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1.
Cureus ; 16(2): e55239, 2024 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-38558696

RESUMO

Normal pressure hydrocephalus (NPH) is characterized by pathologic ventriculomegaly with normal opening pressures on lumbar puncture. It commonly presents with a triad of gait disturbance, cognitive impairment, and urinary bladder detrusor dysfunction. Its pathogenesis is complex but is thought to arise in the setting of imbalanced cerebrospinal fluid (CSF) secretion and absorption. Given that intracranial pressure often remains normal in the setting of NPH, visual symptoms are quite uncommon. Here we present a case of a 70-year-old female with a subacute history of visual aberration described as a seconds-long persistent recurrence of visual images after the stimulus was removed from the visual field in the setting of slowed and unstable gait, urinary urgency, and cognitive impairment. This patient was evaluated and ultimately diagnosed with NPH before undergoing definitive treatment with ventriculoperitoneal shunt implantation. She has shown persistent responsiveness to shunting of the CSF as manifested by sustained improvement in gait speed and stability, urinary bladder urgency, and palinopsia resolution at the six-month follow-up assessment.

2.
Actas Urol Esp (Engl Ed) ; 48(6): 448-453, 2024.
Artigo em Inglês, Espanhol | MEDLINE | ID: mdl-38160792

RESUMO

INTRODUCTION AND OBJECTIVES: Transurethral resection of bladder tumor (TURBT) is crucial in the treatment of bladder tumors and when incorrectly performed can cause staging mistakes. To avoid these errors, a second resection is recommended in selected cases. The aim of this study is to evaluate the surgeon's ability to predict histologically complete primary resection of newly diagnosed bladder tumors avoiding the need for a second TURBT. METHODS: This is a prospective, observational study involving 47 consecutive patients with newly diagnosed bladder tumors who had previously undergone primary TURBT, and met EAU criteria for second-look TURBT. Second-look TURBT specimens were analyzed for routine histological assessment and compared with the surgeon's impression of the tumor at initial resection. RESULTS: Of 91 patients submitted to primary TURBT, 47 met the criteria for second-look TURBT. Second-look specimens revealed residual disease in 20.9% of patients and 3 (6.4%) of patients showed upstaging disease. The sensitivity of a senior to detect disease on second-look TURBT in relation to muscle invasion was 75%, and the specificity was 85%. CONCLUSIONS: Second-look TURBT is crucial in the treatment of bladder cancer and cannot be replaced by a surgeon's opinion, so international recommendations should be followed. Supervision of less experienced surgeons is a cornerstone.


Assuntos
Cistectomia , Cirurgia de Second-Look , Neoplasias da Bexiga Urinária , Neoplasias da Bexiga Urinária/cirurgia , Neoplasias da Bexiga Urinária/patologia , Humanos , Estudos Prospectivos , Masculino , Feminino , Idoso , Cistectomia/métodos , Pessoa de Meia-Idade , Idoso de 80 Anos ou mais , Competência Clínica , Uretra/cirurgia , Ressecção Transuretral de Bexiga
3.
Neurourol Urodyn ; 42(2): 445-452, 2023 02.
Artigo em Inglês | MEDLINE | ID: mdl-36519669

RESUMO

INTRODUCTION: Bladder outlet obstruction alters detrusor contractility, reducing the bladder's ability to respond to large filling with a risk of urinary retention. The objective was to assess the effect of bladder filling volume on detrusor contractility in men with bladder outlet obstruction. METHODS: A prospective multicenter study in two pelviperineology departments. Male patients eligible for urodynamics (IPSS score > 7) were included from January to July 2022. In case of absence of bladder outlet obstruction on pressure-flow studies, they were secondarily excluded. The primary endpoint was the maximum isometric detrusor pressure during a stop-test, corresponding to detrusor contractility, measured at 3 filling volumes (50%, 75%, and 100% of cystometric capacity). RESULTS: Fifty-two patients performed urodynamics, of whom 12 were excluded because of lack of obstruction or inability to perform the stop-test. Detrusor contractility was significantly higher for a 75% bladder filling than 50% and for a 75% filling than 100%, with a mean difference of 19.5; confidence interval (CI) 95% [14.3; 24.8] and 12.2; CI 95% [6.9; 17.5] cmH2 O respectively (p < 0,01). CONCLUSION: In case of bladder outlet obstruction in men, detrusor contractility depends on bladder filling volume, with reduced contractility when the bladder was underfilled or overfilled. This phenomenon could help to explain the mechanisms of urinary retention in men with bladder outlet obstruction.


