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Biomedical subjects

John Bugge Nielsen

Publications and source records attributed to John Bugge Nielsen.

4 recordsLinked to original sources

A new bulking agent (polyacrylamide hydrogel) for treating stress urinary incontinence in women.

OBJECTIVE: To evaluate the efficacy and safety of a transurethral injection with polyacrylamide hydrogel (PAHG) for treating stress urinary incontinence (SUI) in women. PATIENTS AND METHODS: The study comprised 17 women with pure SUI and eight with mixed incontinence (age range 35-84 years). Between November 2001 and November 2003, the women were injected into the urethral wall with a PAHG (Aquamid, Contura International A/S, Denmark), a homogenous, highly biocompatible, atoxic, nonresorbable sterile watery gel consisting of approximately 2.5% cross-linked polyacrylamide and 97.5% nonpyrogenic water. The women were followed prospectively (assessed at 1, 3 and 12 months after treatment) and their clinical outcome documented. RESULTS: Four women did not complete the study, and of the remainder, eight (38%) were subjectively dry and a further nine (43%) improved. Objectively, urine leakage/24 h was decreased by 93% and the number of incontinence episodes by 87%. Quality-of-life measures improved significantly in all domains other than general health perception. There were no significant changes of urodynamic variables. Treatment-related adverse events were recorded in 16 women. Urinary tract infection (10 cases) and urinary retention (five cases) were most common. There were no injection site reactions. CONCLUSION: PAGH seems to be a promising new bulking agent for the treatment of SUI.

Acrylic Resins↗

Experience with Memokath 051 ureteral stent.

OBJECTIVE: The Memokath 051 is a thermo-expandable titanium-nickel spiral developed for long-term ureteral stenting. The aim of this study was to investigate the drainage and safety aspects of this stent. MATERIAL AND METHODS: A total of 3-4 consecutive patients were included: 22 had benign strictures, five had post-irradiation strictures and seven had malignant strictures. Follow-up visits took place after 1 month and thereafter every 3 months for at least 1 year. RESULTS: Thirty-three patients had a total of 37 stents inserted uni- or bilaterally. Pre-insertion dilatation was impossible in one patient and difficult in two, all of whom had post-irradiation strictures. Insertion was complicated in seven patients and uneventful in the other 26. Fifteen stents were in place and functioning with no discomfort or complications at death or the end of follow-up (median 14 months; range 3-30 months), while 22 were non-functioning after 1 day to 16 months (median 5 months). Of these 22 stents, 10 had migrated and 12 were malfunctioning. Among the latter, stricture length was underestimated in four patients, and the stents were replaced successfully shortly after insertion. Four stents were occluded by stones after 1-10 months. No tissue ingrowth was seen. Stent removal was easy, with the exception of one patient with stent calcification. CONCLUSIONS: The Memokath 051 is an alternative for selected patients with non-curable ureteral obstruction but is not suitable for use in patients with functional stenosis or stone formation. Insertion and removal are easy in most patients, but can be difficult or impossible, especially in patients with post-irradiation strictures and retroperitoneal fibrosis. Migration and obstruction can occur and careful follow-up is necessary.

Adult↗

Postpartum urinary incontinence.

BACKGROUND: The aim of the present study was to identify prepregnancy, pregnancy and delivery correlates of urinary incontinence postpartum (PP UI) as reported by women in a cross-sectional population sample. METHODS: A questionnaire-based cross-sectional survey was carried out in 1998 in a random population sample of 3900 20- to 59-year-old women. The present study includes 376 women who had their last delivery during 1993-96. RESULTS: UI immediately after childbirth and 6 months thereafter was reported by 23.4% and 2.7%, respectively. PP UI was strongly associated with UI both before and during the present pregnancy, explaining 37.5% and 51.7% of postpartum UI, respectively. Eight percent experienced their first UI episode ever immediately after the delivery. Among women undergoing a cesarean section 8.8% reported postpartum UI, as contrasted with 24.9% in other women. Postpartum UI was positively associated with perineal suturing but un-associated with labor augmentation, episiotomy, birth weight, and breast-feeding. CONCLUSION: In the present study, which included a comprehensive causal model, postpartum UI could be explained first of all as the decline of pregnancy UI, secondly as a manifestation of a pre-existing tendency to react by UI, and finally as a consequence of the birth process itself.

Adult↗

Does urinary incontinence occurrence depend on the menstrual cycle phase?

BACKGROUND: The aim was to study an eventual co-variation of menstrual cycle progression and urinary incontinence (UI) occurrence in 20-54-year-old-women, who have regular menstrual cycles, which are not influenced by exogenous sex hormones. METHODS: An age-stratified random sample of of 3900 women, aged 20-59 years, answered a questionnaire on UI. The present analysis included 821 women, who reported regular menstrual cycles un-intervened by sex hormone intake. RESULTS: Five percent of the women reported episodes of UI the day before they answered the questionnaire. Urinary incontinence was unassociated with menstrual cycle characteristics, such as time position from day one in the menstrual cycle, presence and amount of bleeding and the number of sanitary towels or tampons used. There was however, a borderline significant association (P = 0.08) with day 11-15 before the expected next menstrual bleeding. CONCLUSIONS: The present data allow for limited co-variation, if any, to exist in UI occurrence with the natural menstrual cycle phases, including the menstruation itself. A hypothesis of a moderate UI increase associated with ovulation however, merits attention.

Adult↗