Search PubMed⌕ Search

SEARCH · Search PubMed

Results for “Urethral Obstruction”

Search indexed PubMed citations on genomics, clinical trials, systematic reviews and public health. Explore titles, authors and supplied subject terms, then open the PubMed record.

Quote a phrase for an exact phrase match. Source license links do not imply unrestricted reuse.

At least 343 records · Page 19Linked to original sources
PubMed1988

Prenatal evaluation and outcome of fetal obstructive uropathies.

Between January 1982 and January 1986, 76 pregnant women between 15 and 40 weeks of gestation were referred because of suspected fetal obstructive urinary tract pathology. A total of 14 high-level (ureter) and 17 low-level (urethral) obstructions were diagnosed. High-level obstructions were at the uretero-pelvic level in 11 and at the uretero-vesical level in 3 cases. Increased amniotic fluid volume was observed in 28 per cent. The survival rate was 86 per cent. In the 17 cases of urethral obstruction, oligohydramnios was present in 70 per cent, associated structural defects in 30 per cent, and abnormal karyotype in 6 per cent. Pregnancy was terminated because of progressive massive hydronephrosis in 41 per cent; intrauterine or neonatal death occurred in 47 per cent, resulting in a survival rate of only 12 per cent.

Evaluation Studies as Topic↗
PubMed1998

[Embryological study of the mechanism of antenatal lower urinary tract obstruction].

Closure of the embryonic bladder based on the results of the study of 25 human embryos (Crown-Rump length: 5mm-60mm) and 8 Born's reconstructions, is presented. It is a complex but well regulated stage of organogenesis. Division of the cloaca depends on caudal regression, development of the genital tubercle and growth of the urorectal fold which joins the cloacal membrane. The didermal cloacal membrane (composed of the ecto and endodermal layers) opens on its caudal part. On the cranial part, there is a cloacal plug, composed of packed cells, which strengthens the inferior part of the genital tubercle. After progressive vacuolation, this plug is colonized by mesodermal tissue derived from the urorectal fold, which assumes the development of the anterior perineum. This stage depends on cranial growth of the genital tubercle. On a human embryo (31 mm Crown-Rump length, 52 days, 10 Weeks of amenorrhea), the bladder is closed, urachus obturated and urethra patent. The vesico-ureteral junction, and prostatic utricle are present and the colliculus seminalis is well developed. A temporary obstruction (caused by asynchronism between urachus closure and urethral opening) can induce antenatal vesicoureteral reflux which could regress after birth. However if urethral obstruction is definitive (posterior urethral valves or atresia), reflux persists. Antenatal sonographic bladder identification is possible after 10 weeks of amenorrhea with visualisation of the two umbilical arteries by color duplex ultrasound. If the urachus remains patent, it can be visualized inside the arterial umbilical triangle, on a transverse view.

Humans↗
PubMed1982

Correction of congenital hydronephrosis in utero II. Decompression reverses the effects of obstruction on the fetal lung and urinary tract.

Urethral obstruction and urachal ligation at 93-107 days gestation produced severe hydronephrosis, hydroureter, megacystis, and urinary ascites as well as significant pulmonary hypoplasia in 17 fetal lambs. Obstructions in 9 fetuses subsequently were relieved in utero by suprapubic cutaneous cystostomy. At birth, all 4 liveborn obstructed lambs had respiratory insufficiency, and only 1 survived. Four others were stillborn. The lungs were significantly hypoplastic by weight and volume (p less than 0.025). All 8 had advanced megacystis, hydroureter, and hydronephrosis but no cystic or dysplastic renal changes. In contrast, 7 liveborn lambs diverted in utero had far less respiratory difficulty and all survived (p = 0.002). Two were stillborn. The lung weight was significantly increased (p less than 0.05). All lambs undergoing in utero decompression showed significant resolution of the severe urinary tract dilatation seen in the obstructed lambs. In utero decompression of the obstructed fetal urinary tract allows the abnormally small lungs to grow and develop and hydronephrosis to resolve.

Animals↗
PubMed2006

Initial observations of reduced uroflow in transgenic adenocarcinoma of murine prostate.

OBJECTIVES: To characterize the voiding function in a transgenic adenocarcinoma of murine prostate (TRAMP) mouse of advanced age, because it might provide a useful model of slow-onset bladder outlet obstruction. Spontaneous death from urinary outlet obstruction occurs in the TRAMP mouse. METHODS: A metabolic cage without a fecal separation screen was placed above a precision balance that reported the mass of the excreta pan every 100 ms. A computational algorithm identified voids suitable for uroflow assessment from other excretory events. A series of images were obtained automatically before and during the excretory events. RESULTS: The TRAMP mouse displayed a pulsatile voiding pattern characterized by a reduction in uroflow, prolongation of voiding, and droplet formation at the tip of the prepuce. Postmortem histologic examination revealed gross enlargement of the prostate, a suburethral tumor, dilation of the lumen of the urethra, and proteinaceous debris in the urethra and bladder. CONCLUSIONS: The observed changes were consistent with urethral obstruction induced by prostate enlargement and/or suburethral tumor. Additional studies are required to ascertain whether prostate enlargement per se is sufficient to produce urethral obstruction in the TRAMP mouse. This transgenic mouse strain may provide a model of slow-onset outlet obstruction that is more representative of bladder outlet obstruction caused by benign prostatic hyperplasia than is the obstruction produced by urethral ligation.