Assuntos
Obstrução do Colo da Bexiga Urinária , Retenção Urinária , Humanos , Masculino , Obstrução do Colo da Bexiga Urinária/etiologia , Bexiga Urinária , Retenção Urinária/complicações , Estudos Prospectivos , Procedimentos Cirúrgicos Urológicos/efeitos adversos , Urodinâmica
4.
Am J Physiol Renal Physiol ; 320(4): F537-F547, 2021 04 01.
Artigo em Inglês | MEDLINE | ID: mdl-33491563

RESUMO

Local or systemic inflammation can severely impair urinary bladder functions and contribute to the development of voiding disorders in millions of people worldwide. Isoprostanes are inflammatory lipid mediators that are upregulated in the blood and urine by oxidative stress and may potentially induce detrusor overactivity. The aim of the present study was to investigate the effects and signal transduction of isoprostanes in human and murine urinary bladders in order to provide potential pharmacological targets in detrusor overactivity. Contraction force was measured with a myograph in murine and human urinary bladder smooth muscle (UBSM) ex vivo. Isoprostane 8-iso-PGE2 and 8-iso-PGF2α evoked dose-dependent contraction in the murine UBSM, which was abolished in mice deficient in the thromboxane prostanoid (TP) receptor. The responses remained unaltered after removal of the mucosa or incubation with tetrodotoxin. Smooth muscle-specific deletion of Gα12/13 protein or inhibition of Rho kinase by Y-27632 decreased the contractions. In Gαq/11-knockout mice, responses were reduced and in the presence of Y-27632 abolished completely. In human UBSM, the TP agonist U-46619 evoked dose-dependent contractions. Neither atropine nor the purinergic receptor antagonist pyridoxalphosphate-6-azophenyl-2',4'-disulfonic acid decreased the effect, indicating that TP receptors directly mediate detrusor muscle contraction. 8-iso-PGE2 and 8-iso-PGF2α evoked dose-dependent contraction in the human UBSM, and these responses were abolished by the TP antagonist SQ-29548 and were decreased by Y-27632. Our results indicate that isoprostanes evoke contraction in murine and human urinary bladders, an effect mediated by the TP receptor. The G12/13-Rho-Rho kinase pathway plays a significant role in mediating the contraction and therefore may be a potential therapeutic target in detrusor overactivity.NEW & NOTEWORTHY Voiding disorders affect millions of people worldwide. Inflammation can impair urinary bladder functions and contribute to the development of detrusor overactivity. The effects and signal transduction of inflammatory lipid mediator isoprostanes were studied in human and murine urinary bladders ex vivo. We found that isoprostanes evoke contraction, an effect mediated by thromboxane prostanoid receptors. The G12/13-Rho-Rho kinase signaling pathway plays a significant role in mediating the contraction and therefore may be a potential therapeutic target.


Assuntos
Isoprostanos/farmacologia , Músculo Liso Vascular/efeitos dos fármacos , Antagonistas de Prostaglandina/farmacologia , Receptores de Prostaglandina/efeitos dos fármacos , Receptores de Tromboxanos/efeitos dos fármacos , Animais , Humanos , Prostaglandinas/farmacologia , Receptores de Tromboxanos/fisiologia
5.
Front Rehabil Sci ; 2: 655400, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-36188844

RESUMO

Introduction: Sacral-Nerve-Neuromodulation (SNM) is an effective treatment increasingly used in patients with urinary (UI) and fecal incontinence (FI). The way it acts in the body at its full potential have not yet been elucidated. The authors review the literature on SNM and the way it possibly works, relating it to a case with an unusually favorable outcome. Case Presentation: A female presented with UI and FI. Operated for meningocele as a neonate. It the age of 5 bilateral Cohen ureter reimplantation performed for persistent urinary infections due to vesicourethral reflux. At the age of 13, she started complaining about UI associated with a hyper functional detrusor muscle. After a diary incontinence evaluation with a standardized questionnaire, SNM was applied at the age of 18 and was retained for 4 years. She was re-evaluated with a yearly follow-up. Results: The patient retained the positive effect of SNM even after its removal and in addition showed signs of improvement. The patient developed the sensation of fillingness of the bladder and the rectum, which she never had before the SNM implantation, sensation which she retained 29 months after (last follow-up) device removal, allowing her to control her voids. Discussion: The modern literature hypothesis that SNM contributes to the plasticity of the nerves through the stimulated area is supported by the present case, in which the SNM effect remained and led to improvements even after its removal. Device settings are presented as they may correlate with the result. This reinforces and expands the frontiers of SNM application and research.

