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Results for “bladder outlet obstruction”

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At least 19 recordsLinked to original sources
PubMed1978

Altered in vitro adrenergic responses of dog detrusor msucle after chronic bladder outlet obstruction.

Muscle strips from the bladder body and dome of normal and control dogs usually demonstrate a relaxing (beta-adrenergic) response to norepinephrine. After bladder outlet obstruction was caused by urethral constriction, all body muscle strips from 7 of 12 dogs (58 per cent) demonstrated contractile (alpha-adrenergic) responses to norepinephrine. Bladder base muscle strips continued to show alpha-adrenergic responses. Desensitization or decreased beta-adrenergic receptor activity may play a part in causing the low compliance and detrusor instability seen in patients with bladder outlet obstruction.

Animals↗
PubMed1979

Bladder outlet obstruction after operation for ureterocele.

Two patients with ureterocele-induced bladder outlet obstruction are presented. In each instance, a broad-based diverticulum had developed in the floor of the bladder as a result of the muscular defect created by a simple ureterocele in one patient and an ectopic ureterocele in the other. This bladder diverticulum produced secondary obstruction of the bladder outlet during the act of voiding. Urinary diversion in one patient had been carried out because of bladder outlet obstruction and was being seriously considered in the other patient because of upper tract deterioration. After the correct diagnosis was established, reconstruction of the muscular defect eliminated the obstruction and reestablished satisfactory bladder function. Urinary diversion was thus prevented in one patient and undiversion accomplished in another, when the true obstructing nature of the bladder diverticulum was established and correct therapy instituted.

Child, Preschool↗
PubMed1978

Detrusor pressure in bladder outlet obstruction.

Synchronous urinary flow and pressure studies were done on 51 male adults consiting of 12 normal subjects and 39 patients with varying degrees of bladder outlet obstruction due to benign prostatic hypertrophy. Mean maximum detrusor pressure levels of 50 mm. Hg and above were found to be indicative of bladder outlet obstruction. Elevated mean maximum detrusor pressure fell preoperatively within normal limits after prostatecomy. Chronic retention of urine was not associated with poor contraction of the detrusor muscle. Clinical findings of obstruction were shown to be inadequate for estimation of maximum detrusor pressure. Recording the detrusor pressure was found to be a better urodynamic test for bladder outlet obstruction than recording the urinary flow rate. Recording urinary flow is, however, a simple test and should remain a screening test for impaired drainage of the bladder outlet.

Aged↗
PubMed1977

[Bladder outlet obstructions: the value of urodynamics (author's transl)].

The uroflowmetry has value (1) as a screening procedure in bladder outlet diseases, and (2) in assessing results of treatment. The results of measurement depend: (1) on the circumstances of micturition; (2) on the bladder volume, and (3) on how far the patient is cooperative. The interpretation of measurements must be related not only to maximum flow and micturition time, but also to a specific micturition pattern. As an isolated method the uroflowmetry has limitations. The value of this procedure may increase by pressure measurements during micturition. However, caution should be exercised in interpreting a resistance factor. Extensive information is presented by simultaneous cine-pressure-flow measurement. Additional urodynamic procedures, especially the urethra pressure profile, are of no value in bladder outlet obstructions.

Adult↗
PubMed1978

Air cystometrography and sphincter electromyography in patients with bladder outlet obstruction.

38 patients with infravesical obstruction secondary to benign prostatic hypertrophy had CO2 cystometrography (CMG) and sphincter electromyography (EMG) at onset of retension and 6 weeks after intermittent bladder drainage. Neurological diseases were excluded in these patients. Three patterns of CMG tracings were obtained and were called, normal, 'compensating' and 'decompensating' on the basis of the volume: pressure ratio of the curves. By strict definition, no abnormal detrusor contractions were seen in any of these patients who also all had normal sphincter electromyography. It is questionable therefore if infravesical obstruction, in the absence of neurological deficits can account for the uninhibited detrusor contractions described in the literature. Rather it is possible to explain the above CMG tracings on the effects of obstruction on the bladder smooth muscle and collagen fibers which have been shown to be non-neural dependent.

