Seminoma in the testes associated with haemospermia.
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Adult↗
Biomedical subjects
H Colstrup
Publications and source records attributed to H Colstrup.
[The urologic specialty. The Danish Society of Urology].
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Humans↗
[Transrectal ultrasonography of the prostate].
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Humans↗
[Waiting lists for men with benign urinary disorders].
This paper reflects the problems in having a large non-specific waiting-list. One hundred and twenty-eight patients were on a waiting-list under the main diagnosis of prostatism. This diagnosis revealed seven patients with cancer in the urinary tract system. Only two-thirds of the patients on the waiting-list were interested in further examination and treatment. This paper emphasizes the need for a more specific referral, when dealing with symptoms from the lower urinary tract system.
Denmark↗
Uroflow in women: an overview and suggestions for the future.
The literature on uroflowmetry in women is presented and evaluated. Uroflowmeters are described and found generally sufficiently accurate, although the errors arising from electronic evaluation may invalidate the test. Six flow curve patterns are proposed in accordance with described pathological conditions. From the literature it is summarized that the normal Qmax is 20-36 ml/s. Qmax is linearly correlated to the voided volume, increasing by 5.6 ml/s/100 ml. Pregnancy, age and menstrual cycle do not influence Qmax. Several pathological conditions have been associated with specific flow curve patterns. These conditions are described and associations with the proposed flow definitions made.
Female↗
Home uroflowmetry by means of the Da Capo home uroflowmeter.
OBJECTIVE: The Da Capo home flowmeter was tested versus the Urodyn 1000 flowmeter. The two flowmeters are based on different principles. The Da Capo is a portable, battery powered flowmeter designed to record all voidings during a period of time (e.g. 24 h) for a single patient. METHODS: The flowmeters were tested with regard to accuracy of measurement of the voided volume and maximum flow (Qmax). Further, the Da Capo was tested by 10 healthy male volunteers, median age 47 years, range 21-57. RESULTS: Both flowmeters were very accurate measuring Qmax and voided volume. A few artifacts arose, i.e. extremely high Qmax values were recorded. All test persons found the flowmeter easy to handle. CONCLUSION: The weight transducer based Da Capo home flowmeter proved as accurate as the stationary flowmeters. It is easy to handle and it provides all-day monitoring of uroflow and voided volume.
Adult↗
Pressure-to-cross-sectional area relationships in the proximal urethra of men with bladder outlet obstruction.
PURPOSE: Related values of pressure and cross-sectional area in the proximal urethra were measured in patients with bladder outlet obstruction. Urethral opening pressure and elastance (the inverse of compliance) were estimated. MATERIALS AND METHODS: We studied 15 men with standard urodynamic examinations. The pressure-to-cross-sectional area relationship in the prostatic urethra was determined using a special probe. RESULTS: Elastance varied significantly along the studied portion of the urethra, with higher values found in the sphincter area. The estimated urethral opening pressure appeared high compared to that in unobstructed cases and without variation along the prostatic urethra. CONCLUSIONS: The most important effect of prostatic obstruction appears to be the increased urethral opening pressure.
Aged↗
A new system for descriptive classification of stones in the upper urinary tract.
A descriptive classification is proposed to stratify upper urinary tract stones by their number, size and location. The system considers the minimal but most important factors regarding the choice of surgical treatment and its success. Its principle is adaptable to more complex staging systems already existing. Practical use of the system has shown it to reflect clinical events, and its simplicity offers an opportunity for compliance in routine clinical study. It facilitates easy computerized stratification of stones in the upper urinary tract.
Humans↗
Pressure/cross-sectional area relations in the proximal urethra of healthy males. Part 1: Elastance and estimated pressure in the uninstrumented urethra.
The pressure/cross-sectional area relation in the resting urethra during the storage phase was studied in 31 healthy male volunteers aged 23-85 years. Measurements were performed at 5-mm intervals from the bladder neck and beyond the region of high pressure, and the elastance and estimated pressure in the uninstrumented urethra (Po) were calculated at each measurement location. All subjects were further evaluated by means of symptom score, prostatic volume determined by rectal ultrasound, urethral pressure profile, cystometry, and pressure flow. The elastance and Po both varied along the urethra, with significantly higher values of both parameters in the sphincteric region as compared to the prostatic area. A significant positive correlation was found between Po and age in the prostatic parts of the urethra, whereas no correlation could be demonstrated between elastance and age in any part of the urethra. These results indicate that the prostatic parts of the urethra are readily distensible at modest intraluminal pressures as compared to the sphincteric segment, and that the intraluminal pressure required to obtain a given distension of this segment of the urethra seems to increase with age. It is suggested that the technique may prove of value in the elucidation of pathophysiological mechanisms related to benign prostatic hyperplasia, and that the technique may bring new insight into the mode of action of various treatment modalities for this disease.
