PubMed · 13699411
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P P FIGDOR. 1960. [Passive congestion and kidney function].. https://pubmed.ncbi.nlm.nih.gov/13699411/
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PURPOSE: In antiquity the visual examination of urine (uroscopy) is well documented. Uroscopy gradually evolved from a prognostic indicator to a diagnostic tool. Comparison of the uses of uroscopy by Hippocrates (400 BC) and Theophilus (700 AD) illustrates this transformation. MATERIALS AND METHODS: We reviewed medical and historical literature as well as the translated works of Hippocrates. RESULTS: Although Hippocrates was one of the first physicians to use urine to interpret human body functioning, urine was mainly used as a means for prognosis and prediction of outcomes of illness. In his text De Urinis Theophilus introduced an innovative doctrine and used uroscopy for diagnosis of illnesses. In this respect uroscopy became a paradigm for later diagnostic strategies and is considered an important milestone in the history of clinical diagnosis. CONCLUSIONS: Hippocrates' writings displayed uroscopy used in examination of illness. However, he considered it in the context for accurate prognoses. Theophilus treated uroscopy in a sophisticated objective manner and attempted to use uroscopy in an orderly, systemic method to accurately diagnose illness. It was through these approaches to uroscopy that Theophilus became one of the physicians who contributed to the birth of medieval medical studies.
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PURPOSE: Pressure-flow studies are currently recognized as the criterion standard to quantify urethral obstruction and its consequence on detrusor contractility. These tests have some disadvantages: they are invasive, time-consuming and expensive and entail risk of disease for the patient. Less invasive methods have been proposed to give the same results without the disadvantages. In this study, we conducted a critical analysis of the devices and techniques and their results. METHOD: After a brief reminder of the general behavior of the flow in an obstructed urethra, we describe the main non-invasive techniques: penile urethral compression-release (PCR), cuffs, and condoms. Using the VBN method, we tried to quantify data from these techniques to specify the relation with the usual parameters of bladder outlet obstruction. RESULTS: In the absence of brisk change of the flow rate, the voiding phases are easily analyzed. With minor corrections, recorded external or cuff pressures could be used in the ICS nomogram; unfortunately, these pressures are greatly modified by perturbations of the nervous control. The spike of flow (due to urine storage in the urethra) observed at resumption of flow after each interruption presents mathematical difficulties for quantitative and reliable modeling but could give a consistent empirical interpretation. CONCLUSION: Of the reported non-invasive tests, all except PCR have an important instrumental heaviness and induce strong perturbations of the nervous control. If they cannot allow an accurate quantification of urethral obstruction and detrusor contractility, they could allow for classification of benign prostatic hypertrophy (BPH) patients. Despite the mathematical problems set by the theory of spikes, the empirical use of the spikes amplitude could perhaps be clinically useful.