Adenocarcinoma↗
PubMed2004

Vertically transmitted hypoplasia of the abdominal wall musculature.

The prune belly syndrome (OMIM 100100) is an association of bladder dilation with hypoplasia of the abdominal wall muscles. This malformation sequence is due to early urethral obstruction. We report a family with abdominal wall muscular hypoplasia as an isolated defect, not associated with the urethral obstruction sequence. The proband is a q3-year-old male who presented with abdominal wall laxity and severe constipation. His mother, maternal grandmother and younger brother had varying degrees of abdominal wall muscular deficiency and constipation. His mother's condition was aggravated by her 2 pregnancies. This family shows vertical transmission (compatible with autosomal dominant or mitochondrial inheritance) of the abdominal phenotype of prune belly sequence without any evidence of urinary tract or renal pathology. The expression in the sons may remain incomplete because abdominal distention due to pregnancy will not occur.

Abdominal Muscles↗
PubMed1986

Food and water intake and urine composition in cats: influence of continuous versus periodic feeding.

Twenty healthy, noncastrated, adult male cats had periodic (11 am to 12 am) or continuous (24 hours daily) access to food. With periodic feeding, cats ate less food, drank less water, and produced less urine than when food was available continuously. The composition of urine obtained by cystocentesis at 7:30 am, 3:30 pm, and 10 pm was influenced somewhat by feeding pattern. With periodic feeding, urine pH was lower at 7:30 am and higher at 3:30 pm than it was with continuous feeding. Most mineral concentrations and urine osmolality-specific gravity did not differ with the different feeding schedules. However, when periodic feeding was used, concentrations of magnesium and phosphorus in urine were as high or higher preprandially (7:30 am) than postprandially (3:30 pm). Frequency of urination per 24 hours was not influenced by the feeding schedule, but the time that urination occurred during the 24-hour period was somewhat different. An experimental, high magnesium diet fed to the cats for 200 days caused urethral obstruction in 7 of 10 cats fed periodically and in 7 of 10 cats fed continuously. Cats with obstruction had urinary mineral concentrations similar to concentrations in cats without obstruction, indicating that urinary mineral concentration may not be the only factor relevant to the process of obstruction. Necropsy findings and histologic evaluation of tissues from the cats indicated incidental lesions or abnormalities caused by urethral obstruction, but did not indicate anatomic abnormalities that would have predisposed the cats to obstruction.(ABSTRACT TRUNCATED AT 250 WORDS)

Animals↗
PubMed1994

Fetal bladder outlet obstruction diagnosed at 13-weeks' gestation.

An ultrasonographic examination revealed increased fetal bladder size as well as fetal bilateral hydronephrosis at 13-weeks' gestation. Diagnosis of the fetal urethral obstruction was made. Repeated ultrasonography was undertaken from the 13th to through 16th weeks of gestation. Percutaneous puncture with aspiration and laboratory analysis of fetal urine was performed at 15-weeks' gestation. The fetal renal function seemed not to be damaged by use of these antenatal procedures. Following induced abortion at 16-weeks' gestation, an autopsy showed that the fetal urethral obstruction was caused by a posterior valve, with no histological evidence of fetal renal dysplasia.

Adult↗
PubMed2003

Urethral erosion after synthetic and nonsynthetic pubovaginal slings: differences in management and continence outcome.

PURPOSE: We present a series of urethral erosion following a pubovaginal sling procedure due to synthetic and nonsynthetic materials and discuss their management and continence outcome. MATERIALS AND METHODS: During a 3-year period 57 patients underwent urethrolysis for urethral obstruction after receiving a pubovaginal sling. Urethral erosion, defined as sling material entering the urethral lumen, was present in 9 patients and this cohort comprises the focus of our review. In 3 patients the eroded material was synthetic, that is ProteGen (Boston Scientific, Natick, Massachusetts) in 2 and polypropylene in 1. This condition was treated with removal of the whole sling, multilayer closure of the erosion and selective use of a Martius flap. In 6 patients the eroded material was nonsynthetic, that is allograft fascia in 5 and autograft fascia in 1. This condition was treated with sling incision and multilayer closure of the urethra. Preoperative assessment included a urogynecologic questionnaire, measurement of pad use, a voiding diary, cystourethroscopy and videourodynamics. Postoperatively similar parameters were used to assess continence outcomes and the need for subsequent procedures. RESULTS: Nine patients were followed 30 months after urethrolysis. All 9 women had some manifestation of voiding dysfunction following the pubovaginal sling procedure, including urinary retention in 4, urge incontinence in 3 and mixed incontinence in 2. Urinary retention resolved in 3 patients and urge incontinence resolved in 4. Stress urinary incontinence (SUI) persisted in 2 of the 3 patients in the synthetic group, while no patient in the nonsynthetic group had recurrent SUI. There were no recurrent urethral erosions or fistulas in either group. CONCLUSIONS: Urethral erosion after a pubovaginal sling procedure can occur irrespective of the sling material. However, recurrent SUI is not an invariable outcome of the management of urethral erosion following the pubovaginal sling procedure.

