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Biomedical subjects

J G Susset

Publications and source records attributed to J G Susset.

At least 19 recordsLinked to original sources
PubMed1990

Biofeedback therapy for female incontinence due to low urethral resistance.

Urinary incontinence, mostly secondary to low urethral resistance, in 15 women was treated for 6 weeks by biofeedback. A new device equipped with visual and audio signals connected to an intravaginal probe was used by the patient for 15 minutes twice a day. Of the patients 12 were continent subjectively and objectively, 2 had 65 and 75% improvement and could lead a normal life, and only 1 failed to respond and was treated surgically. Besides the quality of the device, success depends largely on the quality of moral support given to the patient during the treatment.

Adult↗
PubMed1989

The effect of raveron on the detrusor muscle.

Raveron (a European pharmaceutical consisting of swine prostate extract and m-creosal) was studied in vivo in female mongrel dogs and in vitro bladder studies were conducted on male New Zealand rabbits. Intravenous administration of raveron reduced both the passive and active pressure in dog detrusor in vivo. It did not act in a dose dependent fashion. Chronic treatment with raveron for three to four months caused changes in in rabbits with vesical neck obstruction. An increase in contractility along with a reduced rate of increase in passive force (measurement of bladder stiffness) was observed in relation to obstructed rabbits without treatment. Parallel morphological changes were also observed in this group, consisting of increased muscular hypertrophy, decreased bladder wall thickness and reduced collagen content (readings taken from Masson-Trichrome sections). No influence was observed with bladder specimens from rabbits with six to eight week vesical obstruction or normals that received treatment. In vitro dose response studies showed that a 3.3% dose of raveron significantly reduced passive force in two groups (treated normals and treated rabbits with six to eight week vesical obstruction). Pharmacology studies with potassium chloride and acetylcholine suggest that raveron acts as a calcium antagonist by blocking the influx of extracellular calcium.

Animals↗
PubMed1989

Effect of yohimbine hydrochloride on erectile impotence: a double-blind study.

A double-blind, partial crossover study on the therapeutic effect of yohimbine hydrochloride on erectile dysfunction was done in 82 sexually impotent patients. All patients underwent a multifactorial evaluation, including determination of penile brachial blood pressure index, cavernosography, sacral evoked response, testosterone and prolactin determination, Derogatis sexual dysfunction inventory and daytime arousal test. After 1 month of treatment with a maximum of 42.0 mg. oral yohimbine hydrochloride daily 14 per cent of the patients experienced restoration of full and sustained erections, 20 per cent reported a partial response to the therapy and 65 per cent reported no improvement. Three patients reported a positive placebo effect. Maximum effect takes 2 to 3 weeks to manifest itself. Yohimbine was active in some patients with arterial insufficiency and a unilateral sacral reflex arc lesion, and in 1 with low serum testosterone levels. The 34 per cent response is encouraging, particularly in a Veterans Administration population presenting with a high incidence of diabetes and vascular pathological conditions not found in regular office patients. Only few and benign side effects were recorded, which makes this medication worth an attempt, often as a first line of treatment even at a dose of 8 tablets.

Adult↗
PubMed1988

A comparison of nocturnal penile tumescence and penile response to erotic stimulation during waking states in comprehensively diagnosed groups of males experiencing erectile difficulties.

The erectile responses of 13 nondysfunctional males and 48 dysfunctional males were compared during Nocturnal Penile Tumescence (NPT) and during exposure to erotic videotapes. The results showed distinct patterns of NPT and daytime responding that could differentiate the various subgroups: those displaying (i) no dysfunction; (ii) vasculogenic erectile dysfunction; (iii) high risk for erectile dysfunction (organic and psychogenic); (iv) psychogenic dysfunction; reactive to erotica; and (v) psychogenic dysfunction; nonreactive to erotica. Subjects participating in this study underwent a comprehensive medical and psychological screening to place them in each subgroup. The penile circumference response to erotic stimuli used in conjunction with NPT response appeared useful in differentiating subgroups of erectile dysfunction and suggested the need for further diagnostic refinement in this area. The majority of vasculogenic dysfunctional subjects experienced greater erection responses during exposure to erotic stimulation than during NPT; several of these subjects achieved almost full erections in waking states but were practically flaccid at night. The discussion covers diagnostic and therapeutic implications.