Aged↗
PubMed1975

Bladder outlet obstruction caused by vaginal fibromyoma: the female prostate.

Three patients with urinary difficulty were cured by surgical removal of a viaginal fibromyoma. The appearance of this benign tumor on an intravenous cystogram and cystoscopy as well as the clinical response to surgical removal bears similarity to the hypertrophied prostate in men. The best surgical technique for its removal is enucleation via a vaginal incision.

Adult↗
PubMed1977

Bladder wall tension in benign prostatic hypertrophy.

Two hundred forty-three synchronous urinary flow and intravesical pressure recordings were carried out on 51 men all of whom were over 50 years of age. They consisted of 12 normal subjects and 39 patients with benign prostatic hypertrophy in various stages of bladder outlet obstruction. Bladder wall tension was determined from each pressure and flow recording. Bladder wall tension at the commencement of micturition was found to be of value for the diagnosis of bladder outlet obstruction attributable to benign prostatic hypertrophy. A technique for direct recording of bladder wall tension is desirable.

Aged↗
PubMed1978

Direct recording of urethral resistance using the "urethroresistance".

Observations on urethral resistance during micturition in non-obstructed men and in patients with bladder outlet obstruction owing to benign prostatic hypertrophy are presented. The "Urethroresistance", a new instrument, was used for the direct recording of urethral resistance. The upper limit for the minimum urethral resistance during micturition for normal non-obstructed men was 0.5 units. Two patterns of urethral resistance were observed solely in non-obstructed subjects and 3 other patterns, which were found solely in patients with a moderate or severe degree of bladder outlet obstruction, were shown to be characteristic of bladder outlet obstruction. While direct recording of urethral resistance is a better test for bladder outlet obstruction than the recording of urinary flow rate the recording of urinary flow is a simple urodynamic test, which remains a useful screening test for bladder outlet obstruction. With the exception of severe obstructive symptoms none of the other clinical methods for the assessment of bladder outlet obstruction--the size of the prostate gland, the volume of post-micturition residual urine and the degree of bladder trabeculation--is reliable to determine the degree of bladder outlet obstruction.

Aged↗
PubMed1976

The effect of a 6FG urethral catheter on urinary flow in benign prostatic hypertrophy.

Free voiding and micturition alongside a fine indwelling urethral catheter of similar voided volumes of urine were recorded for 43 men over 50 years of age. All had benign prostatic hypertrophy. Ten men had no bladder outlet obstruction, seven had clinically questionable obstruction, nine had slight obstruction and 17 had moderate or severe bladder outlet obstruction. I found no statistically significant lowering of peak flow rate when voiding was carried out alongside an indwelling 6FG catheter in subjects with no obstruction and with various degrees of bladder outlet obstruction due to benign prostatic hypertrophy. My findings demonstrate that the lower urinary tract is not a simple hydrodynamic system but a biologically functioning organ. The bladder outflow tract possesses considerable elasticity and accommodation. The present findings justify the use of the fine perurethral catheter technic for urodynamic studies, particularly in subjects with clinically questionable bladder outlet obstruction due to benign prostatic hypertrophy.

Aged↗
PubMed1976

Urinary flow rate in benign prostatic hypertrophy.

Multiple urinary flow measurements were recorded on 12 men without bladder outlet obstruction, ten men with a clinically doubtful diagnosis of bladder outlet obstruction due to benign prostatic hypertrophy, 29 men with a proven clinical diagnosis of bladder outlet obstruction due to benign prostatic hypertrophy and eight men before and after prostatic surgery. All were over 50 years of age. Mean peak flow rates for non-obstructed men varied from 11.8 to 35.0 ml per second and the minimum threshold for mean peak flow rate in these subjects was 15.0 ml per second for voided volumes of 200 ml and above. The vast majority of subjects with obstruction had mean peak flow rates below 15 ml per second. Mean peak flow rates reverted to normal after prostatic surgery. Our findings justify the use of multiple determinations of peak flow rate as a routine screening examination in subjects who may have bladder outlet obstruction due to benign prostatic hypertrophy.

