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Biomedical subjects

W Fischer-Rasmussen

Publications and source records attributed to W Fischer-Rasmussen.

At least 37 records · Page 2Linked to original sources
PubMed1990

Stress urinary incontinence and posterior bladder suspension defects. Results of vaginal repair versus Burch colposuspension.

Vaginal repair has been recommended in cases of stress urinary incontinence and posterior bladder suspension defect diagnosed by colpocysto-urethrography. Thirty-eight women with stress urinary incontinence and posterior suspension defect have been treated. First, 19 women underwent a vaginal repair. In a second period, another 19 consecutive patients had a colposuspension a.m. Burch. The patients have been evaluated 6 months postoperatively and at a long-term follow-up. No significant difference was found postoperatively in the frequency of symptoms and signs of stress incontinence, either after 6 months or at the long-term follow-up. A significantly smaller frequency of genital prolapse was found in the colposuspension group at long-term follow-up. No side effects such as frequency, urgency or bacteriuria were evident in the group treated by colposuspension. With reservation to the non-randomized allocation, it may be concluded that a radiographic distinction between anterior and posterior bladder suspension defects in choosing the surgical approach is unnecessary.

Adult↗
PubMed1990

Treatment of stress urinary incontinence.

This review presents reported cure and improvement rates of stress urinary incontinence in women obtained by different treatment modalities. Apart from the urodynamic findings, histological and histochemical changes of the pelvic floor may be clinically relevant to treatment in the future. Long-term cure and improvement rates achieved by non-surgical treatment (physiotherapy, biofeedback, bladder training, electrostimulation) are commented on. These rates range from 40-60% for physiotherapy and electrostimulation but are considerably less after biofeedback and bladder training. Pharmacotherapy is unlikely to offer more than a placebo effect. Studies of a single surgical procedure usually report high cure rates. In making the appropriate choice of operation the best guidelines are the cure rates from comparative or prospective randomized reports. From such studies an abdominal retropubic suspension operation (cure rates after five years 57-78 %) is more likely to help the patient than an anterior colporrhaphy (cure rates 31-70 %) or a transvaginal needle bladder neck suspension (cure rates 39-61 %). In selected patients sling procedures or the use of artificial sphincters may produce excellent results (70-80 %). To estimate the results of different treatments urine loss should be assessed objectively and physical restrictions and hygienic and social implications taken into account. A method of pre- and post-treatment "performance scores" should be developed.

Female↗
PubMed1987

The long-term prognosis of bacteriuria in pregnancy. A 16 to 17 year follow-up study.

An investigation made in 1966-67 of 2,122 pregnant women revealed 182 (8.6%) with significant asymptomatic bacteriuria, of whom 127 could be located in 1983. In 182 non-bacteriuric controls from the same investigation 105 could be located. Eight bacteriuric and 1 non-bacteriuric patient had died, all from causes of death unrelated to urinary tract infections. Data were collected by questionnaires, together with a urine specimen from approximately 73% of the survivors. No differences could be found between the initial bacteriuric and non-bacteriuric group concerning the number and complications of later pregnancies, urinary tract infections requiring hospitalization, or recognized arterial hypertension. In 1983, more of the initially bacteriuric women had experienced urinary tract infections not demanding hospitalization and more were bacteriuric (greater than or equal to 10(5) col/ml), compared with the controls: 36.5% and 28.8%, respectively. These high rates probably indicate some contamination due to self-sampling. B. anitratum was a new bacteria emerging, compared with the original study.

Bacteriuria↗
PubMed1986

Predictive values of diagnostic tests in the evaluation of female urinary stress incontinence.

Preoperatively a collaboration between gynecologists, urologists and radiologists is essential for the diagnostic accuracy of urinary incontinence especially to isolate stress incontinence for surgical treatment. The aim of this study was to estimate the value of these combined efforts. 212 women referred for urinary incontinence were assessed by history of micturition, pelvic examination, cystoscopy, cystometry, stress test for urine loss, uroflowmetry and colpo-cysto-urethrography. A final diagnosis obtained on this basis classified the patients in stress incontinence (130), urge incontinence (47), neuromuscular dysfunction (6), uncertain type (10), other disease (8) and no incontinence (11). According to calculations of predictive values of positive and negative tests, respectively, each single test in the preoperative investigation programme was evaluated regarding the final diagnosis stress incontinence. It was assumed that the symptom stress incontinence, the pelvic examination and the colpo-cysto-urethrography were of minor or no importance for the diagnosis stress incontinence but might have been for the choice of surgical treatment. Cystoscopy and uroflowmetry had no place in daily routine. In contrast normal cystometry and especially the sign stress incontinence deserved consideration of refinements.