6.
Heliyon ; 6(11): e05472, 2020 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-33251357

RESUMO

The 6-hydroxydopamine (6-OHDA) rat model is one of the most common animal models of Parkinson's disease. When experimentally inducing dopaminergic neurodegeneration in the nigrostriatal pathway using 6-OHDA, the noradrenergic reuptake inhibitor desipramine is often systemically injected in order to protect against damages to the noradrenergic system in the brain. An increasing number of studies are focusing on understanding the pathophysiological changes underlying autonomic non-motor symptoms, in particular urinary bladder and gastrointestinal dysfunctions, of the disease. Several of these studies have investigated the contractile properties and the activation of smooth muscle in the 6-OHDA rat model. Since the injection of desipramine is commonly placed in close proximity to the urinary bladder and gastrointestinal tract, in the current study we wanted to understand if the drug alone has an effect. For this, we have injected a single dose (25 mg/kg) of desipramine either intraperitonially or subcutaneously and investigated smooth muscle contractility in vitro in the urinary bladder, proximal colon and distal ileum four weeks post injection. Our data show that desipramine significantly alters smooth muscle contractility of the urinary bladder and proximal colon in healthy rats. Conclusively, we suggest, based on our data, that desipramine should be omitted when using the 6-OHDA rat model to investigate smooth muscle function in Parkinson's disease research.

7.
Bladder (San Franc) ; 7(2): e42, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32775484

RESUMO

OBJECTIVES: To determine the rate of residual disease and under-staging after primary transurethral resection (TUR) of bladder tumors (TURBT) in tertiary hospitals in Western Australia. METHODS: A retrospective study was performed evaluating all patients with TaHG (stage Ta, high-grade), T1LG (stage T1, low-grade) or T1HG (stage T1, high-grade) bladder cancer on primary TURBT conducted between January 1, 2012 and December 31, 2017 at the four largest metropolitan public hospitals in Western Australia. Only patients who underwent repeat resection within 3 months from initial resection were included. Those with previous history of bladder cancer, incomplete follow-up data and visibly incomplete initial resection were excluded. Baseline patient demographics, macroscopic clearance at initial resection, and disease data at initial and repeat resections were recorded. RESULTS: Sixty-seven patients with a median age of 71 years were included in this study. At initial resection, T1HG was the most common disease stage (64.2%) and detrusor muscle was present in 82.1% of initial resections. At repeat resection, 41.8% of cases had residual disease. The rate of upstaging to muscle-invasive bladder cancer was 3.0%. Patients treated by operators with five or less years of formal training did not have a significantly different rate of residual disease from patients treated by operators with more than five years of experience. CONCLUSIONS: Repeat TUR should remain an essential practice due to high rates of residual disease and a small risk of tumor under-staging. The presence of detrusor muscle and macroscopic clearance should not be used as surrogates for adequacy of resection or consideration of avoiding a repeat TUR, even for TaHG disease.