Fascia Lata↗
PubMed2000

Diagnosis and treatment of obstructive urolithiasis in a captive Rocky Mountain wapiti (Cervus elaphus nelsoni).

A captive 5-yr-old castrated male Rocky Mountain wapiti (Cervus elaphus nelsoni) developed stranguria. Rectal palpation and physical examination indicated urethral obstruction that was subsequently relieved by urethrostomy and required only minimal aftercare. The wapiti was able to urinate freely after surgery; however, the obstruction recurred 27 mo later. Urethral catheterization relieved the second obstruction, which was caused by a large calculus composed of calcium carbonate and magnesium carbonate. Urolithiasis may have been associated with a diet high in calcium, and urethral obstruction may have been associated with castration at an early age. The wapiti continued to urinate freely 9 mo after relief of the second obstruction and 3 yr after the initial surgery.

Analgesics, Opioid↗
PubMed1997

Effects of acute complete outlet obstruction on the NADPH-diaphorase reactivity in the intramural ganglia of the guinea pig urinary bladder: light and electron microscopic studies.

PURPOSE: The present study aims to examine the effect of complete outlet obstruction on the nicotinamide adenine dinucleotide phosphate-diaphorase (NADPH-d) reactivity in the intramural ganglion cells of the guinea pig urinary bladder. MATERIALS AND METHODS: Adult male guinea pigs were divided into control (normal and sham-operated) and urethral obstructed (12, 24, and 48 hours after complete obstruction) groups. NADPH-d reactivity in the intramural neurons of the urinary bladder was examined by light and electron microscopy. RESULTS: At 12 hours after urethral obstruction, an increase in number of intensely stained NADPH-d intramural neurons was detected. This was sustained till 24 hours whence some of the neurons appeared to undergo degenerative changes. Neuronal degeneration was more drastic at 48 hours. Results of cell counts showed a 32% reduction in number of NADPH-d positive neurons of the urinary bladder at this time point. Electron microscopy showed that all neurons undergoing degeneration displayed NADPH-d reactivity. A large accumulation of NADPH-d reaction product was observed in degenerating neurons whose mitochondria appeared swollen along with dilatation of Golgi saccules. At 48 hours, some neurons displayed total vacuolation and lysis of mitochondria. CONCLUSION: Present results show that acute complete outlet obstruction can lead to degeneration and consequent cell death in the intramural ganglion cells of the guinea pig urinary bladder. The increased NADPH-d reactivity in such neurons suggests that nitric oxide may be involved in neuronal death in the urinary bladder following acute urinary retention.

Animals↗
PubMed2006

Smooth muscle trans-membrane sarcoglycan complex in partial bladder outlet obstruction.

The urinary bladder experiences both distension and contraction as a part of the normal filling and emptying cycle. To empty properly, tension generated intracellularly in a smooth muscle cell must be smoothly and efficiently transferred across its sarcolemma to the basement membrane, which mediates its binding to both the extracellular matrix and to other cells. As a consequence of urethral obstruction, the bladder cannot generate appropriate force to contract the organ, thereby leading to inefficient emptying and associated sequelae. In this study, an animal model of urethral obstruction was utilized to study the membrane-associated structures that transfer tension across the sarcolemma of bladder smooth muscle cells. Immunohistochemical localization of key components of the smooth muscle tension transfer apparatus (TTA) was performed utilizing specific antibodies against:(1) the alpha-chains of type IV collagen, a basement membrane component, and (2) beta-sarcoglycan, an integral membrane protein that is a participant in the physical linkage between the cytoskeleton and the basement membrane. We demonstrate, in obstructed animals, that there is a pronounced disruption of the TTA with a physical displacement of these two components that can be demonstrated at the level of the light microscope using scanning confocal microscopy. Electron microscopy further demonstrates significant increases in the size of the junctional plaques between smooth muscle cells.

Animals↗
PubMed1977

Studies of enuresis. VIII. Detrusor and sphincter instability caused by overactivity of integral voiding reflexes.

