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Biomedical subjects

C J Godec

Publications and source records attributed to C J Godec.

At least 55 records · Page 3Linked to original sources
PubMed1982

Another aspect of acute urinary retention in young patients.

Four homosexual men and one heterosexual woman presented with acute urinary retention secondary to intense anal intercourse. All had normal urologic histories. Their residual urine volumes ranged from 475 ml to 1,400 ml. Urinalyses and urine cultures were negative. All were treated with an indwelling Foley catheter and then with bethanechol and dibenzyline. Normal micturition was restored. To evaluate the influence of anal dilatation on detrusor function, five control patients with urge incontinence were studied. A cystometrogram (CMG) displayed a hyperreflexic bladder pattern in all five patients. Average bladder capacity was 86 ml. Calibrated anal dilatation increased bladder capacity to the average value of 406 ml on CMG. The diameter of anal dilatation ranged from 3.5 cm to 5 cm. Intense anal intercourse producing severe anal dilatation triggers reflex bladder inhibition leading to acute urinary retention. The sensory input travels from the dilated anus to the sacral spinal micturition center, which sends inhibitory stimuli to the urinary bladder.

Acute Disease↗
PubMed1982

The penis-a possible alternative emergency venous access for males?

For male patients in whom no other immediate venous channel is available, the intrapenile route may represent a life-saving alternative. Acute injection of fluid into corpora cavernosa was used to produce penile erection. With this simple injection technique, a high volume of fluid can be injected in a short time. Among 33 patients, only one was noted to have minor subcutaneous hematoma. The use of the intrapenile route of venous access is suggested for patients with severe hypovolemic shock. The principal advantage of the proposed method of venous injection is that it could represent a high-volume venous access system and is independent of the patient's volemic condition.

Catheterization↗
PubMed1981

Psychosocial aspects of micturition.

The complex act of micturition is still insufficiently understood and a controversial neuromuscular phenomenon. In humans, the urinary bladder reflects the constant accommodation to physiologic, psychologic, and social aspects of micturition. This article deals with these additional dimensions of micturition of which the urologist should be aware.

Animals↗
PubMed1981

Diagnostic strategy in evaluation of renal abscess.

The diagnosis of renal abscess is still a challenging problem. Early manifestations are usually nonspecific and nonlocalizing. Clinical picture, laboratory data, and intravenous pyelogram do not always differentiate between inflammatory lesions and neoplastic processes. Two cases with bilateral, metachronous renal abscesses are presented. The use of 111Indium scan is probably the major recent advance used for unmasking this inflammatory lesion. Sonography, computerized tomography scan, and even arteriography are sometimes necessary to establish reliable preoperative diagnosis. The diagnostic strategy for a systematic approach to the lesion is outlined.

Abscess↗
PubMed1981

Quantification of erection.

In the study of impotence the objective measurement of erection is not yet available. The commercially available nocturnal penile tumescence device records penile expansion only. Penile stiffness and intracavernosal pressure have not been measured. We only developed a penile model in which the simultaneous measurement of expansion and intraluminal pressure could be recorded. In the patient a similar measuring system has been used in acutely produced penile erection and serves as a point of reference to be compared to spontaneous erections recorded at night with the nocturnal penile tumescence device. The ratio between the artificial acute erection and the spontaneous nocturnal erection was calculated and aided in the evaluation of impotence.

Adult↗
PubMed1981

Micturition syncope.

Micturition syncope is a poorly understood neurophysiological event. Increased vagal stimulation at night, vagal sensory input from the bladder during micturition and standing position during voiding represent the most common triggering factors of this syndrome. Postural hypotension, caused by standing during micturition, may explain the predominance of male victims. Two cases are reported--a classic male example and an unusual incident in a woman.

Adult↗
PubMed1981

Melanoma of the female urethra.

Our patient had a highly malignant and poorly differentiated tumor in the distal urethra. A conservative operation was performed because the precise nature of the tumor was not clear with light microscopy. An ultrastructural study established the final diagnosis of malignant urethral melanoma and anterior exenteration was performed. An aggressive operation should be considered as the primary approach once malignant melanoma is diagnosed. Ultrastructural studies should be introduced early in the diagnostic process when light microscopy is insufficient to provide a definitive diagnosis of urethral malignancy.

Female↗
PubMed1981

Optimal parameters of electrical stimulation in the treatment of urinary incontinence.

We evaluated five types of electrical stimulation (continuous, intermittent pseudorandomized, randomized (stochastic), and intermittent randomized) for their effects on muscle contraction and muscle fatigue in 12 patients with urinary incontinence. Continuous stimulation, used in the available commercial stimulators, was not optimal. Randomized (stochastic) stimulation seems to be optimal although this conclusion was not statistically confirmed.

