Biofeedback and electrical stimulation therapy for treating urinary incontinence and voiding dysfunction: one center's experience.

Urinary incontinence affects 13 million Americans at a cost of $11.2 billion annually to the community. With an aging population, these numbers are expected to increase substantially in coming years. At the Bladder Control Center in Cincinnati, staff have completed over 3,600 biofeedback sessions with encouraging results.

Overnight concentration of urine. Natural defense mechanism against urinary tract infection.

Growth of Escherichia coli 06 was compared in concentrated overnight urine and dilute daytime urine. In concentrated urine, 90 per cent of the initial inoculum died during the lag phase and surviving bacteria had a long lag period before they started to grow. Once growth began, these bacteria required fifty-five hours to reach their maximum growth yield. In dilute urine, 75 per cent of the same bacteria survived the lag phase; once growth began, they reached maximum growth yield in only thirteen hours. These observations suggest that concentrated overnight urine serves as a natural defense mechanism against urinary tract infections.

Immune complexes in transitional cell carcinoma.

Bladder cancer patients from 2 different medical centers were examined to establish whether such patients have circulating immune complexes. Four methods of analysis were used: 1) polyethylene glycol precipitation, 2) double crossed immunoelectrophoresis, 3) Raji cell and 4) Clq binding assays. In the first group of 24 patients 17 had positive results on cystoscopy for pathologically defined tumors at the time of the serum sample. Two tested positive for the presence of circulating immune complexes by all 4 techniques and an additional 1 tested positive by 3 of the 4 techniques. In the second group of 54 patients (41 of whom had pathologically definable tumors at sample date) 9 were judged possibly positive by the Raji cell assay, the polyethylene glycol and double crossed immunoelectrophoresis techniques. When tested by the Clq binding assay 8 of the 9 patients were positive, most being in the range of 260 to 320 microgram/ml. immune complex. Combining all data from the 78 patients with bladder cancer the results in 10 cases definitely were positive by all 4 techniques and an additional 2 were positive by 3 techniques. Our data indicate that a low percentage (13 to 15 per cent) of patients with bladder cancer has circulating immune complexes. Of interest is that the complexes, as judged by our assay procedures, bind Clq, contain aggregated IgG and can be dissociated into antigen and antibody. Thus, the immune complexes are similar to those found in immune complex diseases.

Pitfalls of urodynamics.

Increased interest and use of urodynamic testing have led many clinicians to rely on the results for patient care. Numerous shortcomings and possible sources of error have been identified. Well trained personnel, properly structured examination rooms and understanding of the potential pitfalls in urodynamics are essential to proper medical management of patients with micturition problems.

A computer-assisted filing system for urologic information.

Our increasingly inefficient, cumbersome, often ineffective and time-consuming manual mental cataloguing and retrieving system indicated to us that there must be a better technique available. However, our search of existing systems failed to reveal any matching our needs. Therefore, we developed a 4-category system for cataloguing and retrieving urologic materials. Our program is divided into 3 sections: 1) index, 2) catalogued data and 3) computer programs. We have used this system for more than a year and believe that it has satisfied our original requirements. It is easily adaptable to changes of information, allows for identification of unlimited types of material, offers thorough and accurate data retrieval techniques and is economical now that the expense of organizing the system is behind.