Adult↗
Pressure/cross-sectional area relations in the proximal urethra of healthy males. Part 2: Power generation during voluntary contraction.
The power generation in the proximal urethra during voluntary squeezing was studied in 30 healthy male volunteers aged 23-85 years. Measurements were performed at 5-mm intervals from the bladder neck and beyond the region of high pressure, and the maximum power generation during contraction was calculated at each measurement location. All subjects were further evaluated by means of symptom score, prostatic volume determined by rectal ultrasound, urethral pressure profile, cystometry, and pressure flow. There was a significant variation in power generation along the urethra, with minimum values in the prostatic segments and an approximately 5-fold increase in the high pressure zone. Power generation remained high in the urethral segment distal to the high pressure zone. No correlation between age and power generation could be demonstrated in any part of the urethra. The technique employed does not allow for a differentiation of the individual muscles involved, however, it is suggested that the pelvic floor dominates above the level of the perineal membrane, whereas the striated muscles of the penis may influence the proximal part of the spongious urethra. Physiologically, the contractile capability of the male urethra is probably important for the continence function, as well as it may be of significance for the normal ejaculatory function.
Adult↗
The urethral resistance to rapid dilation: an analysis of the effect of autonomic receptor stimulation and blockade and of pudendal nerve blockade in healthy females.
The urethral closure function is based upon permanently as well as adjunctively acting closure forces during rest and stress episodes, respectively. During urine ingression intra- and peri-urethral structures are suddenly stretched resulting in a pressure response which strengthens the closure function by sustaining the resistance to dilatation of the urethra. A method for measurement of the resistance to rapid urethral dilatation was used to evaluate the influence of noradrenaline, prazosin, terbutaline, propranolol, carbachol, and atropine, as well as bilateral pudendal nerve blockades in 40 healthy women. The drugs caused no significant change in the urethral resistance to dilatation, whereas the pudendal blockade produced a significant (p < 0.05) reduction at the bladder neck and in the high pressure zone. Although a quantitative assessment of their contribution cannot be obtained from this study, it may be concluded that the striated muscles innervated by the pudendal nerve are of major importance for the urethral resistance to dilatation.
Adult↗
Voiding problems in patients with HIV infection and AIDS.
The prevalence and type of urinary voiding problems were prospectively investigated in 77 men and four women (median age 36 years) with HIV infection or AIDS consecutively attending an outpatient clinic. Urologic symptoms were registered from replies to a questionnaire and urologic evaluation was made when indicated. All patients were neurologically examined. In addition, urodynamic data from ten consecutively referred HIV/AIDS patients were retrospectively analyzed. Two of the 81 prospectively studied patients had severe, and eight had moderate voiding problems, while 19 had pathologic findings at neurologic examination. Of three patients referred for urodynamic investigation, two were found to have neurogenic bladder dysfunction. In three of the total 13 urodynamically studied patients the findings suggested neurogenic bladder dysfunction secondary to the infection. We conclude that HIV/AIDS infection affects voiding only in minor degree, and when it does the disease is often advanced and dominated by symptoms from other organs. The relevance of urologic/urodynamic investigation in HIV/AIDS patients thus seems limited.
Acquired Immunodeficiency Syndrome↗
[Varicocele of the testis. A comparison between laparoscopic and conventional surgery].
We compared the results of laparoscopic varicocelectomy in 11 patients with those of 11 conventional varicocelectomies. There was a significantly longer operating time for laparoscopic surgery (45 versus 35 minutes), but a shorter hospital stay (one versus two days) and a quicker return to normal activity (two versus four days). There was no statistically significant difference in the outcome of surgery in the two groups concerning symptomatology and objective findings, but three patients, all conventionally operated, had no effect of the operation. One patient, operated laparoscopically, had signs of genitofemoral nerve injury. We conclude that laparoscopic varicocelectomy may be superior to conventional surgery, but further evaluation in larger, prospective studies is warranted.
Adolescent↗
The effect of pharmacological stimulation and blockade of autonomic receptors and of pudendal blockade on urethral stress relaxation in healthy women.
OBJECTIVE: To examine the influence of autonomic receptor stimulation and blockade (noradrenaline, prazosin, terbutaline, propranolol, carbachol and atropine), and of pudendal nerve blockade on urethral stress relaxation. SUBJECTS AND METHODS: Forty healthy women were evaluated. The stress relaxation parameter was defined as the relative rate of pressure decrease during a fixed period of time following a rapid dilatation of the urethra. The dilatation was performed by water-infusion into a small rubber cylinder placed in the urethra. RESULTS: The drugs did not affect stress relaxation significantly, whereas the pudendal blockade produced a significant change along the length of the urethra characterized by a faster pressure decay following dilatation. CONCLUSION: In women, stress relaxation in the urethra relies significantly on the pudendal nerve-innervated striated muscles.
