ABSTRACT
164 women from 18 to 74 years of age (mean 48.3) with urinary incontinence, previously not operated, with out any neurogenic symptoms, with sterile urine were studied. The kind of incontinence was estimated on the basis of clinical history and examination, the analysis of frequency/volume charts, free uroflowmetry and cystometry in sitting and standing positions. Genuine stress incontinence (GSI) was recognized in 121 (73.8%) women, urge incontinence (UI) in 15 (9.1%), and mixed incontinence (MI) in remaining 28 (17.1%) women. Women with UI and MI had significantly more often both daytime (12.5 +/- 6.4 and 10.3 +/- 2.5), and night-time mictions, comparing to GSI (7.2 +/- 2.8) with simultaneously smaller daytime voided volumes (91 +/- 36.0 ml and 125 +/- 50.0 ml) comparing to GSI (175 +/- 151 ml). Mean voided volume and Qmax in free uroflowmetry were significantly greater in GSI (293 +/- 124 ml, 24.6 +/- 8.4 ml/s comparing to 165 +/- 69.0 ml, 17.0 +/- 7.8 ml/s in UI). The bladders of women with UI showed motoric and sensoric hyperactivity, uninhibited detrusor contractions, decreased CysCapmax, higher PdetCysCapmax, and decreased compliance. Mean CysCapmax was 240 +/- 102 ml, with first sensation after filling mean 145 +/- 90.1 ml, with Pdet 29.3 +/- 13.4 cm H2O, and compliance 13.2 +/- 7.7 ml/cm H2O. In women with both GSI and MI the values were significantly higher and were respectively, for CysCapmax 455 +/- 148 ml, 308 +/- 58 ml, for VFD 237 +/- 76 ml and 169 +/- 25 ml, PdetCysCapmax 12.9 +/- 5.4 cm H2O and 16.5 +/- 4.9 cm H2O, and for C 41.7 +/- 20.5 ml/cm H2O and 28.2 +/- 8.1 ml/cm H2O. The urge syndrome accompanied by urine incontinence, decreased functional bladder capacity evaluated from frequency/volume charts and free uroflowmetry are the indications for performing cystometry with simultaneous monitoring of abdominal pressure. It allows to recognize urge and mixed incontinence.
Subject(s)
Urinary Incontinence/classification , Urinary Incontinence/physiopathology , Adult , Aged , Diagnosis, Differential , Female , Humans , Middle Aged , Posture , Urinary Bladder Diseases/diagnosis , Urinary Bladder Diseases/physiopathology , Urinary Incontinence, Stress/diagnosis , Urinary Incontinence, Stress/physiopathology , UrodynamicsABSTRACT
Transrectal ultrasound (TRUS) is the popular tool in the diagnostics of benign prostatic hyperplasia (BPH) mainly visualizing the static image of prostate with closed urethra. The aim of this study was to observe the changes of the shapes and dimensions of prostatic urethra during micturition using transrectal probe, with simultaneous uroflowmetry. 174 men were examined. 58 of them (aged 20-40 y.) non obstructed--control group, 57 (aged 41-60 y.) and 59 (aged 61-80 y.) with bladder outlet obstruction (BOO) symptoms. TRUS with videorecording in upright position was done. Simultaneously uroflowmetry was performed. Maximal dimensions of the cross-sections of the prostatic urethra in sagittal plane were taken on two levels. First at the bladder neck (S1, mm), second in the middle of the prostatic urethra (S2, mm). The relations between dimensions and uroflowmetry were analyzed using also the average of the sum od S1 and S2 (S3 mm). The average dimension of S1 and S2 decreased with age from 6.3 and 7.0 mm in control group, to 5.1 and 4.5 mm in patients over the age of 60. The average of S3 decreased from 13.3 to 9.5 mm. In all groups statistically significant relations between maximal flow rate (Qmax) and S1, S2 were noted (p < 0.001 and p < 0.05). Particularly strong relations between Qmax and S3 were stated (p < 0.0001). On the base of these results the nomograms were created which allow to calculate the approximate Qmax basing on the prostatic urethra cross dimension. The TRUS measurement of the prostatic urethra cross sections during micturition allows to calculate approximately the Qmax, especially on the base of S3. The observation of the changes of the shapes and dimensions of the prostatic urethra during micturition will make easier to localize and state the character of BOO. The low Qmax with simultaneous correct cross dimensions of the prostatic urethra can suggest the detrusor insufficiency.
