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Biomedical subjects

A Ingelman-Sundberg

Publications and source records attributed to A Ingelman-Sundberg.

At least 19 recordsLinked to original sources
PubMed1983

The influence of an early diagnosis on the results of surgical treatment of ectopic pregnancy.

The postoperative fertility of 292 cases of ectopic pregnancy treated 1972-1979 was studied. Of these 156 were operated upon during 1972-1976, when only determinations of HCG in urine were available and 136 during 1977-1979, when RIA-determinations of HCG in serum made an earlier pregnancy diagnosis possible. In spite of the fact that the time of observation was shorter in the second group the pregnancy rate was 41% compared to 31% in the first one (P less than 0.05). The rate of childbirth among the pregnancies in the second group was 72% compared to only 55% in the first one (P less than 0.05).

Adolescent↗
PubMed1982

[Operative therapy of urinary incontinence. Preoperative requirements--operation methods--after care].

Optimum success may be obtained from those incontinence operations which form one coherent unity with presurgical and postsurgical measures. Full elucidation of the symptom of urinary incontinence has proved to be the most important preoperative necessity. More comprehensive urometric objectivation will be required for problems which cannot be answered by a minimum programme. Time-consuming diagnosis should be, basically, accompanied by conservative incontinence treatment, primarily for three reasons, substantiation of diagnosis, avoidance of meaningless surgery, and improvement of conditions for the operation proper as well as for its lasting success. - The sling operation, retropubic urethrocystopexy, and vaginoplasty are major groups in stress incontinence surgery which are described by illustrated examples. Reference is made to partial denervation of the urinary bladder as a possible therapeutic approach to urge incontinence. Proposals are made for proper choice of methods, in agreement with both the general state of the art and the author's personal experience. - Postoperatively, particular attention should be given to continued physiotherapy, endurance of adequate micturition without residual urine, and nephrological follow-up care of patients with urinary tract infection who had failed to respond to therapy. The difficulties implied in identification of lasting results may be seen from the findings obtained from follow-up examination of patients on whom pubococcygeal repair had been performed. Something between four and five months will be required for optimum multi-step therapy.

Female↗
PubMed1980

Surgical treatment of post abortum endometriosis of the bladder and postoperative bladder function.

During the years 1953-1967, 17 women with endometriosis of the urinary bladder were treated with extirpation of the endometrial tissue, including partial or total resection of the trigone. In all cases the endometriosis had followed vaginal hysterotomy for legal abortion. Urethrocystoscopy was performed and the residual urine and bladder capacity were measured in all the patients one month and one year after the bladder operation. At follow-up in 1978 only 4 of the 17 women were available for urodynamic studies. Combined urethrocystometry, recording of the urethral pressure profile and measurement of the maximal urethral pressure in supine and standing positions were performed in these four patients, using the technique of Ulmsten et al. In all cases in the series, including those with trigone extirpation, all the tested parameters were normal. The writers therefore conclude that even total trigone resection can be done without disturbance to the bladder function.

Abortion, Induced↗
PubMed1978

Pressure transmission to the pre-urethral space in stress incontinence.

Pressure transmission from the abdomen to the pre-urethral space has been studied in stress- incontinent women and in some women following pubococcygeal repair for stress incontinence. Pressure was recorded at different levels of the pre-urethral space and simultaneously in the bladder. Simultaneous measurements inside and outside the urethra at different levels above the external urethral meatus showed that an intra-abdominal pressure rise was transmitted via the pre-urethral space to the urethra. Pressure was transmitted almost in full to the surroundings of the lower-most part of the bladder, but outside the functional urethra, transmission was successively more defective along the urethra towards the external meatus. Therefore, a short functional length and a distal maximal pressure plateau in the urethra, as in stress incontinence, is a disadvantage. Pressure losses amount to 1/3 or more. Pressure transmission could be improved to "supranormal" values by establishing firm support for the urethra, thereby allowing a minimum of rotational descent with stress and providing good counterpressure.

Female↗
PubMed1978

Urethral pressure profile before, during and after pubococcygeal repair for stress incontinence.

In two groups of women the urethral pressure profile was recorded using a microtransducer catheter. Both groups were of approximately the same age, one consisting of continent women, the other of women with severe stress incontinence. Sixteen stress incontinent woman were examined before and after pubococcygeal repair and 10 of these were also examined during the operation. The two groups were compared for differences in the urethral pressure profile in the continent and incontinent states. The stress incontinent women had a significantly shorter functional length of the urethra (10 mm) but the same maximal urethral pressure as continent women. Remarkable changes in these parameters were seen during the operation. However, at the examination 3 months postoperatively, they had totally disappeared. The only change in the urethral pressure profile which persisted after the operation was a higher pressure in the proximal part of the urethra so that a urethral maximal pressure plateau had been established. This plateau was also seen, on a higher level, in the continent state.

Female↗
PubMed1978

Reversible sterilization.

The present techniques for sterilization of women consist of different methods to block the passage through the oviducts. The disadvantage of all techniques is that the possiblity of restoring fertility is very limited. The aim of the present study is to demonstrate a method of sterilization which is reversible.

Animals↗
PubMed1978

Surgical treatment of urinary fistulae.

A survey is presented, based upon a personal material of 225 cases of urinary fistulae. 173 of them were postoperative or obstetric fistulae, whereas 52 had appeared after a radiological or combined radiological and surgical treatment for cancer of the uterus. --The author's method for preparing the fistula region from a transverse incision under the external urethral orifice is described as well as his grafting techniques. Vessels are brought to the fistula region by using flaps from one or both pubococcygeus muscles, the rectus abdominis muscle or the gracilis muscle. --For vesico-vaginal fistulae situated high up in the fundus a graft from the omentum majus or an appendix epiploica is sometimes used. They can usually be grasped from below after the peritoneum has been opened. --In cases where the ureters were also damaged by irradiation a special technique was used. After the damaged part of the ureter had been resected the ureters were implanted into an ileum segment which was anastomosed to the bladder fistula. --In one of the 173 non-irradiated cases, a Bricker-bladder had finally to be made because of the failure to achieve a functioning urethra. The others were all cured after one or in a few cases two operations. --Among the 52 cases, which had been irradiated, 46 coud to be made, one got a fast growing local recurrence of the carcinoma and one had too bad general condition to allow a diversion operation. Two patients have rest fistulae but may be possible to cure conservatively.

Diagnosis, Differential↗
PubMed1976

In vivo determination of the stress-strain relation of the human myometrium.

Smooth muscle is capable of responding by contraction to mechanical distension. Neither the structural basis for this phenomenon nor the theories of smooth muscle behavior are completely clear. A method is now described by which the contractile response to mechanical distension of the human uterine muscle in vivo is determined. The distension is enforced sinusoidally within the frequency range 0.005-2 Hz, by filling and emptying a rubber balloon introduced into the uterine cavity. A tonometric index of the myometrium is defined using Hook's law after the approximate evaluation of a contractile modulus and the tangential stress and strain in the inner layer of the uterine wall. The regression line of indices upon frequency is calculated and intercept and regression coefficient of the equation for basic conditions are compared with those obtained during administration of pharmacologically active agents. It is suggested that the differences in intercepts and regression coefficients be used as a measure of drug effect.

Adaptation, Physiological↗