Biomedical subjects
Publications and source records attributed to J Janez.
The omentum was used in the treatment of seven patients presenting with complex vesicovaginal fistulae, and three patients with urethrovaginal fistulae. The operation was immediately successful in all cases. The three patients with urethrovaginal fistulae subsequently suffered from stress incontinence, which was treated by a sling operation three months later.
The pressure in the area of distal urethral sphincter was measured in 30 patients with symptoms of stress, urge, and mixed stress and urge incontinence. Sphincteric pressures were obtained from 3 to 4 urethral pressure profiles and recordings of the pressure measured with the sensor placed at the site of the distal sphincter for periods of up to ten minutes. In 33 per cent of the patients, the latter method revealed significant pressure variations which rarely were seen in a small series of urethral pressure profiles. The diagnostic reliability of the urethral pressure profile with respect to pressure variations is discussed, and the spatial organization of the pressure variations is measured and discussed.
The electric impedance of urine is considerably lower than that of urothelium: thus electrodes placed in the urethra can be used to show when urine penetrates the urethra during incontinence. This principle is presented as part of a possible diagnostic test of urethral incompetence.
The pressure-distention relations of the obstructed urethra were estimated from urethral pressure profiles measured with catheters of different diameters. Ten patients with obstruction of proximal and distal urethra were studied. The pressure-distention relations in the corresponding intact parts of the urethra were used as control data. The pressure-distention relation appears to be a good diagnostic indicator of changes in the viscoelastic properties of the urethral tissue at the site of the obstruction.
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Ninety-eight patients with urinary incontinence have been treated with maximal electrical stimulation (MES) The MES method used is a modification of previously used similar methods of maximal stimulation with respect to reduced intensity of stimulation and reduced number of electrodes. Thus, discomfort to the patient during treatment is considerably lessened. Anal or vaginal MES produced temporary or sustained improvement or relief of incontinence in 47 of 98 patients.
Urethral and bladder responses to anal electrical stimulation were evaluated by cystometry and urethral pressure profile measurements in 55 patients with different urethral-bladder dysfunctions. In 50 per cent of the patients examined the electrical stimulation caused normal reciprocal response, that is bladder inhibition with urethral contraction. In other patients the electrical stimulation caused almost all other possible bladder and urethral responses.