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At least 163 records · Page 9Linked to original sources
PubMed1977

Urethral pressure profilometry: assessment of urethral function by combined intraurethral pressure and electromyographic recording.

The technique of combined electromyographic and carbon dioxide urethral pressure profilometry is described and analyzed. The low viscous drag of carbon dioxide permits the use of catheter infusion rates above the critical threshold, where the compressibility of the gas does not influence the accuracy of the pressure recording. Clinical urethral function studies with this technique in benign prostatic hypertrophy, stress incontinence and traumatic spinal cord injury have documented the diagnostic value of the test. Furthermore, the impact of surgical or pharmacological treatment upon urethral function has been delineated.

Carbon Dioxide↗
PubMed1994

Elimination of the influence of intravesical pressure on the micturitional urethral pressure profile by calculation of urethral cross-sectional area: an experimental study.

OBJECTIVE: To determine whether it is possible to eliminate the influence of intravesical pressure on the pressure drop recorded between the bladder and prostatic urethra during the micturitional urethral pressure profile (MUPP). MATERIALS AND METHODS: An experimental study using an artificial bladder/urethral model and computerized urethral pressure profile measurement system. RESULTS: By simultaneous measurement of the flow rate and MUPP it is possible to calculate a theoretical cross-sectional area, based on Griffiths' theory of flow through distensible tubes. The calculated cross-sectional area for a given constriction remains the same despite changes in the driving pressure. CONCLUSION: The effect of changes in intravesical pressure on the MUPP can be eliminated by calculation of the urethral cross-sectional area. This parameter forms part of the Schäfer model of obstruction and this technique may therefore be useful in quantifying bladder outlet obstruction.

Humans↗
PubMed1999

Surgical anatomy of the somatic terminal innervation to the anal and urethral sphincters: role in anal and urethral surgery.

PURPOSE: The gross anatomy of the pudendal nerve branches was studied to identify more precisely the neuroanatomical relationship in the region of the anal canal, bladder neck and proximal urethra. Such knowledge is essential for the development of surgical techniques that avoid nerve injury in sphincteroplasty for anal and urinary stress incontinence, and in pudendal canal decompression. MATERIALS AND METHODS: The pudendal nerve terminal branches were dissected in 7 female and 5 male formalin fixed cadavers, including 6 fully mature neonates and 6 adults, a mean age of 37.6 years. The nerves were traced from the pudendal nerve to their termination in the anal and urethral sphincters, and pelvic floor muscles. RESULTS: The inferior rectal nerve occupied the lower half of the ischiorectal fossa. Immediately after emerging from the pudendal canal it extended a motor branch to the levator ani muscle and the cutaneous perianal and scrotal branches. The nerve terminated in the external anal sphincter at the 3 and 9 o'clock positions. Inside the pudendal canal the perineal nerve gave rise to a scrotal branch which joined the scrotal branch of the inferior rectal nerve to form the common scrotal nerve. About 2 to 3 cm. from the pudendal canal the perineal nerve extended a branch to the bulbocavernosus muscle and divided into the terminal scrotal and motor branches, which penetrated the striated urethral sphincter at the 3 and 9 o'clock positions. The deep dorsal nerve of penis or clitoris coursed forward into the ischiorectal fossa, emerged from the deep perineal pouch and penetrated the suspensory ligament to the dorsum of the penis or clitoris. CONCLUSIONS: The identification of the precise anatomical relation of the somatic nerve termination to the anal and urethral sphincters seems vital to avoid sphincter denervation during surgery for the correction of fecal and stress urinary incontinence.

Adult↗
PubMedDate not supplied

Trans urethral electric vaporisation of prostate as an alternate to trans urethral resection in benign prostatic hyperplasia.

BACKGROUND: There is an impression that trans urethral electric vaporisation of prostate (TUEVP) is a relatively safe surgical procedure for obstructing benign prostates, however before considering it an alternative to Trans urethral resection (TURP) in our setting. we conducted this study to assess its safety. convenience and especially cost effectiveness in our practice. METHODS: Fifty patients with signs of benign prostatic enlargement causing acute urinary retention were selected and divided into two equal groups A and B. Patients of group A underwent TURP while the group B patients had TUEVP. Postoperative follow up to assess the results of the surgeries, including noting the complication rate, began 24 hour after the catheter was removed, continuing during postoperative visits of the patient at 2 weeks, 3 months and finally 6 months. RESULTS: For approximately same size prostate, the mean operation time was less for TUEVP as compared to the TURP. The mean volume of irrigating fluid used and the number of blood transfusions required was also less in the TUEVP patients. In addition. TURP patients were also noted to have slight postoperative hyponatraemia. Clot retention was more frequent in the TURP group than the TUEVP group. Urethral catheters were required for longer duration (mean duration 74.88 hrs vs 24hrs, p=0.0001) and so was the hospital stay (mean duration 6.25 days vs 4.4 days. p=0.0046) in the TURP group patients. Total mean cost of treatment was also higher in the patients undergoing TURP. Among the complications, only the peroperative blood transfusion rate was higher in the TURP patients as noted above. CONCLUSIONS: The TURP has slightly higher morbidity and is costlier than TUEVP but its results in terms of relieving outflow obstruction are significantly better than TUEVP. It is therefore concluded that TURP is a more effective procedure but TUEVP with lesser morbidity and cost, is more suitable for relatively lesser obstructions in our setting.

