Tulane experience with management of urinary incontinence after placement of an artificial urinary sphincter

Summary Persistent urinary incontinence following placement of an artificial urinary sphincter (AUS) presents a challenging diagnostic problem. This report reviews 30 cases (27 males and 3 females) involving urinary incontinence following AUS placement. The mean age of the patients was 64.4 years (range, 10–79 years). Physical examination demonstrated evidence or suspicion of infection or erosion in 7 patients, and subsequent cystoscopic examination revealed erosion caused by the cuff in 6 of these 7 cases. The remaining 23 patients were evaluated by videofluorourodynamics (VFUD) to ascertain the cause of incontinence. VFUD demonstrated detrusor instability in 9 patients (39%), low detrusor compliance in 3 patients (13%), and poor detrusor contractility in 1 patient (4.4%). Bladder-outlet obstruction was diagnosed in 2 patients (8.8%) — 1 with bladder-neck contracture and 1 with ureteral stricture. Altogether, 2 (8.8%) cases of tissue atrophy were diagnosed with low urethral closing pressure at the cuff. In all, 1 patient (4.4%) was diagnosed as having a vesicovaginal fistula, 1 (4.4%) had a tubing kink, and 4 (17%) had leaking devices diagnosed during VFUD by cycling of the device. Of the 23 patients, 21 (91%) demonstrably improved or became fully continent after appropriate treatment had been initiated. A review of this study suggests that the majority of incontinent patients after AUS implantation can be managed successfully, provided that a systematic diagnostic approach is followed and appropriate treatment is initiated.     

Sub-urethral slings for treatment of stress urinary incontinence

Sling surgery is considered to be the gold standard for the treatment of incontinence resulting from internal sphincter deficiency. A century of experience is reviewed and evolving new concepts and techniques are presented.     

The Yeast flora of Egyptian Butter

All the 200 butter samples examined were found to contain yeasts. The species isolated were Trichosporon, Candida, Endomycopsis and Saccharomyces. Trichosporon species constituted most of the isolates (56.9 %), while Saccharomyces species was less met with (1.1 %).
Spoilage of butter by yeasts is caused by the breakdown of carbohydrates and fats liberating gases and acids which change the flavour and cause its rancidity.
The importance of antibiotics as predisposing factor for yeast infection of the udder was discussed.     

Continuous monitoring of micturition pattern in nonhuman primates: Technique

A complete system for continuous monitoring of micturition pattern in nonhuman primates is described and was tested using female rhesus monkeys. The system consists of modified standard animal cages, load cell transducers continuously activated and linked to a Grass polygraph. Potential problems or sources of error are described and overcome. The limitations are described; however, the system is proven to be reliable, durable, and accurate. © 1992 Wiley-Liss, Inc.     

Dermatologic complications in renal transplant recipients versus uraemic patients under maintenance haemodialysis treatment

One hundred and twelve renal transplant recipients and 40 patients with chronic renal failure undergoing maintenance haemodialysis were included in this study. Skin infections were the most common complication in renal transplant recipients (67.8%), with fungal infections being the most frequent (58%). Kaposi's sarcoma was found in three of our transplant patients (2.6%); no other skin tumors were observed in our cases. The second most frequent skin complication after infections was acne lesions (43.7%). On the other hand, pallor and dryness were the most common skin signs observed in uraemic patients; fungal infections were found in 15%. No skin neoplasms were found in the uraemic patients. In conclusion, skin infections and Kaposi's sarcoma are more common in renal transplant recipients than in uraemic patients under haemodialysis maintenance treatment.     

Effect of time interval and overdistension on repeated urodynamic studies.

Repeated urodynamic testing of the lower urinary tract is often needed both clinically and experimentally. The objective of this study is to find out the time interval needed if repeated urodynamic tests are required even if overdistension occurs initially. Three hundred forty urodynamic studies were performed using five female rhesus monkeys (Macaca mulatta). Two groups of experiments (with or without bladder overdistension) were performed at the following time intervals: immediate, 15, 30 and 45 minutes after the initial urodynamic study. All urodynamic parameters (pressure, capacity, compliance and detrusor strength) were reproducible after a 30-minute waiting period. In case of overdistension, a 45-minute period is required.     

Pilzse in Lebensmitteln: Incidence of Candida species in Damietta cheese

De 200 muestras de queso se aislaron 380 cepas de levaduras. Candida (C.) parapsilosis, C. parapsilosis var. intermedia, C. tenuis, C. guilliermondii, C. pulcherrima, C. reukaufii y C. albicans fueron las cepas mas frecuentemente halladas, mientras que se halló C. robusta, forma imperfecta de Saccharomyces cerevisiae, sólo en 2 muestras.     

Irritable bladder syndrome in an animal model: A continuous monitoring study

Irritable bladder syndrome (IBS) was induced in four female African green monkeys (Cercopithecus aethiops) by the use of intravesical instillation of acetone. The animals were housed in a modified metabolic cage for continuous micturition monitoring, and two uroflowmeters connected to a remote PC monitored the frequency, voided volumes, and peak flows. Before and after, urea absorption studies and urodynamics were obtained for each animal. Urea absorption increased significantly after acetone instillation and returned to baseline after 4 weeks (26 to 66 to 32%). Intravesical acetone instillation produced marked effects on bladder physiology in the first week. Bladder compliance dropped from a baseline of 10.47 to 0.58 ml/cm H₂O. The voiding pattern changed from a normal pattern with a mean voided volume of 17.58 ml into marked increase in frequency and dribbling pattern with few voids (mean = 5.03 ml). Systematic behavioral observations were carried out for 4 hours per day utilizing an observation program on a laptop computer. Activity patterns, attention, sterotypic behaviors, and self-directed activities were recorded for each monkey. The animals demonstrated decreased frequency of activity and increased frequency in self-directed activities (groom, scratch), behaviors consistent with an animal experiencing pain or discomfort. The findings suggested that IBS induction in monkeys is feasible and produces a clinical picture similar to interstitial cystitis in humans. It offers a suitable animal model to enhance the understanding of voiding dysfunction with its neural pathways and to test the different therapeutic modalities to control IBS. © 1995 Wiley-Liss, Inc.