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Biomedical subjects

M Fall

Publications and source records attributed to M Fall.

At least 55 records · Page 3Linked to original sources
PubMed1979

Ureteral complications after intravesical formalin instillation.

Results of formalin therapy for hemorrhage owing to post-radiation cystitis have been studied with special reference to the frequency and severity of ureteral complications. Gross bleeding stopped in 25 of 27 patients within 48 hours. However, 5 patients became anuric immediately after the instillation and in another 7 patients a transient increase in the serum creatinine level was observed. Urinary diversion was necessary in 11 of the 27 patients. The complication rate in the present study is considerably higher than reported previously. Complications may be explained by vesicoureteral reflux of a too strong formalin-alcohol solution. To avoid future complications we suggest that 1) a high diuresis should be induced peroperatively, 2) a 1 to 2 per cent formalin solution without alcohol should be used and 3) the instillation pressure should not exceed 15 cm. water.

Aged↗
PubMed1978

Reflex mechanisms for bladder inhibition.

Continence of urine requires ability of the bladder to maintain a low intravesical pressure at increasing filling, in order to preserve a positive urethral-bladder pressure gradient. During micturition the conditions are reversed: the bladder has to generate pressures exceeding the urethral pressure, which also presupposes that the urethra opens and remains open as long as is required for all urine to be expelled. These events are made possible by a complicated pattern of central and peripheral neural responses, affecting the bladder-urethral unit. The pioneer work of determining the reflex mechanisms involved in the regulation of the lower urinary tract was done at the beginning of this century. Recently, further studies have been made and by means of electrophysiological investigations previous data have been confirmed. In this communication some important observations are reviewed and one example is given of how bladder inhibitory reflexes are utilized in therapy.

Animals↗
PubMed1978

Effects of electrical intravaginal stimulation on bladder volume: an experimental and clinical study.

Clinical observations have indicated that not only stress incontinence due to defective urethral closure but also urge incontinence due to bladder hyperactivity can be successfully treated by electrical stimulation of the pelvic floor. Clinical investigations revealed that intravaginal electrical stimulation caused bladder inhibition registered as a volume increase. This inhibition was most marked at a low stimulation frequency (10 Hz). Animal experiments indicated that the bladder inhibition was achieved by autonomic spinal reflex mechanisms activated by stimulation of pudendal afferents.

Animals↗
PubMed1977

The effect of intravaginal electrical stimulation on the feline urethra and urinary bladder. Electrical parameters.

Intravaginal electrical stimulation (IVS) in cats caused urethral closure and bladder inhibition. The aim was to ascertain the electrical parameters most appropriate for these effects. Minimum voltage was used as main criterion to select an effective, non-destructive stimulation when the shape, frequency and duration of the pulses were systematically varied. Urethral closure was achieved at minimum voltage (3 V) with alternating pulses at a frequency of 50 Hz and a pulse duration of 1.5 ms. Corresponding optimal parameters for bladder inhibition were: alternating pulses, 10 Hz and 1.5 ms. Minimum voltage was 1 V. Moreover, the positions of the electrodes were of significance for the responses. The clinical implications of these findings are that: 1)more differentiated treatment of incontinence could be achieved by adapting the stimulation parameters to the cause of incontinence, and 2) specific electrode positions would probably give optimal responses.

Animals↗
PubMed1977

Intravaginal electrical stimulation. Clinical experiments of urethral closure.

The effect on the urethra of intravaginal electrical stimulation (IVS) was registered by means of urethral pressure profiles (UPP). With the object of finding the most appropriate electrical parameters and optimal electrode positions within the vagina, 24 patients with stress incontinence, 22 with urgency and 4 continent women were studied. Electrical stimulation was given via an obturator with seven electrodes, which could be connected in different combinations of pairs. In all the women, stimulation with the electrodes in specific positions effected a more marked rise in the UPPs than with the electrodes in other positions. A change in position of more than 5 to 10 mm caused a decrease in the response. It was determined that a frequency of between 20 to 50 Hz with a pulse duration of 1 to 5 ms was most effective for urethral closure.

Adult↗
PubMed1977

Intravaginal electrical stimulation. Clinical experiments on bladder inhibition.

The effect of intravaginal electrical stimulation (IVS) on the bladder in 17 patients with motor detrusor instability was explored. Isotonic volume registrations and cystometries were used for evaluation of volume increase and inhibition of abortive detrusor contractions. With either one or the other method, bladder inhibition was found in all patients, but with both methods only in 6. During isotonic volume registration, the volume increase showed considerable variations ranging between 4 to 465%, and during cystometry between 11 to 3500%. Bladder inhibition proved to be most effective when using a frequency of 10 Hz.

Adult↗
PubMed1977

Mechanisms for closure of the human urethra during intravaginal electrical stimulation.

The effect of intravaginal electrical stimulation (IVS) on the urethral pressure profile (UPP) before and during succinylcholine blockade or spinal anaesthesia was studied in patients with stress incontinence and in patients with clinically normal urethral function. During succinylcholine blockade, the UPP was lowered to 74% and during spinal anaesthesia to 39% of the original maximal UPP. IVS could not influence the UPP during succinylcholine blockade, while the UPP could be restored during spinal anaesthesia when the stimulation strength was increased 3 to 4 times. The following conclusions were arrived at: 1) The urethral effect of IVS is due to activation of somatic nerves and not to activation of nerves supplying smooth muscles or direct activation of striated and smooth muscles. 2) The more pronounced depression of the UPP during spinal anaesthesia compared to succinylcholine blockade should be caused by the loss of nervous activity of the smooth muscles. 3) The fact that the UPP could be restored during spinal anaesthesia indicates that activation of somatic efferents can compensate for the loss of striated and smooth muscle activity. Therefore, IVS can control incontinence in partial lower motor neuron lesions, provided a sufficient number of efferent neurons are preserved.

Adult↗
PubMed1977

Long-term intravaginal electrical stimulation in urge and stress incontinence.

Using a new device for intravaginal electrical stimulation (IVS), 24 women with pure stress incontinence, mixed urge and stress incontinence or urge incontinence due to detrusor instability, were treated. To minimize mechanical discomfort, the electrode carrier was made of flexible material and inflatable. Furthermore, this design facilitated fixed, constant positioning of the electrodes at individually tested sites to produce maximum response at voltage well tolerated by the patient. The stimulation frequency was adjusted to suit the cause of incontinence: 20 to 50 Hz in stress incontinence, 10 Hz detrusor instability. The electrode carrier was well accepted. Seven of the 9 patients with pure stress incontinence became continent during IVS. Three of them have so far remained continent for 2 to 8 months without IVS. The 15 patients with detrusor instability or mixed incontinence were all free from symptoms after IVS for more than 3 months. Two of them have remained cured for more than 3 months after they had stopped IVS.

Adult↗