Aged↗
PubMed2006

[Surgical treatment of post-traumatic complete urethral rupture: deferred urgent urethral suture or delayed repair?].

OBJECTIVE: To compare the results of deferred urgent surgical treatment and delayed repair in post-traumatic complete urethral rupture. PATIENTS AND METHOD: Between 1986 and 2003, sixty patients were operated for complete rupture of the posterior urethra. In the absence of any serious visceral or skeletal lesions, 32 patients were operated within five to ten days (Group I). In 28 cases (Group II), patients were operated 8 months after the injury via a perineo-transsymphyseal approach. RESULTS: The mean age of these patients was 28 years (range: 18 to 53 years). With a minimum follow-up of 2 years (range: 2-14 years), the urine stream was considered to be satisfactory in 90% of patients of group I and in 100% of cases of group II. Continence was perfect in 91% of patients in the two groups. Erectile dysfunction was observed in 22% of cases of Group I versus 28.5% of cases of Group II. CONCLUSION: Deferred urgent end-to-end urethral suture and delayed urethroplasty give globally comparable results. Deferred urgent end-to-end urethral suture must be performed whenever possible. The perineo-transsymphyseal approach must be reserved to the treatment of large stenoses in multi-operated or delayed repair patients.

Adolescent↗
PubMed1981

[Studies of vesico-urethral function by urethral pressure profile during drug treatment (author's transl)].

The urethral closure pressure profile (UPP) examination was performed routinely together with the administration of alpha-blockers. By the measurement of UPP, we can understand whether the organic changes at the bladder neck have already occurred or not. Further, by calculating the decreasing rate of the pressure at the bladder neck (BNP) and the maximum urethral closure pressure (MP), we can determine which nerve component is affected. Particularly, when we want to detect the affected nerve component in a mild disorder of vesico-urethral function, the measurement of UPP is quite useful as one of the screening urodynamic tests.

Adrenergic alpha-Antagonists↗
PubMed1995

Urethral reconstruction after pelvic fracture with urethral disruption: the gold standard.

Traumatic injuries with disruption of the posterior urethra frequently occur in patients who sustain pelvic fracture. Several endoscopic and open reconstructive techniques have been proposed for management of such urethral injuries. Treatment objectives include restoration of physiological urethral voiding with preservation of urinary continence and sexual function. This article summarizes the current recommendations for evaluation and treatment of patients with traumatic posterior urethral injuries. The various reconstructive techniques are reviewed and selection criteria and clinical outcomes are evaluated.

Fractures, Bone↗
PubMed1987

Anterior urethral valves resulting from congenital urethral diverticula.

Five cases of anterior urethral diverticula with resulting anterior urethral valves are reported. All children presented with a poor stream. Diagnosis was accomplished by voiding cystourethrography, and treatment was by open resection of the diverticulum in four neonates and endoscopic excision of the valve in a four-year-old boy.

Child, Preschool↗
PubMed1975

Use of the Otis urethrotome in the treatment of urethral strictures and congenital urethral stenoses.

Internal urethrotomy using the Otis urethrotome is described in detail. Performing this procedure in 23 patients with urethral strictures, no further dilatations of the urethra were necessary in approximately 60%. If internal urethrotomy, which offers the advantages of having a very low rate of complications and which may be repeated, proves unsuccessful, a urethroplasty can still be carried out. As a preliminary procedure to transurethral resection of the prostate by cold punch technique, internal urethrotomy appears to be of great value in preventing urethral strictures - as demonstrated by follow-up studies in 351 patients.

Adult↗
PubMed2006

The safety and efficacy of ethylene vinyl alcohol copolymer as an intra-urethral bulking agent in women with intrinsic urethral deficiency.

The purpose of this post-marketing case-series is to report the short-term safety and effectiveness of ethylene vinyl alcohol (EVA) copolymer (Tegress; C.R. Bard, Covington, GA, USA) in the treatment of intrinsic sphincter deficiency (ISD). The charts of all female patients who received ethylene vinyl alcohol (EVA) copolymer between 2005 and 2006 were reviewed for demographics, physical exam, urodynamic findings, outcomes and complications. Nineteen of twenty women who received EVA during this period completed follow-up. After an average of 1.4 injections, approximately 58% of the patients had a complication related to the procedure with 37% experiencing urethral erosion. Of the patients, 10.5% reported at least a 50% subjective improvement in their symptoms. Intra-urethral bulking for the treatment of SID is meant to be minimally invasive and safe with minimal reports of complications. This series of 19 patients show significant percentage of patients experiencing serious complications with Tegress. Additionally, Tegress may be less efficacious than reported in the FDA trials, especially those with prior injections. A long-term prospective study needs to be performed in women with ISD before treatment can be recommended for general use by all gynecologists and urologists.

Adult↗
PubMed1984

Closure of the bladder neck in spinal cord injury patients with urethral sphincteric incompetence and irreparable urethral pathological conditions.

