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Biomedical subjects

L Penders

Publications and source records attributed to L Penders.

At least 19 recordsLinked to original sources
PubMed1993

Colpocystodefecography.

PURPOSE: To assess, in one single procedure, a complete study of the female pelvis, including the Douglas pouch. METHODS: Colpocystodefecography (CCD) combines vaginal opacification, voiding cystography, and defecography. Three hundred examinations are reviewed. RESULTS: Thanks to the simultaneous visualization of the pelvic structures, CCD proved to be more useful than clinical evaluation to diagnose prolapses and particularly Douglas pouch hernias (enteroceles), the clinical diagnosis of which was missed in 93 of 111 cases. Moreover, in addition to morphologic and functional information, CCD brings about a new insight in the study of pelvic organs reciprocal influences, should they be positive (supporting function) or negative (external compression). Finally, significative pelvic surgery and particularly hysterectomy enhances greatly the risk of enteroceles. CONCLUSION: CCD is helpful in the preoperative staging, especially in the selection of the surgical procedure that will least likely predispose to possible late postoperative complications such as vaginal prolapses or enteroceles.

Adult↗
PubMed1990

[Bladder instability and kinesitherapy. The concept of deficient bladder instability].

The authors present a series of 30 unstable bladders treated only by perineal muscular reeducation by contact. The best results are obtained in the group presenting with pelvic floor hypotonia and USI (urinary stress incontinence) (efficiency 71.5%), especially when the closure pressure is normal (100%). The urodynamic control and the ominous disappearance of the associated USI confirm a muscular role of the treatment rather than a psychogenic one, the stabilization of the bladder being achieved through the perineo-detrusor inhibitory reflex. Because of this specific and efficient treatment the attention is drawn to the pelvic muscular weakness in the genesis of detrusor instability which is then called "deficitory instability". The interest of a clinical classification of detrusor instability is discussed.

Adult↗
PubMed1990

[Synopsis of neurological bladder sphincter dysfunctions].

The synopsis of neurogenic lower urinary tract dysfunctions aims to be practical and tries to give some simple algorithms to the physician to help his understanding of the pathophysiology and to guide him towards an easy, functional, preventive and chronological exploration and treatment.

Algorithms↗
PubMed1990

[Reinforced colposuspension (modified Cukier's operation). Immediate results, complications, indications].

In order to avoid mean term failures of colposuspension and short term obstructive complications of sling procedure, the author present a technique of urethropexy combining the two principles: reinforced colposuspension. A series of 67 consecutive procedures is subdivided in 45 stress incontinence and 22 incontinence with prolapse simultaneously treated by spinofixation. Continence is obtained in 97.6% and 91% respectively. Severe obstruction is observed in 3%, all of the first group. There is no infection due to this combined approach. The closure pressure remains similar or increases in 75% of the cases. Compared to others colposuspensions, this technique offers a conceptual advantage, without added morbidity. It is especially indicated when the closure pressure is low, the vaginal wall is weak, or when combined with a spinofixation.

Aged↗
PubMed1990

[2 classical contraindications for enteroplasty in spina bifida].

The authors report two cases of spina bifida which illustrate the two major contraindications of enteroplasty and stress the importance of a detubulated intestinal patch and an isometric ureterocystometry in the diagnosis and treatment of neurogenic bladder.

Child↗
PubMed1990

[Unstable bladder and kinesitherapy. The concept of deficient unstable bladder].

The authors present a series of 30 unstable bladders treated only by perineal muscular reeducation by contact. The best results are obtained in the group presenting with pelvic floor hypotonia and USI (efficiency 71.5%), especially when the closure pressure is normal (100%). The urodynamic control and the ominious disappearance of the associated USI confirm a muscular role of the treatment rather than a psychogenic one, the stabilization of the bladder being achieved through the perineo-detrusor inhibitory reflex. Because of this specific and efficient treatment the attention is drawn to the pelvic muscular weakness in the genesis of detrusor instability which is then called "deficitory instability". The interest of a clinical classification of detrusor instability is discussed.

Adult↗
PubMed1985

[Striated sphincter of the urethra. 4: Therapeutic possibilities].

Treatment of non-neurologic dyssynergia is aimed at diminishing urethral sensory impulses or the motor component of the dysreflexia. Although formal proof of efficacy is lacking, urethral dilatation or meatoplasty in young girls is still used when an obstacle exists to passage of a balloon catheter. Functional obstruction is treated by Valium for its muscle-relaxant properties, alpha-blocking agents or biofeedback. In recent neurologic dyssynergia good results have been obtained after infiltrations of the para-urethral sphincter by an endo-urethral approach. Sphincterotomy is the treatment of choice when fibrosis has developed, particularly when the upper urinary tract is being affected: it can be performed earlier in cases where the dyssynergia fails to respond to well adapted conservative therapy. The site of section should be at 12 o'clock for anatomophysiologic reasons and to reduce the risk of impotence. The only treatment for rhabdosphincter deficiency is physiotherapy: reeducation and electric stimulation. Correctly instituted reeducation involves several phases: beginning with consciousness and learning of sphincter function it terminates in the automatic activation of the sphincter as for example during certain efforts. Results of several documented series in the urologic literature are encouraging.

Bacterial Infections↗
PubMed1984

Alpha-blockers in the treatment of benign prostatic hypertrophy: physiological basis and review of the problem.

After reviewing the pharmacological and physiological basis for the treatment of benign prostatic hypertrophy (BPH) symptoms with alpha 1-adrenergic blockers, the authors analyze the clinical trials published in the literature. The indications, doses, side effects and contraindications for the alpha 1 blockers in the treatment of BPH are summarized.

Adrenergic alpha-Antagonists↗