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1.
J R Andersen G Lose M N?rgaard H Stimpel J T Andersen 《British journal of urology》1988,61(4):310-313
In a randomised, double-blind study, 20 women with idiopathic detrusor instability and associated symptoms were treated with terodiline 25 mg bd, placebo, and emepronium bromide 200 mg tds--each drug being given for 3 weeks with placebo as wash-out period before cross-over. The results were evaluated according to drug preference, frequency charts and elimination of detrusor instability on cystometry. Serum levels of both drugs were monitored as control of tablet intake. The preference for terodiline to placebo was statistically significant: 14/3 women (P less than 0.05), and the majority of women (12/4) preferred terodiline to emepronium. Terodiline also gave a small but significant reduction in 24 h micturition frequency and eliminated detrusor instability in almost 50% of the patients (P less than 0.05). Side effects were frequent but mild in all three treatment periods. It was concluded that terodiline offers an alternative in the treatment of female detrusor instability. 相似文献
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During the last year we developed a disposable anal plug electrode for pelvic floor/external anal sphincter electromyography. The electrode consists of 2 disposable silver chloride surface electrodes mounted on a trochlear-shaped sponge. Testing of the new electrode with simultaneous registration of external anal sphincter electromyography using a coaxial needle electrode showed synchronous electromyographic patterns. In clinical urodynamic studies, including 48 cystometry studies with anal sphincter electromyography and 48 pressure-flow electromyographic studies, the electrode provided technically good and reliable electromyograms. The electrode design secures good contact to the recording surface and a safe fixation of the electrode during recording. The compressibility of the electrode might circumvent the problem of possible detrusor reflex inhibition induced by conventional hard anal plug electrodes. We recommend this technique for anal sphincter electromyography, since it is simple, reliable and without discomfort, and it does not require sterilization of the electrode. 相似文献
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To study the acute effect of norfenefrine, given orally in aqueous solution, on the urethral closure function, profilometry was performed before and after administration of placebo and increasing doses of norfenefrine in 6 females with genuine stress incontinence. A weak increase in urethral pressure was observed after administration of 90 mg of norfenefrine. No changes in heart rate and blood pressure occurred. The results indicate that the direct sympathomimetic effect of norfenefrine is weak. It is suggested that norfenefrine mainly acts via indirect mechanisms. 相似文献
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Yasmine Khayyami Niels Klarskov Gunnar Lose 《International urogynecology journal》2016,27(10):1449-1458
Introduction and hypothesis
The urethral closure mechanism in women is incompletely understood. Measuring closure function in a collapsed urethral tube without distending the tube and changing its natural shape is impossible with conventional methods. Over the last decade, studies with urethral pressure reflectometry (UPR), a method that measures pressure and the corresponding cross-sectional area along the entire length of the urethra continuously by means of acoustic reflectometry, have been performed. The studies have mainly been performed on patients with stress urinary incontinence (SUI).Methods
Our aim was to provide an overview of the studies conducted with UPR, establishing whether the method may be used in clinical practice. We reviewed all literature published on UPR.Results
Urethral pressure reflectometry is easily performed with limited bother for the patient. The catheter consists of a 45-cm-long PVC tube connected to a thin and highly flexible polyurethane bag, which is placed in the urethra. When inserted, the bag only occupies 0.4 mm2 of the urethra, respecting the natural shape and orientation of the urethra and, most importantly; respecting the laws of physics when measuring urethral pressure. UPR can discriminate patients with SUI from continent women and separate assessment of the sphincter function and support system is possible. Also, UPR has revealed statistically significant differences in urethral pressures after drug therapy for SUI.Conclusions
We conclude that UPR has a place in clinical practice. The method has shown groundbreaking potential in the understanding of urethral dysfunction in SUI patients.8.
Introduction and hypothesis
We evaluated the effect of adding pelvic floor muscle training (PFMT) to a structured lifestyle advice program.Methods
This was a single-blinded randomized trial of women with symptomatic pelvic organ prolapse (POP) stage?≥?II. Participants were randomized to a structured lifestyle advice program with or without PFMT. Both groups received similar lifestyle advice in six separate group sessions. The combined group performed group PFMT after an individual assessment. Primary outcome was a global improvement scale at six-month follow-up. Secondary outcomes were the global scale and objective POP at three-month follow-up, symptoms and quality of life including sexuality, at three and six-month follow-up. A clinically relevant change of symptoms was defined as ≥15 %.Results
We included 109 women. Eighty-nine women (82 %) completed three months follow-up; 85 (78 %) completed six-month follow-up. At both follow-ups, significantly more women in the combined group reported improvement in the global scale. At the three-month follow-up, the combined group only had significant improvement of POP symptoms while only the lifestyle advice group had significant improvement of quality of life. Change in objective POP and sexuality was nonsignificant. The symptom score improved 17 % in the combined group and 14 % in the lifestyle advice group (P?=?0.57). Significantly more women in the lifestyle advice group had sought further treatment at the six-month follow-up.Conclusion
Adding PFMT to a structured lifestyle advice program gave superior results in a global scale and for POP symptoms. Overall effect of either intervention barely reached clinical relevance.9.
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