Ninety-one children with nocturnal enuresis or enuresis plus daytime urgency incontinence were studied by cystometry. Seventy-two per cent of the girls and 62 per cent of the boys had evidence of bladder instability. Sixty-eight children in whom abnormalities were found on preliminary voiding urodynamics or voiding cystourethrography also underwent calibration and endoscopic examination under anesthesia. An atropine-suppression test was also performed preoperatively in some children with a markedly unstable bladder demonstrated on preoperative cystometry. In the majority of children tested suppression of bladder instability with atropine was demonstrable. Voluntary detrusor sphincter dyssynergia was demonstrated in a majority of the children with daytime urgency incontinence. Sixty-five per cent of the boys and 81 per cent of the girls were treated for urethral obstructive lesions suspected to be of functional urodynamic significance. Postoperative cystometry showed marked improvement in bladder stability in 57 per cent of the girls and 63 per cent of the boys treated for suspected urethral obstructive pathology. The anticholinergic suppression test was found to have no significant predictive value relative to the cause or surgical curability of bladder instability. The pathophysiologic significance of overactivity of integral voiding reflexes 6 through 11 is described.

Child↗
PubMed1995

[Transurethral resection of prostate cancer: efficacy and morbidity].

OBJECTIVES: The efficacy and morbidity of transurethral resection of the prostate (TURP) were evaluated in patients with urinary retention and prostatic carcinoma. METHODS: From 1990 to 1993, 30 patients with infravesical obstruction secondary to prostate cancer were treated by TURP. The results were considered good when patients were able to void and were completely continent following the procedure, whereas poor results were defined as incontinence or no relief of urethral obstruction 21 days following catheter removal. RESULTS: Patient mean age was 72 years and the average weight of resected tissue ranged from 8 to 105 gms (mean 19.5 gms). The median postoperative follow-up period was 20.5 months (range 6-36 months). During this time, there were no deaths and 72.5% of the patients showed normal post-TURP micturition. Eight patients (27.5%) developed the following complications: 3 were incontinent, 6 had persistent obstruction and 1 patient had both complications. Presurgical hormone therapy, high-grade tumors and patient age under 70 years appear to be statistically related to poor outcome following TURP. CONCLUSIONS: TURP is an effective treatment with a relatively low morbidity and offers a viable option for patients with symptomatic urethral obstruction due to prostate cancer.

Aged↗
PubMed1994

Obstruction of urethral stents by mucosal overgrowth.

Urethral strictures are difficult to cure. In 1988, a new treatment was reported, consisting of dilation or incision of the stricture followed by implantation of a specially designed stent meant to allow the urethral epithelium to heal and cover the stent while preventing shrinkage of the scar and reappearance of the stricture. Two cases are reported here in which implantation of the stent resulted in a foreign-body reaction and obstruction of the lumen of the urethra. The area obstructed was reopened by transurethral removal of the reactive tissue. The long-term effect of this reaction on the patency of the urethra is still unknown.

Aged↗
PubMed1986

[Rupturing of valves of the posterior urethra in the newborn using a balloon catheter. Results of the technic apropos of a series of 10 children].

Prenatal ultrasonographic diagnosis of urethral valves is now common. Treatment of the urethral obstruction has sometimes to be done in low weight newborn babies. In these babies, the stripping of valves using a Fogarty catheter provides an helpful way of treatment, easier than endoscopy. The technique is presented here. The results of this procedure in 10 neonates with a follow up of 3 to 22 months are reported. The urethral obstruction is easily cured in most patients without using a previous diversion. This procedure is indicated in premature or hypotrophic newborns when the urethral size is too small to allow a safe endoscopic section of the valves. We did not observe secondary stricture. Follow up is too short to allow a correct investigation of the continence.

Catheterization↗
PubMed2001

Model-based estimation of male urethral resistance and elasticity using pressure-flow data.

To assess urethral resistance and changes in the urethral elasticity during voiding, a lumped parameter model of the urethra was developed. The model uses pressure and flow measurements to estimate time-dependent resistance and elasticity factor. The model includes a resistance that has a function of the cross-section and urethral elasticity. Two resistivity types are compared in the constricted flow-controlling zone of the urethra: Poiseouille resistance and the Bernoulli effect. Using real pressure-flow data sets, the model was used to estimate urethral resistance and changes in urethral elasticity during voiding. Estimation of the elasticity show that in a normal patient relaxation of the urethra is a process that continues until the end of voiding. This has important implications with regard to the present methods that are used in the clinic to assess urethral obstruction or constriction. The resistance as calculated by this model, may be a useful indicator of urethral constriction and obstruction, since it is especially independent of the bladder function. Changes in the urethral elasticity during voiding which are estimated by the model add a new diagnostic parameter to pressure-flow studies.

Algorithms↗