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C Laudermilch

Publications and source records attributed to C Laudermilch.

2 recordsLinked to original sources
PubMed1997

Reproductive understanding, sexual functioning and testosterone levels in men with spina bifida.

PURPOSE: We assessed the sexual functioning and understanding in men with myelodysplasia. MATERIALS AND METHODS: Of the 378 patients with myelodysplasia followed at our multidisciplinary clinic 170 are adults, including 58 men older than 18 years. A total of 57 men was available for interview. A questionnaire was administered to determine patient educational level, sexual understanding, sexual function and marital status, and serum testosterone levels were measured. RESULTS: The majority of the patients learned about sexual reproduction from school classes with 48 (84%) having achieved a twelfth grade education or higher. A total of 41 patients (72%) accurately described the basic concepts of reproductive physiology. Penile erections were experienced by 41 men (72%) including 27 (66%) who ejaculated with erection. Three patients ejaculated without erection. Sexual intercourse was attempted by 20 men (35%). Of the 11 patients (19%) who attempted to father children 8 (14%) were successful. Twelve patients (21%) have been married, including 2 who are divorced. Serum testosterone levels in 44 patients were normally distributed. CONCLUSIONS: Sexual reproductive understanding, and erectile and ejaculatory function are present in many men with myelodysplasia. The level of the neurological lesion was not predictive of erectile or ejaculatory function but it appears that reproductive potential is favored by lower and less severe lesions. All but 1 of the 8 patients who fathered children had an L5 or sacral neurological level lesion, each was ambulatory and none had a ventriculoperitoneal shunt at the time of conception. These data may prove useful when counseling patients and their parents about eventual sexual performance.

Adolescent↗
PubMed1994

Transurethral electrical bladder stimulation: a followup report.

Transurethral electrical bladder stimulation (TEBS) initially proposed to rehabilitate the neurogenic bladder has been promoted in the United States since the mid 1980s. The ultimate goal of TEBS is volitional voiding. Since January 1989 we performed 938 sessions of stimulation comprising 64 TEBS series in 25 patients with neurogenic bladders. A cystometrogram was performed before each series of stimulation to monitor progress, and at the time of this review parental impressions of the stimulation were obtained by a telephone interview questionnaire. The initial evaluation cystometrogram before stimulation revealed that 18 patients (72%) had bladder contractions. After TEBS 24 patients (96%) manifest contractions. Before stimulation only 3 children sensed the contractions, while during stimulation half of the patients perceived the contractions. A cystometrogram performed before each series demonstrated a greater than 20% increase in the age adjusted bladder capacity in 6 of the 18 patients (33%) with serial studies. Improvements in the end filling pressure defined by clinically significant decreases were observed in 5 of these patients (28%). Results of the telephone questionnaire revealed that the parents perceived a benefit from stimulation more often than the urodynamic studies could confirm. In our experience TEBS is a time-consuming, labor intensive technique. The limited urodynamic benefits our patients achieved have not materially altered the daily voiding regimen and, because of these factors, we are not enrolling any new patients in our TEBS program.

Adolescent↗