Adult↗
PubMed1986

Deep-penile-vein arterialization for arterial and venous impotence.

Eleven impotent men underwent deep-penile-vein arterialization after preoperative assessment by a multidisciplinary team. Penile Doppler pressures, testosterone levels, and nocturnal penile tumescence were used to establish a vasculogenic etiology. Cavernosography, artificial erection by saline infusion, and selective hypogastric arteriography were obtained to delineate whether arterial, venous, or mixed (arterial/venous) factors predominated. Penile revascularization consisted of femoral artery to deep-penile-vein saphenous bypass, with ligation of superficial veins at the base of the penis in patients with venous leakage. Cumulative graft patency was 91% up to 20 months. There were no deaths. The average preoperative flow requirement of values greater than 250 mL/min was reduced to 59 mL/min postoperatively. Follow-up results of nocturnal penile tumescence were excellent in four of four patients with venous (venous leakage), two of three patients with arterial, and one of four patients with mixed factors. Deep-penile-vein arterialization appears to be beneficial for impotence secondary to venous leakage, with inconsistent results for arterial and mixed factors.

Adult↗
PubMed1986

Effect of vesical outlet obstruction on detrusor contractility and passive properties in rabbits.

Outlet obstruction was induced in 16 New Zealand rabbits by implanting a polyethylene tube (20 F) for a period of three months. The tube was slit longitudinally and placed around the bladder neck, between the ureters and vasa deferentia. It was left open to induce moderate obstruction and closed by a suture to induce severe obstruction. The animals were studied by cutting consecutive rings from each bladder, which were subjected to the following studies: morphology, contractility and mechanical properties. Morphology. Histology sections of the rings, studied by Hematoxylin and Eosin and Masson-Trichrome stains, demonstrated smooth muscle hypertrophy in moderate obstruction, while hyperplasia was the predominant response in severe obstruction. The average nuclear count per square millimeter of smooth muscle was 251 in controls, 87 in moderate obstruction and 705 in severe obstruction. Bladder wall thickness was significantly increased after both moderate and severe obstruction, as compared to controls. Contractility and mechanical properties. Each ring was tested in a muscle chamber under conditions of maximal electrical stimulation (100 V, 2 ms, 40 Hz). For each ring, full force-length relationships (active and passive) were obtained by stretching the rings in successive increments until length of maximal active force development was reached. Force was normalized per unit cross-sectional area (stress), and length according to a "reference" underformed state (per cent of unloaded length). The maximum active stress of the rings was taken as a measure of bladder contractility, and the rate of increase in passive force as a measure of detrusor stiffness. In all groups, the body of the detrusor exerted better contractility, as compared to a rigid, less contractile base. In the obstructed groups, detrusor contractility was significantly decreased at the body level, with increased stiffness, as compared to controls. The length at which maximum contractility was exerted, however, increased in moderate obstruction, and decreased in severe obstruction.

Animals↗
PubMed1986

Cavernosography in conjunction with artificial erection for evaluation of venous leakage in impotent men.

Twenty men with incomplete penile erection or inability to maintain an erection were evaluated to determine if venous leakage was a cause. Cavernosography was performed in conjunction with artificial erection induced by infusion of saline into the corpus cavernosa. Thirteen patients requiring higher than normal rates of saline infusion to achieve or maintain erection showed filling of superficial veins in the flaccid state as well as during erection. In five of the seven patients with normal saline requirements there was no filling of superficial veins, and two showed filling in the flaccid state only. Of the thirteen patients whose conditions were diagnosed as venous leakage, seven underwent surgical ligation of superficial veins and deep penile vein arterialization by a saphenous vein bypass graft between the superficial femoral artery and deep penile vein. All these patients had reduced saline requirements postoperatively. When cavernosography is performed in the flaccid state only, filling of superficial veins can occur normally; therefore, these studies should be performed with artificial erection.