Electric Stimulation Therapy↗
PubMed1980

Detrusor hyperreflexia inhibited by anal dilatation.

Urge incontinence in 6 patients was found to be due to detrusor hyperreflexia. A cystometrogram was repeated during calibrated anal dilatation and showed increased bladder capacity and decreased hyperreflexia in 4 patients and a normal curve in 2 patients. The mechanism of this response is discussed.

Adolescent↗
PubMed1980

Emphysematous pyelonephritis in a solitary kidney.

Emphysematous pyelonephritis in a solitary kidney was present in a diabetic patient with servere electrolyte imbalance, hyperglycemia, oliguria and electrocardiographic changes suggestive of myocardial infarction. Percutaneous nephrostomy was performed as a life-saving procedure and a week later a large matrix stone obstructing the renal pelvis was removed. The optimal therapy with a surgical or conservative approach is discussed. The use of percutaneous nephrostomy as an initial lifesaving procedure is suggested.

Diabetes Complications↗
PubMed1980

Correlation among cystometry, urethral pressure profilometry and pelvic floor electromyography in the evaluation of female patients with voiding dysfunction symptoms.

We herein evaluate the correlation among cystometry, urethral pressure profilometry and pelvic floor electromyography in 137 female patients. The predominant symptom was frequency in 40 patients, urge incontinence in 31 and stress incontinence in 66. There appeared to be a correlation between urge incontinence and a hyperreflexic cystometrogram but no correlation was noted between either frequency or stress incontinence and the cystometrogram profile. The urethral pressure profile showed a correlation between stress incontinence and the lowest profile measurements. Frequency and urge incontinence had similar profile measurements except for maximum urethral planimetry. Electromyography showed that the external urethral sphincter had a different finding than the levator ani or the external anal sphincters in all 3 groups of female patients. The external urethral sphincter had a higher percentage of denervation than the other 2 muscles, especially in the stress incontinence group.

Anal Canal↗
PubMed1980

Comparison of pressure measurements in the lower urinary and lower fecal pathways.

The bladder and rectal ampullae have similar but not identical innervation from the spinal cord S2 to S4. A comparison of the functional behavior of the bladder and rectal ampullae was done with a cystometrogram and an ampullometrogram. The behavior of the urethral and anal sphincters was compared with electromyography and pressure profiles. In 20 patients there was a close relationship between the functional behavior of the lower urinary and lower fecal pathways.

Adult↗
PubMed1980

Cystometric variations during postural changes and functional electrical stimulation of the pelvic floor muscles.

Postural changes did not affect the cystometric curves of bladder function that were hyperreflexic, flaccid or secondary to bladder wall changes (fibrosis and inflammation). However, postural changes did affect normal curves in some patients with a history of micsturition disorders and resulted in detrusor instability when the patient was standing or walking. Functional electrical stimulation of the pelvic floor muscles during the cystometrogram inhibited detrusor instability of these patients in all positions. Use of postural changes and functional electrical stimulation of the pelvic floor muscles during the cystometrogram inhibited detrusor instability of these patients in all positions. Use of postural changes and functional electrical stimulation of the pelvic floor muscles is suggested to determine actual bladder function and to exclude possible artifacts in the curve.

Adolescent↗
PubMed1980

Functional evaluation of the rectal ampulla with ampullometrogram.

An ampullometrogram (AMG) was done in 20 patients to evaluate the rectal ampulla as a functional unit. Results were compared to a cystometrogram (CMG). The AMG displayed a normal curve (capacity 230 to 330 ml; pressure 47 to 80 cmH(2)O) in 14 of 16 patients having a normal CMG. The AMG was hyporeflexic (variable capacity; no increase in pressure at capacity) in 3 of 5 patients having a hyporeflexic CMG and hyperreflexic (capacity less than 175 ml, pressure over 80 cmH(2)O) in one patient having a hyperreflexic CMG. This technique might represent a useful clinical adjunct in the evaluation of bladder dysfunction, the evaluation of neurogenic type bowel dysfunction, and in the possible use of functional electrical stimulation for treatment of faecal incontinence or constipation.

Adult↗
PubMed1979

Rapid and slow-fill gas cystometry. Influence on bladder capacity and diagnosis of hyperreflexic bladder.

Rapid-fill gas cystometry has been criticized for giving a falsely low value of bladder volume and for inducing an "artefact", the hyperreflexic bladder. This study in 72 patients revealed that the average capacity with slow-fill air cystometry was less than with rapid fill. The diagnosis of hyperreflexic bladder was made more often with slow fill than with rapid fill in these 72 patients.

Adult↗