8.
Exp Ther Med ; 13(6): 3424-3432, 2017 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-28587421

RESUMO

Suo Quan Wan (SQW) has been used to treat lower urinary tract symptoms (LUTS) in elderly patients for hundreds of years in China. ß-adrenoceptors (ß-ARs), particularly ß3-adrenoceptor (ß3-AR), was reported to be important in the bladder dysfunction of the elderly. The present study was conducted to explore the effect of ß-AR, and particularly the ß3-adrenoceptor, in aging rat bladder function in vitro and to test the therapeutic effect of SQW on LUTS in an aging rat model based on the ß3-adrenoceptor. Briefly, the bladder detrusor muscles of young (age, 3 months) and aging (age, 15 months) female rats were separated. A ß-AR non-selective agonist, isoprenaline (ISO), subtype ß3-AR agonist (BRL37344A) and ß3-AR antagonist (SR59230A) were used to define the tension change of detrusor muscles between young and aging rats in vitro. For blank controls, 12 young rats were marked, and 48 aging female rats were randomly divided into four groups as follows: Model, SQW high, SQW middle and SQW low. Following oral administration of SQW for 6 weeks in aging rats, urodynamic and bladder detrusor tests were used to evaluate the therapeutic effect of SQW. The expression of ß3-AR mRNA was investigated using reverse transcription-quantitative polymerase chain reaction. Using ISO and BRL37344A in vitro, maximum relaxation (Emax), intrinsic activity (IA), and log (50% effective concentration) (PD2) were significantly decreased in aging rats compared with that in young rats (P<0.05). Significant changes were also observed in the ß3-AR antagonist experiment, which blocked ISO-induced relaxation, with significant decreases observed in Emax, IA and PD2, and a significant increase observed in PA2 for the aging rats compared with the young controls (P<0.05). SQW was demonstrated to enhance bladder control, storage and contraction ability. Furthermore, SQW was able to increase the sensitivity and expression of ß3-AR in an aging rat. In conclusion, the decrease in ß3-AR sensitivity in aging rats and the expression resulted in bladder detrusor dysfunction. In addition, the therapeutic effect of SQW against LUTS relies on the former's effect on the urethral sphincter, bladder detrusor and ß3-AR.

9.
Journal of Clinical Surgery ; (12): 463-465, 2017.
Artigo em Chinês | WPRIM (Pacífico Ocidental) | ID: wpr-620683

RESUMO

Objective To analyze the urodynamic data of the patients with benign prostatic hyperplasia(BPH)and provide evidence for the therapy.Methods 452 patients with BPH were selected.The mean age was(65.6 ±5.65)years(51 to 89 years).All patients had intact history documents which included the results of cystoscopy,urodynamics,doppler,DRE and PSA.Results 15 cases were not diagnosed with BOO.430 cases were diagnosed with BOO,among them,65 cases of bladder detrusor muscle weakness,bladder detrusor instability(detrusor,DI,instability)in 365 cases,3 cases were normal,and the other 4 cases had detrusor atony.In 445 patients the mean maximum urinary flow rate(8.32±3.15)ml/s,the average residual urine volume(87.68±79.46)ml,the average maximum flow rate when the detrusor pressure(62.32±7.54)cm H2O,maximum urethral closure pressure was(86.43±18.35)cmH2O,among which 19 cases were not suitable for surgery.At the end of the 426 patients underwent surgical treatment,postoperative follow-up of 3 to 18 months,the International Prostate Symptom Score(IPSS)from 0 to 5,the quality of life index(QOL)score of 0 to 1,Qmax 11 to 21 ml /s,residual urine(45.6±36.2)ml.There were significant differences between the preoperative and postoperative indexes(P<0.05).Conclusion Urodynamic tests can avoid the blindness in the surgery treatment of BPH.