Adult↗
PubMed1985

Pathologic involvement of the urinary bladder in progressive systemic sclerosis.

We describe 2 patients with progressive systemic sclerosis (PSS) who manifested characteristic pathologic abnormalities in the urinary bladder. Increased connective tissue deposition in the lamina propria and between smooth muscle bundles was demonstrated in both patients and endovascular proliferation in small arteries of the bladder was noted in one patient. Both patients had persistent unexplained microscopic hematuria; one patient manifested urinary frequency and incontinence. The relationship of these clinical abnormalities to the pathologic findings in the bladder is unclear. Structural or functional abnormalities of the urinary bladder may develop in patients with PSS.

Adult↗
PubMed1984

Rapid cystometry and sacral-evoked response in the diagnosis of peripheral bladder and sphincter denervation.

Rapid cystometry and sacral-evoked responses were used in 25 patients presenting with peripheral nerve lesions affecting the bladder. Type A contractions were found on rapid cystometry in 87 per cent of the patients, while these waves were only occasional and inconsistent in 79 controls. The efficiency of this test to demonstrate sacral denervation was 88 per cent. Sacral-evoked response showed an increased latency or absence of response in 95 per cent of the patients. These tests are proposed as useful clinical tools for the diagnosis of a peripheral sacral nerve lesion.

Adult↗
PubMed1978

Collagen in 155 human bladders.

The percentage of bladder collagen, as obtained by the dosage of hydroxyproline, was determined in autopsy specimens from 48 female and 107 male cadavers. The average percentage of collagen in the human bladder is 57.4 per cent (+/- 9) of the dry weight of insoluble protein. There is good correlation (r = 0.55) between detrusor and trigone collagen content. There is no significant difference between pre- and postpuberty age groups in relative collagen content. In females more than 50 years of age there is a significant increase in collagen.

Adolescent↗
PubMed1976

The influence of vesical distension on the urethral resistance to flow: a possible role for prostaglandins?

The possible role of prostaglandins in the mediation and/or modulation of the urethral response to vesical distension was investigated in female dogs. Three criteria for the possible involvement of these mediators have been investigated. Indomethacin could block the reduction of urethral resistance observed during vesical distension. Intra-arterial infusion of exogenous prostaglandin E2 resulted in a dose-dependent reduction in the urethral resistance to flow. Moreover, a significant release of prostaglandin E2 in the venous blood during the course of vesical distension could be demonstrated. The functional significance, mechanisms of release and mode of action of these highly active lipids are discussed.

Animals↗
PubMed1976

Study on the efficiency of electric stimulation of the pelvic floor.

The continuous electric stimulation of the anal sphincter leads to the onset of a very quick fatigue of the muscle, with a progressive decrease of the amplitude of contraction after 15 min of stimulation. Under the same experimental conditions intermittent stimulation leads to a sustained contraction amplitude. Ts and Tr combinations that can give efficiency rates of contraction above 80 per cent were defined. The results of this study could be applied when intermittent electric stimulation of the pelvic floor is indicated for the treatment of anal or urinary incontinence.

Anal Canal↗
PubMed1976

Urodynamic assessment of stress incontinence and its therapeutic implications.

Urethral fibrosis and sphincter incompetence commonly are associated in the genesis of stress incontinence. Other factors are often associated, such as bladder hyperactivity and increased demand on the sphincter mechanism created by contracted or large atonic bladder or polyuria. The frequent association of several factors and the limited information given by the classical methods suggest a need for the routine use of objective urodynamic studies in the assessment of stress incontinence. A more conservative, better oriented, therapeutic approach may result from this concept.

Female↗
PubMed1975

Urethral pressure profile. Standardization of technique and study of reproducibility.

The different methods utilized for measurement of urethral resistance were critically reviewed. Using dogs, experiments were done to standardize the pressure profile measurement. A catheter with eight side holes measureing 0.34 mm. each was found to give the best results. The various parameters which can influence the procedure were analyzed. Strict specifications are proposed to be utilized for such a procedure.

Animals↗