Aged↗
PubMed1978

Urodynamics in benign prostatic hypertrophy.

Synchronous urinary flow and pressure studies were carried out on 51 male subjects of whom 12 were normal subjects and 39 had benign prostatic hypertrophy with varying degrees of bladder outlet obstruction. A urodynamic scoring system was evolved for accurate and objective diagnosis of bladder outlet obstruction. The minimum urethral resistance was found to be the most valuable single urodynamic parameter for the diagnosis of bladder outlet obstruction. Hitherto this urodynamic parameter was determined through tedious calculations. In the course of the present study a new instrument, the Urethroresistance, was devised for the direct recording of urethral resistance during micturition.

Aged↗
PubMed1977

Intravesical pressure in benign prostatic hypertrophy.

Synchronous pressure and flow studies were carried out on 51 men over 50 years of age. The subjects were divided into groups based on degree of bladder outlet obstruction. Eight patients were also examined six to ten weeks after prostatectomy. Following multiple pressure and flow recordings, the mean premicturition resting intravesical pressure, the mean intravesical pressure at the commencement of voiding (the commencing intravesical pressure), the mean maximum intravesical pressure and the mean intravesical pressure at the end of voiding (mean cessation intravesical pressure) were determined for each subject. The maximum intravesical pressure varies in the same individual. A mean maximum intravesical pressure of 75 mm Hg and above indicates moderate or severe bladder outlet obstruction. However, this pressure is not of value in the determination of clinically doubtful or mild obstruction. None of the other intra-vesical pressures is of value in the diagnosis of bladder outlet obstruction. Six to ten weeks following successful prostatectomy the mean maximum intravesical pressure fell to normal limits.

Aged↗
PubMed1976

Correlations between clinical findings and urinary flow rate in benign prostatic hypertrophy.

Measurement of urinary flow rate was carried out on 39 male patients with bladder outlet obstruction due to benign prostatic hypertrophy. All patients were over 50 years of age. Ten subjects, by clinical evaluation, had doubtful bladder outlet obstruction, nine had mild obstruction and 20 patients had moderate or severe obstruction. Four criteria were used for clinical diagnosis: obstructive symptoms, size of prostate by rectal digital exploration, volume of postmicturition residual urine and degree of bladder trabeculation seen on cystourethroscopy. Considerable inaccuracy results from basing the degree of impairment of urinary flow on the patient's obstructive symptoms, degree of prostatic enlargement, postmicturition residual urine or degree of bladder trabeculation. Severe obstruction symptoms generally indicate impaired urinary flow but the absence of obstructive symptoms does not exclude impaired flow.

Aged↗
PubMed1979

Anterior vaginal repair, cause of troublesome voiding disorders?

Clinical experience and urodynamic observations in 85 female patients with voiding disorders after anterior vaginal repair are presented. Iatrogenic or persistent urinary stress incontinence (72%), irritable trigone syndrome (48%), bladder outlet obstruction (40%), unstable bladder (25%) and recurrent cystitis (23.5%) were the most frequent findings. Also, 5 cases of urogenital fistula and 2 cases of loss of a great part of the urethra were noted. Attempts to cure these complications with different pharmacologic agents and/or surgical methods were often disappointing.

Female↗
PubMed1976

Patterns of urinary flow in benign prostatic hypertrophy.

Multiple urinary flow recordings were carried out on 51 men and without bladder outlet obstruction due to benign prostatic hypertrophy. All patients were over 50 years of age. Six urinary flow patterns (types 0-5) were defined. Types 0-3 were found in patients without obstruction, while all six patients were observed in those with clinical obstruction. Following prostatic surgery, only types 1, 2 and 3 were found. Only type 5 flow pattern can be determined by flow rate alone because it is by definition on the curve obtained when peak flow rate is below 4 ml per second. In this study, no type of flow pattern was characteristic of bladder outlet obstruction due to benign prostatic hypertrophy. The supposedly characteristic type of flow pattern in this clinical condition reported by earlier workers is mainly a result of a difference in the age distribution between their control and test groups.

Aged↗