic investigations in female incontinence.

The usual method of filling cystometry fails to assess the mechanism of urinary leakage in more than half the women who complain of incontinence. Telemetric studies with televised observation provide the patient with a relative degree of privacy and thus make possible urodynamic investigations independent of restrictive laboratory conditions. Twelve women (mean age 49.8 years) underwent usual cystometric studies and subsequent telemetric urodynamic study via identical catheters and electrodes. In regular cystometry urine loss was detected in four of 12 women, while telemetric study allowed evidence of urine loss in seven of 12 women. Leakage was provoked by raised bladder pressure under various simulated stress conditions. Five non-incontinent women in the telemetric study had markedly lower bladder pressures under stress conditions than the remainder of the patients. During the voiding phase, maximum and average flow rates were increased in the telemetric study despite a slightly reduced micturition pressure and a reduced volume voided. Our discussion shows this finding to be related to lowered psychogenic stress. The introduction of telemetric techniques in urodynamics provides a further refinement of investigative methods, which may help to better understand bladder and sphincter behavior both in normal physiologic conditions and in cases of pathologic changes.

Adult↗
PubMed1980

Silicone-silver penile prosthesis: description, operative approach and results.

A silicone penile prosthesis in which silver wires are embedded to allow for voluntary bending of the penis for urination and resting position and for straightening for intercourse is described. The implantation is done via a hemicircular incision on the dorsum of the penis in the sulcus coronarius. Buck's fascia is identified and opened, and the corpora are dilated up to 30F. After the exact length is determined with a special sizer the prosthesis is slipped into each corpus cavernosum. The advantage of this approach is the optimal insertion of the prosthesis distal to the sulcus coronarius, thereby preventing kinking of the glans during intercourse. Our experiences with the implantation in 17 patients followed for 1 to 14 months showed successful results in 15.

Humans↗
PubMed1980

Male stress incontinence. Diagnostic work-up and therapteutic considerations.

Urinary incontinence in 80 men was classifed by combined radiological and urodynamic techniques. 28 cases of pure stress incontinence were evaluated for grading of sphincteric loss. Clinical and sphincterometric data were correlated. Functional urethral length, urethral closure pressure at rest and with voluntary sphicter activation, and pressure transmission under stress were used to estimate the remaining sphincteric functions. Theoretical guidelines are drawn for the use of operative sphincter repair based on the grade of stress incontinence.

Adolescent↗
PubMed1980

Telemetric urodynamic investigations in normal males.

To study the applicability of telemetry in urodynamics, 10 healthy males were evaluated by both standard and telemetric urodynamic techniques. TV observation made correlation of the data with the actual situation possible. During bladder filling, intravesical pressure could be registrated in a lying, sitting and standing position. Stress conditions such as walking, running, climbing steps, kneebends, push-ups and even handstands were tested. Detrusor instability was detected with telemetric techniques in 6 volunteers, while regular cystometry showed evidence of instability in only 2 cases. Desire to void occurred in telemetric studies at lower bladder volume than in regular cystometry. A normal voiding phase was registered in all telemetric investigations, while 3/10 men displayed an abnormal micturition pattern in regular sitting cystometry. The advantages of telemetric urodynamic investigations are: (1) simulation of several stress conditions because of the patient's independence of stationary laboratory equipment; (2) lowered psychogenic stress as the patient is left undisturbed and can urinate in a normal position and (3) 24-hour investigations. It is indicated in (1) incontinence if no urine loss can be detected by regular cystometry; (2) micturition disorders in psychogenic inhibition of micturition is suspected, and (3) enuresis if 24-hour investigations are desired.

Adult↗
PubMed1980

Curiosity in urology? Masturbation injuries.

48 masturbation injuries (12 cases of foreign bodies introduced into urethra and urinary bladder and 36 cases of 'vacuum cleaner injuries' to the penis) were seen. One case is reported. Reference is made to the necessity for psychiatric follow-up treatment after urological therapy.

Female↗
PubMed1979

Interstitial cell tumor of testis: a delicate problem.

Interstitial cell tumor of the testis is a rare tumor in humans. There have been 39 cases reported in children and 13 malignant tumors in adults. Two cases of interstitial cell tumor in childhood, 5 benign types in adults, and 2 malignant tumors are presented herein. In regard to the therapeutic consequences, a plea is made to define the malignant potential of the tumor on histologic criteria alone.

Adult↗
PubMed1979

Indication and value of bladder neck incision.

200 bladder neck incisions in 172 patients with mechanical or functional outlet obstruction of neurogenic and nonneurogenic etiology are reported. The incision was performed with an electric cautery needle at 5--7--12 o'clock. Parameters of success were, beside the subjective reports, residual urine, urinary flow and a sophisticated urodynamic study. 71% of the women and 76% of the men showed improvement or relief of symptoms. Retrograde ejaculation was observed in only 7% of the men; the rate of complications was 2.5%. Despite limited experience and the lack of long-term follow-up, this technique is recommended for routine use.

Adolescent↗
PubMed1979

Effect of flavoxate on hyperactive detrusor muscle.

The effect of Flavoxate on hyperactive detrusor contraction was studied in 37 patients, including 11 patients in whom the drug was administered intravenously during the urodynamic study. Beside the evaluation of frequency, nocturia and enuresis, the amplitude and the onset of uninhibited detrusor contraction (in correlation to bladder volume) was registered. The results showed subjective improvement in 61.3%. The complaints mentioned above improved in approximately 50%. The urodynamic data showed diminishing of the mean pressure during uninhibited detrusor contraction by almost 50% and the delay of the onset by 80% of bladder capacity. However, average bladder capacity increase was only 19%. It finally became obvious that the effect of Flavoxate was markedly worse in the neurogenic bladder group in comparison to the motoric urge patients.

Adolescent↗
PubMed1979

[Urodynamics of normal and disordered miction].

The lower urinary tract undergoes a threefold nervous regulation. The normal miction is characterized by the fact that in the contraction of the detrusor an active reflected relaxation of the urethral occlusive mechanism develops. This could be proved experimentally at an animal model. On principle the miction could be disturbed on four ways: Incontinence, obstruction, neurogenic bladder, instability of the bladder. The most important differential diagnosis in the incontenencies is the differentiation between stress incontinence and urge incontinence, this differentiation is urodynamically significantly possible. In an obstructive disturbance of the miction one differs the mechanically fixed obstructions from the functional disturbances. For the two possibilities clinical instances are cited: Urethral valve--spastic neck of the bladder--detrusor-sphincter-dyssynergy. Neurogenic disturbances of micturition may be diagnosed only to the extent that their effect is objectiviable at the aim organ (urinary bladder and urethra). Non-neurogenic disturbances, however, show identical pictures, so that one may speak of a disturbance of micturition which corresponds to a certain type of neurogenic lesion. Every kind of disturbance of micturition needs an exact diagnostics. Urodynamic examinations are in every case necessary for the differential diagnosis of the individual disturbance.

Humans↗