10.
Zhonghua Nan Ke Xue ; 22(8): 720-724, 2016 Aug.
Artigo em Chinês | MEDLINE | ID: mdl-29019229

RESUMO

OBJECTIVE: To compare and analyze the effects of transurethral resection of the prostate (TURP) and transurethral holmium laser enucleation of the prostate (HoLEP) in the treatment of benign prostatic hyperplasia (BPH) with bladder detrusor overactivity. METHODS: his study included 51 cases of BPH with bladder detrusor overactivity treated by TURP and another 58 treated by HoLEP. We evaluated the urination of the two groups of patients during the recovery period and at 3 and 6 months postoperatively. RESULTS: There were no statistically significant differences in such baseline data as the blood PSA level, prostate volume, International Prostate Symptom Score (IPSS), and quality of life (QOL) between the two groups of patients, except in effective bladder capacity, which was higher in the TURP than in the HoLEP group (ï¼»315±59ï¼½ vs ï¼»287±76ï¼½ ml, P<0.05). Urine storage symptoms were obviously improved in both of the groups postoperatively, with the storage symptoms score significantly decreased from 12.6±4.9 preoperatively to 7.5±3.9 at 3 months and 6.1±4.2 at 6 months after surgery in the TURP group (P<0.01) and from 13.7±5.7 to 7.9±4.2 and 7.0±5.1 in the HoLEP group (P<0.01). HoLEP manifested significant advantages over TURP in the postoperative urethral catheterization time (ï¼»2.7±0.8ï¼½ vs ï¼»5.1±1.2ï¼½ d, P<0.05), postoperative bladder contracture time (ï¼»4.1±1.9ï¼½ vs ï¼»5.8±2.4ï¼½ d, P<0.05), postoperative hospital stay (ï¼»4.4±1.8ï¼½ vs ï¼»5.9±2.5ï¼½ d, P<0.05), and improvement of the maximum urinary flow rate, which was increased from (7.9±3.7) ml/s preoperatively to (16.8±4.3) ml/s at 3 months after surgery in the HoLEP group and from (8.6±3.2) ml/s to (14.6±4.3) ml/s in the TURP group (P<0.05). CONCLUSIONS: Both TURP and HoLEP can improve bladder function and detrusor overactivity in BPH patients, with similar effects in improving urination at 3 to 6 months after surgery. However, HoLEP has more advantages over TURP during the period of postoperative recovery.


Assuntos
Lasers de Estado Sólido/uso terapêutico , Próstata/cirurgia , Hiperplasia Prostática/cirurgia , Ressecção Transuretral da Próstata/métodos , Bexiga Urinária Hiperativa/cirurgia , Humanos , Tempo de Internação , Masculino , Qualidade de Vida , Resultado do Tratamento , Obstrução do Colo da Bexiga Urinária/cirurgia , Cateterismo Urinário/estatística & dados numéricos , Micção/fisiologia
11.
National Journal of Andrology ; (12): 720-724, 2016.
Artigo em Chinês | WPRIM (Pacífico Ocidental) | ID: wpr-262318

RESUMO

<p><b>Objective</b>To compare and analyze the effects of transurethral resection of the prostate (TURP) and transurethral holmium laser enucleation of the prostate (HoLEP) in the treatment of benign prostatic hyperplasia (BPH) with bladder detrusor overactivity.</p><p><b>METHODS</b>his study included 51 cases of BPH with bladder detrusor overactivity treated by TURP and another 58 treated by HoLEP. We evaluated the urination of the two groups of patients during the recovery period and at 3 and 6 months postoperatively.</p><p><b>RESULTS</b>There were no statistically significant differences in such baseline data as the blood PSA level, prostate volume, International Prostate Symptom Score (IPSS), and quality of life (QOL) between the two groups of patients, except in effective bladder capacity, which was higher in the TURP than in the HoLEP group ([315±59] vs [287±76] ml, P<0.05). Urine storage symptoms were obviously improved in both of the groups postoperatively, with the storage symptoms score significantly decreased from 12.6±4.9 preoperatively to 7.5±3.9 at 3 months and 6.1±4.2 at 6 months after surgery in the TURP group (P<0.01) and from 13.7±5.7 to 7.9±4.2 and 7.0±5.1 in the HoLEP group (P<0.01). HoLEP manifested significant advantages over TURP in the postoperative urethral catheterization time ([2.7±0.8] vs [5.1±1.2] d, P<0.05), postoperative bladder contracture time ([4.1±1.9] vs [5.8±2.4] d, P<0.05), postoperative hospital stay ([4.4±1.8] vs [5.9±2.5] d, P<0.05), and improvement of the maximum urinary flow rate, which was increased from (7.9±3.7) ml/s preoperatively to (16.8±4.3) ml/s at 3 months after surgery in the HoLEP group and from (8.6±3.2) ml/s to (14.6±4.3) ml/s in the TURP group (P<0.05).</p><p><b>CONCLUSIONS</b>Both TURP and HoLEP can improve bladder function and detrusor overactivity in BPH patients, with similar effects in improving urination at 3 to 6 months after surgery. However, HoLEP has more advantages over TURP during the period of postoperative recovery.</p>