Adult↗
PubMed1986

Endoscann cell sampling for cytological assessment of endometrial pathology.

Cytological samples of the endometrium obtained by Endoscann were compared with histological preparations from conventional curettage of the uterine cavity (D & C) in 275 women. Indications of D & C were irregular menstrual bleeding, postmenopausal bleeding, or suspected ovarian or cervical neoplasia in women of 50 years or more. The women were consecutively enrolled in the study and had an average age of 60.2 years (range 50-87). The cytological investigation detected all 16 cases of endometrial cancer but none of 6 cases of atypical hyperplasia. Insertion of the Endoscann cell sampler was easily performed in 87% of the patients in whom cervical dilatation was unnecessary. The cytological technique had 11 cases of insufficient material (4%). By D & C, sufficient material for histological evaluation could not be obtained in 32 cases (12%). The predictive value of a positive test with respect to endometrial carcinoma was 0.38, the corresponding sensitivity was 1.00, and the specificity 0.90. A positive cytology should lead to immediate further investigation.

Adult↗
PubMed1986

The value of colpo-cysto-urethrography in female stress- and urge incontinence and following operation.

The value of colpo-cysto-urethrography (CCU) in female stress- and urge incontinence was measured. In a prospective series of 172 consecutive females with stress- or urge incontinence, CCU was performed and assessed with regard to no suspension defects, anterior defects, or posterior defects, respectively. Six months following operative repair for stress incontinence, CCU was repeated in 97 patients and compared with operative success. CCU was of minor value in the differentiation between stress- and urge incontinence. In stress incontinence, CCU was of greater value for the preoperative planning of operative technique, vaginal or abdominal, but could be omitted when pelvic examination did not disclose genital prolapse, as this excluded posterior suspension defects at CCU. Postoperative CCU was of minor value, and poorly correlated to operative success or failure. Stress incontinence with anterior suspension defects was best treated by abdominal colposuspension, even when complicated by genital prolapse. With no suspension defect at CCU, vaginal and abdominal repair were equally good alternatives. Posterior suspension defects had the lowest cure rate.

Female↗
PubMed1985

Malignant hemangiopericytoma of the ovary.

Tumors originating from the blood vessels seldom occur in the ovaries, and primary hemangiopericytoma localized to the ovaries has not previously been described. In the case reported here a bilateral ovarian tumor was found, with one metastasis to the terminal ileum. It was not possible to perform a radical operation, and the patient was after-treated with external irradiation therapy and chemotherapy. For 9 1/2 months the tumor receded, whereafter it appeared to be stationary for 13 months, to the death of the patient. At autopsy the tumor was in evident regression and there were no signs of metastases.

Female↗
PubMed1985

Suprapubic versus transurethral bladder drainage after colposuspension/vaginal repair.

Ninety-two patients with preoperative sterile urine undergoing colposuspension or vaginal repair operation for stress urinary incontinence and/or genital descensus were randomized to either suprapubic or transurethral postoperative catheter drainage. The prevalence of significant bacteriuria on the fifth postoperative day was statistically significantly lower when using suprapubic catheter (20.8%) than with transurethral catheter drainage (45.5%). This applied especially to colposuspension. The rate of postoperatively impaired bladder emptying also tended to be reduced when using suprapubic catheter. At follow-up after one year, postoperative bacteriuria was closely correlated to increased rates of both clinical cystitis and asymptomatic significant bacteriuria. Thus it is recommended to use suprapubic bladder drainage not only after colposuspension but also after vaginal repair in an effort to avoid an increased risk of urinary infections.

Adult↗
PubMed1985

Maternal-serum-alphafetoprotein screening for fetal malformations in 28 062 pregnancies. A four-year experience from a low-risk area.

From 1st March, 1980 and up to 29th February 1984 a multicenter serum alpha-fetoprotein (S-AFP) screening project was carried out for the detection of severe fetal malformations. S-AFP was determined by a radio-immunoassay in 28 062 pregnant women between the 16th and 20th week of gestation. Patients with elevated S-AFP values, e.g. above 95 percentile, were examined further with a second S-AFP and by ultrasound scan. 244 amniocenteses (0.9%) were carried out to detect 62 malformations (21 anencephalies, 14 spina bifidas, 2 encephaloceles, 7 omphaloceles, 5 gastroschises, 4 chromosome abnormalities and 9 other malformations). Fifteen of the 16 cases of spina bifida could not be verified by ultrasound scan, whereas all other malformations except chromosome abnormalities were confirmed by ultrasonography. Two cases of spina bifida and one case of skin-covered encephalocele had normal S-AFP concentrations and were therefore not detected. There were no definitive false-positives, e.g. therapeutic abortion of a normal fetus. Our conclusion is that a nationwide S-AFP screening should be recommended.