Subject(s)
Prostatic Hyperplasia/diagnostic imaging , Prostatic Hyperplasia/physiopathology , Rectum/diagnostic imaging , Urethra/diagnostic imaging , Urethra/physiopathology , Adult , Aged , Aged, 80 and over , Humans , Male , Middle Aged , Prostatic Hyperplasia/complications , Ultrasonography , Urinary Bladder Neck Obstruction/diagnosis , Urinary Bladder Neck Obstruction/etiology , Urinary Bladder Neck Obstruction/physiopathology , UrodynamicsABSTRACT
The aim of our studies was the evaluation of diagnostic usefulness of the 1-hour pad weight test in the different types of female incontinence. We examined 189 women at the age from 16 to 74 with the incontinence in anamnesis. The test was performed accordingly to the I.C.S. guidelines. The positive result of the test (more that 2 grams increase in the pad weigh) was found in 136 (71.6%) of examined women; including moderate urine leak in 24%, big in 55.1% and severe in 20.6% of them. The biggest average increase in pad weigh was found in urinary incontinence associated with the urgency, corresponding to 88.9 g in mixed incontinence and to 67.4 g in genuine urge incontinence. The sensitivity, specificity and efficacy of the test was 78.6%, 72% and 77% respectively. The shortened 1-hour pad weigh test is a simple and effective examination, especially in the stress incontinence. It is less effective in genuine urge incontinence and giggle incontinence. The negative effect of the 1-hour test, when the patients complaints coexist, should be the indication to repeat the test or to perform the 24-hour test. In the doubtful cases, before the surgery, the diagnostics should be extended to the full urodynamic examination.
Subject(s)
Ambulatory Care , Urinary Incontinence/diagnosis , Adolescent , Adult , Aged , Female , Humans , Middle Aged , UrodynamicsABSTRACT
An analysis is presented of 70 patients treated for renal trauma in the I Department of Urology in Katowice in the years 1974-1989. Renal damage was evaluated according to a three-grade scoring system. Conservative treatment was given to 43 patients (61.4%), including 14 patients with I degree trauma, 12 with II degrees, and 17 with III degrees trauma. Nephrectomy was performed in 17 cases, and 10 sparing operations were carried out--one combined with splenectomy.
Subject(s)
Kidney/injuries , Wounds, Nonpenetrating/surgery , Adolescent , Adult , Aged , Female , Humans , Injury Severity Score , Kidney/surgery , Male , Middle Aged , Nephrectomy , Wounds, Nonpenetrating/diagnosisABSTRACT
A technique of urinary stone removal from ureter, bladder and urethra by means of a PCNL set is described. Results are excellent and the procedure seems to be simple.
Subject(s)
Lithotripsy/methods , Nephrostomy, Percutaneous , Ureteral Calculi/therapy , Urethral Diseases/therapy , Urinary Bladder Calculi/therapy , Adult , Female , Humans , Male , Urinary Calculi/therapyABSTRACT
Between January 1988 and December 1990, 210 staghorn stones were treated in 185 patients with combination of percutaneous nephrolithotripsy and extracorporeal shock-wave lithotripsy. A total number of 105 patients (110 renal units) were controlled with a mean follow-up of at least 16 months after the last ESWL procedure. Of these, 77 renal units (70.0%) were stone free, 11 (10.0%) had stone particles less than 5 mm in largest diameter and 22 renal units (20.0%) had stone particles larger than 5 mm.
Subject(s)
Kidney Calculi/therapy , Kidney Pelvis , Lithotripsy , Nephrostomy, Percutaneous , Adolescent , Adult , Aged , Child , Combined Modality Therapy , Female , Follow-Up Studies , Humans , Lithotripsy/adverse effects , Male , Middle Aged , Nephrostomy, Percutaneous/adverse effects , Time Factors , Treatment OutcomeSubject(s)
Blood Coagulation Disorders/complications , Kidney Calculi/therapy , Kidney Pelvis , Lithotripsy/methods , Nephrostomy, Percutaneous/methods , Respiratory Insufficiency/complications , Adolescent , Adult , Aged , Child , Child, Preschool , Contraindications , Humans , Kidney Calculi/complications , Lithotripsy/adverse effects , Middle Aged , Particle Size , PremedicationSubject(s)
Kidney Calculi/therapy , Kidney Pelvis , Lithotripsy/methods , Nephrostomy, Percutaneous/methods , Adolescent , Child , Child, Preschool , Female , Hardness , Humans , Kidney Calices , Male , Particle Size , PremedicationSubject(s)
Kidney Calculi/therapy , Kidney Pelvis , Lithotripsy/methods , Nephrostomy, Percutaneous/methods , Adolescent , Adult , Child , Female , Follow-Up Studies , Humans , Male , Middle Aged , Particle Size , Recurrence , Time FactorsSubject(s)
Kidney Calculi/therapy , Kidney Pelvis , Kidney/abnormalities , Lithotripsy/methods , Nephrostomy, Percutaneous/methods , Ureter/abnormalities , Ureterocele/complications , Adolescent , Adult , Aged , Child , Endoscopy/methods , Female , Humans , Kidney Calculi/etiology , Male , Middle AgedABSTRACT
The authors review their experience with percutaneous endopyelotomy in the treatment of ureteropelvic junction (UPJ) stenosis. The method was used in 64 patients of whom 59 had also renal stones. There was only one patient with secondary UPJ stenosis following pyeloplasty. The total success rate was 61%. It is pointed out that the results depend in a great part on the skill of the surgeon.
Subject(s)
Nephrostomy, Percutaneous , Ureteral Obstruction/therapy , Female , Humans , Kidney Calculi/therapy , Kidney Pelvis/surgery , Male , Stents , Urinary Catheterization/methodsABSTRACT
This study presents long-term results of treatment of urethral strictures in 178 men who underwent direct vision cold urethrotomy between January 1, 1979 and December 31, 1984. Satisfactory urodynamic results were achieved in 69.7% of cases.