Assuntos
Humanos , Masculino , Lasers de Estado Sólido , Usos Terapêuticos , Tempo de Internação , Próstata , Cirurgia Geral , Hiperplasia Prostática , Cirurgia Geral , Qualidade de Vida , Ressecção Transuretral da Próstata , Métodos , Resultado do Tratamento , Obstrução do Colo da Bexiga Urinária , Cirurgia Geral , Bexiga Urinária Hiperativa , Cirurgia Geral , Cateterismo Urinário , Micção , Fisiologia
12.
J Ethnopharmacol ; 150(3): 1128-36, 2013 Dec 12.
Artigo em Inglês | MEDLINE | ID: mdl-24184080

RESUMO

ETHNOPHARMACOLOGICAL RELEVANCE: Coptidis Rhizoma has been used to treat diabetes mellitus for more than 1400 years in China. Berberine, one of the main alkaloids of Coptidis Rhizoma, is a principal antidiabetic component of Coptidis Rhizoma. To investigate the effects of berberine on impaired neurogenic contractility of detrusor muscle from urinary bladder of rats with early stage diabetes. MATERIALS AND METHODS: The detrusor muscle strips were isolated from urinary bladders of streptozotocin-induced diabetic rats, 5% sucrose-induced diuretic rats or normal rats, and were placed in organ bath. The contractions induced by electrical field stimulation (EFS), carbachol, KCl, adenosine triphosphate, and the effects of berberine on those contractions were measured. RESULTS: The EFS- or KCl-induced contraction of detrusor muscle was significantly decreased in diabetic rats as compared with diuretic or normal rats. Atropine and suramin inhibited EFS-induced contraction. In diabetic rats, the atropine sensitive components were decreased in EFS-induced contraction of detrusor muscle, and the adenosine triphosphate-induced contraction was significantly increased. The carbachol-induced contrations were not different among groups. Berberine significantly potentiated EFS-induced contractions of detrusor muscle both from normal and diabetic rats, but the potentiated effect of BBR was more sensitive to atropine in diabetic rats. Berberine also potentiated adenosine triphosphate-induced contraction of detrusor muscle, but did not change carbachol- or KCl-induced contraction. CONCLUSION: The neurogenic contraction of urinary bladder detrusor muscle is decreased while purinergic contraction of bladder detrusor muscle is increased in rats with early stage diabetes. Berberine increases the neurogenic contractile response to EFS possibly via both presynaptic increasing neurotransmitters release and postsynaptic potentiation of purinergic transmitter-regulated response in rat urinary bladder detrusor; and in diabetic rats, berberine increases neurogenic contractile response mainly via the presynaptic increasing acetylcholine release.


Assuntos
Berberina/farmacologia , Diabetes Mellitus Experimental/fisiopatologia , Contração Muscular/efeitos dos fármacos , Bexiga Urinária/efeitos dos fármacos , Trifosfato de Adenosina/farmacologia , Animais , Carbacol/farmacologia , Estimulação Elétrica , Técnicas In Vitro , Masculino , Músculo Liso/efeitos dos fármacos , Músculo Liso/fisiologia , Fenilefrina/farmacologia , Cloreto de Potássio/farmacologia , Ratos , Ratos Sprague-Dawley , Bexiga Urinária/fisiopatologia
13.
Artigo em Chinês | WPRIM (Pacífico Ocidental) | ID: wpr-392096

RESUMO

Objective To explore the cause of acute urinary retention (AUR) ,the functional change of bladder detrusor. Methods The clinical data in 178 patients with AUR combined with urodynamic study were retrospectively analyzed. Results In male patients,the main cause of AUR was bladder oudet obstruction(BOO) ,the percent was 60.63%(77/127) ,in age more than 50 years old patients, while, in age less than 50 years old patients,the main cause was detrusor arcflexia (DUA), the percent was 72.55% (37/51), because of trauma of Iumbosacral vertebrae. In the female patients, the main cause of AUR was DUA. Between male and female patients with age more than 50 years old, there was significant difference in the cases of low compliance and DUA (P < 0.01) ,unstable bladder and BOO (P < 0.05). Conclusions The main cause of AUR in elderly male patients is BOO, which induces low eompliance and unstable bladder. While the main cause of AUR in female patients and young-middle age male is DUA .The function of detrusor changes differently with various causes.