Abdominal Muscles↗
PubMed1985

Emepronium carrageenate: clinical effects and urinary excretion in treatment of female urge incontinence.

Eighteen women (median age 54 years, 36-79) with urinary motor urge (n = 13) or sensory urge (n = 5) incontinence were treated for three 2-week periods with emepronium carrageenate (EC) (Cetiprin Novum) in daily doses of 500 and 1000 mg and placebo. Subjectively the women experienced an increased ability to control micturition, i.e. less urge, during EC treatment. Only mild and mainly anticholinergic side effects were recorded, most frequently dryness of the mouth. As regards side effects, the evaluation of objective effects were complicated by a tendency towards carry-over effect to placebo. Placebo in the first treatment periods were analysed solely; no effects of placebo could be demonstrated. Compared with the reference period, decreases in the total number of micturitions (approx. 20%) and in the number of urge incontinence episodes (approx. 75%) were seen. As compared with placebo, a significant increase (approx. 25%) in the average micturition volume could be demonstrated. The percentage urinary excretion of emepronium decreased with increasing oral intake and with advancing age. Probably, an initial daily dosage of 500 mg EC will do well in younger women (less than 50 years), whereas elder patients may need 1000 mg. Further dosage recommendations are given.

Adult↗
PubMed1984

Evaluation of long-term safety and clinical benefit of terodiline in women with urgency/urge incontinence. A multicentre study.

Terodiline is a secondary amine with anticholinergic and calcium antagonistic properties. The drug has been shown in controlled studies to be effective in patients with motor urge incontinence. In order to evaluate safety and clinical benefits of terodiline during long-term therapy in women with urgency/urge incontinence, a 6-month study has been performed. The study was designed as an open multicentre study with a run-in period and assessments after 3 and 6 months treatment. One hundred patients with a mean age of 48 years (range 18-78) were included. The daily dose was 50 mg, given as 25 mg in the morning and 25 mg at night. The safety was evaluated by recording of adverse reactions and measurements of haematology (B-Hb, B-erythrocytes, B-leukocytes, B-thrombocytes), liver function (S-ALAT, S-ASAT, S-ALP), kidney function (S-creatinine), ESR, heart rate and blood pressure. Clinical benefits were assessed by changes in micturition patterns, cystometry and patient preferences. Ninety-one patients were evaluated after 3 months and seventy after both 3 and 6 months. Terodiline was in most patients well tolerated and adverse reactions, usually those to be expected from the pharmacological effects of the drug, caused withdrawals in 12 patients. Mean levels of all variables on clinical chemistry were well within the normal range. No significant changes were seen except for a small increase in B-thrombocytes, S-creatinine and ESR. No significant changes in heart rate or blood pressure occurred except for a small but statistically significant increase (about 2 mmHg) in resting diastolic blood pressure after 6 months. A statistically significant decrease of voluntary as well as involuntary micturitions was seen. The number of voluntary micturitions decreased from a mean of 10.8 during run-in by 2.4 per day (p less than 0.01) during the first period and by 2.5 per day (p less than 0.01) during the whole 6-month therapy. Involuntary micturitions decreased by 1.3 from 2.7 per day (p less than 0.01) after 3 months and by 1.1 per day (p less than 0.01) after 6 months. Both bladder volume at first sensation to void and the maximum cystometric bladder capacity increased significantly from 134 ml by 56 (p less than 0.01) and 63 ml (p less than 0.01) after 3 and 6 months and from 252 ml by 54 (p less than 0.01) and 66 ml (p less than 0.01) after 3 and 6 months, respectively. No significant changes in bladder pressure or residual urine were shown.(ABSTRACT TRUNCATED AT 400 WORDS)

Adolescent↗
PubMed1981

Relation of estriol in saliva to serum estriol during normal pregnancy.

As saliva is an easily accessible biological material, compared with 24-hour urine and blood, the salivary concentration of estriol was studied from the 30th to the 41st week of gestation in 268 samples from 124 normal pregnancies. At the same time, venous blood samples were drawn and analyzed for total and unconjugated estriol. The mean values for the concentration of total estriol in saliva in the 30th and 41st weeks were 2.8 and 7.2 nmol/l respectively. The salivary estriol concentration appears to increase in perfect conformity with its serum concentration in the course of gestation. If estriol in saliva also reflects low serum values and an impaired function of the feto-placental unit, analyses of the saliva may be applicable as a screening procedure in high-risk pregnancies.

Adolescent↗