Total urinary incontinence developed secondary to incompetence of the urethral closing mechanism in 8 spinal cord injury patients who were on Foley catheter drainage (5 patients) or suprapubic cystostomy (3 patients). All patients had irreparable urethrocutaneous fistulas and 4 had urethroperineal erosion. Closure of the bladder neck with drainage via a suprapubic cystostomy tube was used to divert the urinary stream. Bladder neck closure was successful in alleviating total urethral urinary incontinence in all patients. However, suprapubic abdominal leakage developed in 2 patients. This procedure should be recommended cautiously when a maximal bladder capacity greater than 125 cc cannot be maintained unless concomitant augmentation cystoplasty also is considered.

Humans↗
PubMed1981

Prevention of urethral strictures in the management of posterior urethral valves.

Our 28 patients with posterior urethral valves managed with transurethral resection have sufficient followup to evaluate the development of urethral strictures. Of these 28 patients 14 were less than 1 year old when the valves were resected and strictures developed in 7 (50 per cent). Of the 14 patients who were more than 1 year old when the valves were resected none had a stricture. Within the latter group was a subgroup of patients who were treated with early vesicostomy and later valve resection. None of these patients suffered a stricture. Our data indicate that stricture formation is high when valve resection is attempted in the neonate or small infant and can be prevented by primary vesicostomy and delayed valve resection.

Adolescent↗
PubMed1986

[Significance of the urethral pressure profile in the diagnosis of urethral diverticulum].

Diverticulum of the urethra was diagnosed by us in ten women during the past two years. In nine of these, the urethral pressure profile showed a characteristic course: In the region of the diverticulum--confirmed subsequently by radiography--a drop in pressure was recorded as a sign of damage to the wall. The value and importance of the individual steps in the diagnosis of diverticula are discussed. Suspicion of a diverticulum in the urethra can be raised by careful anamnesis and by means of the urethral pressure profile. This suspicion can be safely confirmed or refuted via urethrography using the double-balloon catheter.

Adult↗
PubMed1999

Balloon dilation of posterior urethral stricture secondary to radiation and cryotherapy in a patient with a functional artificial urethral sphincter.

Severe urethral stricture disease as an isolated entity can be a management dilemma. In the patient described here, this problem was associated with prior external-beam radiation and cryosurgical ablation of the prostate, and a functional artificial urethral sphincter (AUS) had been placed. An attempt to relieve partial urinary obstruction while preserving AUS function led to successful balloon dilation proximal to the sphincter cuff.

Aged↗
PubMedDate not supplied

Epidemiology of venereal urethritis: comparison of gonorrhea and nongonococcal urethritis.

Gonorrhea (GU) and nongonococcal urethritis (NGU), the commonest sexually transmitted diseases in men, are endemic at high levels in most regions of the world, despite effective methods of diagnosis and treatment. NGU is a milder disease with a longer incubation period and longer duration of symptoms before treatment. Although Chlamydia trachomatis and Ureaplasma urealyticum appear to account for a majority of NGU cases, the cause of approximately 20% of cases remains unknown. NGU is about twice as common as GU in Western countries, and on the basis of national statistics from Great Britain, its incidence has been thought to be increasing more rapidly. However, data from individual clinics suggest that incidence of both diseases has remained stable over the past decade. The increased incidence of NGU in Great Britain over the past decade probably results from increased recognition or reporting. Marked socioeconomic and racial differences in both relative incidence of and susceptibility to NGU and GU have been found repeatedly but are unexplained. Men appear to transmit GU to women more efficiently than vice versa. Neisseria gonorrhoeae appears to be more infectious than C. trachomatis for both men and women, but interpretation of differences in susceptibility and transmission is hindered by ignorance of natural and acquired immunity to these agents. Of the several important time intervals in chains of transmission of venereal urethritis, only incubation periods and iatrotropic intervals for GU and NGU and the posttreatment period of infectivity for GU are known.

Chlamydia Infections↗
PubMed1981

Observer variation in the interpretation of Gram-stained urethral smears: implications for the diagnosis of non-specific urethritis.

A study was carried out to determine whether the diagnosis of non-specific urethritis was affected by differences in the microscopical interpretation of urethral smears between individual observers (interobserver variation) and the same observer on separate occasions (intraobserver variation). A marked degree of both intraobserver and interobserver variation was found which--depending on the diagnostic criteria adopted--could affect both the diagnosis and treatment of many patients attending a clinic of genitourinary medicine.

Bacteriological Techniques↗
PubMed2004

Urethral reconstruction after total penectomy for urethral cancer.

A 59-year-old white man developed a ventral ulcer with irregular limits in the middle portion of the penis. The result of the pathologic analysis was compatible with invasive squamous cell urethral carcinoma. A total penectomy was performed. In these cases, the usually recommended urinary diversion is perineal urethrostomy. However, due to the specifications of the case, perineal urethrostomy could not be performed. The literature did not offer any other alternative for patients with this same condition. Therefore, a urethral reconstruction using a groin skin flap had to be performed.

Carcinoma, Squamous Cell↗