Adult↗
The dynamic urethral sphincter function in healthy females assessed by rapid dilatations in the resting state: evaluation of reproducibility.
Recording the pressure response to rapid dilatations enables one to assess urethral sphincter function. The rapid dilatations of the urethra experimentally simulate the ingression of urine. A method that enables standardized dilatations of 2-mm long urethral segments was urine (USED).A method that enables standardized dilatations of 2-mm long urethral segments was used, and the subsequent pressure response was measured. The reproducibility of the urethral pressure response to rapid and standardized dilatations was evaluated by repeating the measurements after 1 week in 10 healthy females. The pressure response showed an acceptable reproducibility. The urethral pressure increase as a response to dilatation is considered to rely on stretching of intra- and periurethral fibers. Calculations of strain (change in length divided by the original length) of circularly arranged fibers when the urethra is dilated indicate that the tension (and pressure) bearing layers must be located outside a circular zone with a radius of 4 mm perpendicular to the longitudinal axis of the urethra.
Adult↗
The dynamic pressure response to rapid dilatation of the resting urethra in healthy women: an in vivo evaluation of visco-elastic properties.
The urethral pressure response to a sudden forced dilatation was studied at the bladder neck, in the high-pressure zone and in the distal urethra in ten healthy female volunteers. The pressure response was fitted with a double exponential function of the form Pt = Pequ + P alpha e-t/tau alpha + P beta e-t/tau beta, where Pequ, P alpha and P beta are constants, and tau alpha and tau beta are time constants; this equation has previously been demonstrated to describe the pressure decay following dilatation. On the basis of a theoretical model the elastic and viscous constants for the urethral tissues were computed. The results showed significant differences along the urethra, with the high-pressure zone showing the highest maximum and equilibrium pressures, fastest pressure decay and highest elastic coefficient. The pressure response represents an integrated stress response from the surrounding structures, which reflects the visco-elastic properties of the tissues involved. The findings seem therefore to correlate well with the anatomical findings, which have shown a high fibre density of the horseshoe-shaped rhabdosphincter in the mid-portion of the urethra. The method permits a detailed assessment of static and dynamic urethral responses to dilatation which can be applied as an experimental simulation of urine ingression, and is therefore presumed to be of value in the evaluation of normal and pathological urethral sphincter function.
Adult↗
A technique for measurement of related values of pressure and cross-sectional area in the male urethra.
A probe for measurement of related values of cross-sectional area and pressure in the male urethra was constructed. The probe allows induction of variable pressures or fluid volumes in a distensible balloon located in the urethra and simultaneous recording of related values of cross-sectional area and pressure. Cross-sectional area is measured in the range of 11-102 mm2 using the field-gradient principle. Pressure is measured in the range of 0-250 cmH2O using tip transducers. The time constant for cross-sectional area measurement is 0.02 s and that for pressure measurement, 0.007 s. The pressures required to reach the maximal and minimal cross-sectional areas of the balloon are 2.8 and -2.4 cmH2O, respectively. The shape of the probe after its placement in the urethra was studied by transrectal ultrasound in five volunteers. The results showed that the measurement error caused by the slope of the balloon walls or the forced bending of the catheter did not exceed 5%. The method enables a description of the biomechanical properties of the male urethra at rest in terms of estimated pressure at zero cross-sectional area, elastance, and stress-relaxation and at voluntary contraction in terms of work and power as evaluated at well-defined anatomical locations.
Adult↗
In vivo evaluation of visco-elasticity in a biological tube. Part 1. Stress relaxation in the female urethra studied by cross-sectional area and pressure measurements.
The urethral response to a sudden forced dilatation was studied by a mathematical analysis of the pressure response in ten healthy women. A total of 60 dilatations, using various sizes and velocities of deformation, were performed in the high-pressure zone. The decay in pressure during relaxation proved to follow an exponential equation of the following form: Y = Z + C alpha e-t/tau alpha + C beta e-t/tau beta, where Z is the equilibrium pressure, C alpha and C beta are pressure decay, and T alpha and T beta are time constants. The time constants were unaffected by the circumstances of dilatation, whereas all the other parameters were correlated to size or velocity of dilatation, or both. The time constants showed a fairly high reproducibility when repeated after one weak. The method is presumed to characterise the tissue composition of the periluminal tissue layers and may prove useful in the evaluation of the normal urethral sphincter function. Furthermore, it may prove of value in the elucidation of the pathophysiology of stress urinary incontinence.
Adult↗