14.
Chinese Journal of Urology ; (12): 422-424, 2008.
Artigo em Chinês | WPRIM (Pacífico Ocidental) | ID: wpr-400444

RESUMO

Objective To evaluate the relationship between urodynamics and ultrastructure of bladder detrusor in patients with benign prostatic hyperplasia(BPH). Methods The ultrastructure of detrusor was studied by transmission electron microscopy in 43 cases of BPH(mean age 69.5±6.0 years)and 21 cases(mean age 65.4±7.2 years)of geriatric without bladder outlet obstruction(the controls).All the cases were performed urodynamic test. Results The IPSS(21.1±3.0 VS 7.6±1.4),maximum flow rate(7.7±1.3 ml/s VS 14.9±2.3 ml/s)and AG(44.8±9.9 VS 19.0±5.9)showed significant differences between the the BPH group and control group(P<0.01).Pdet-Qmax in the BPH group(60.1±11.0 cm H20)was higher than that in the control group(48.7±7.1 cm H2o) (P<0.05).The relative density of mitochondria in the BPH group(0.81±0.24)was lower than that in the control group(1.03±0.11)(P<0.05).The intercellular linkage in the BPH group(19.4±4.8 rim)was larger than the control group(14.1±2.0 nm)(P<0.05). Conclusions The swelling and reduction of the relative density of mitochondria could be seen in the bladder detrusor of BPH patients.The large intercellular linkage might be the reason of decrease the coordinate contractility of the blad-der detrusor.

15.
Artigo em Chinês | WPRIM (Pacífico Ocidental) | ID: wpr-381700

RESUMO

Objective To investigate the P2X3 receptor expression in L6-S1 dorsal root ganglion (DRG)and bladder detrusor in a rat model of neurogenic bladder and urethra. Methods Eighty Sprague-Dawley rats wererecruited and randomly divided into a sacral injury group, a suprasacral injury group and a control group. Spinal tran-section was performed to establish the animal model of neurogenic bladder and urethra in rats of the sacral injurygroup and suprasacral injury group. Check the P2X3 receptor expression in DBG and bladder detrusor among thethree groups by Western blot test at 20 days after model establishment. Results P2X3 receptor expression in L6-S1DRG of sacral injury group was significantly less than that of the suprasacral injury group, which was in turn signifi-cantly higher than that of the control group. P2X3 receptor expression in bladder detrusor of sacral injury group wassignificantly lower than that of the suprasacral injury group, which was in turn significantly higher than that of thecontrol group. Conclusion There was close relationship between P2X3 receptor expression and dysfunction of blad-der and urethra.

16.
Artigo em Chinês | WPRIM (Pacífico Ocidental) | ID: wpr-979437

RESUMO

@#ObjectiveTo investigate the effects of electroacupuncture in Guanyuan(Ren4) and Zhongji(Ren3) on the functions of neurogenic bladder in patients with spinal cord injury(SCI) with the standard urodynamic measure.Methods15 patients with neurogenic bladder after SCI were included into the study.During urodynamic measure,they accepted electroacupuncture in Guanyuan(Ren4) and Zhongji(Ren3).The changes of the bladder storage volume(VH2O),bladder pressure(Pves),detrusor pressure(Pdet) and bladder compliance(BC) before and after electroacupuncture were recorded.ResultsThe patients' VH2O increased from(124.00±77.37) ml to(144.47±85.87) ml(P<0.01),Pves decreased from(65.33±23.90) cmH2O to(55.27±17.52) cmH2O(P<0.05),Pdet decreased from(52.87±18.68) cmH2O to(44.93±15.82) cmH2O(P<0.05)and BC increased from(2.35±2.05) ml/cmH2O to(3.48±3.04) ml/cmH2O(P<0.01).ConclusionElectroacupuncture is effective on neurogenic bladder recovery in patients with SCI.

17.
Artigo em Chinês | WPRIM (Pacífico Ocidental) | ID: wpr-586199

RESUMO

Considerable advances have been made in the understanding of the cellular processes that result in contraction and relaxation of detrusor smooth muscle recently,particularly in the role and modulation of calcium.Several changes in these cellular mechanisms that impair normal function have been observed in detrusor muscle from patients with unstable bladders.Whether these changes represent primary causes of bladder dysfunction or whether they are secondary to bladder dysfunction remains to be determined.Nevertheless,the identification of specific cellular lesions in bladder dysfunction presents a novel approach to identification of drug targets and potential treatment modalities.

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