The authors carried out detailed experiments on cats under anaesthesia, with electrical stimulation of the L7, S1, S2 and S3 ventral roots and of the vesical detrusor in order to study their contraction. They varied the frequency, intensity and duration parameters of the stimulation beats, using as contraction index, the variations in the intravesical pressure measured by means of a urethral catheter. They controlled the intraabdominal pressure by means of a ball and juxtavesical catheter full of H2O. They investigated two main aspects: 1) The stimulation of which root is most effective, and 2) what combination of stimulation parameters produces the greatest and longest-lasting contractile response and miction. The L7 stimulation was ineffective and S2 was the root which produced the greatest increases in pressure. Increases in frequency and intensity in the course of stimulation up to 20 Hz and 6 mA were progressively more effective. The discontinued stimuli 1 s on 1 s off, were more effective, partially revealing the effects of "fatigue". Finally, the authors discuss the problems of electric stimulation of lumbo-sacral roots.

Animals↗

PubMedDate not supplied

[Xanthogranulomatous pyelonephritis in renal allograft. Report of a case and review of the literature].

Clinic report case of a kidney-transplanted female who, after one year of normal functioning, developed xantogranulomatous pyelonephritis in the renal allograft. Clinical presentation was mesorenal tumoration causing pyelocaliecstasis, which coincided with a progressive decline of renal function due to interstitial rejection. Diagnosis by eco-doppler imaging, CAT, arteriography, renogram and descending pyelography were non-specific in relation to the process benignant or malignant nature. Surgical examination with obtention of biopsy was not conclusive with regard to diagnosis and so, during a second surgery, transplanctectomy was chosen. The histological examination showed that the expansive process of the allograft corresponded to a case of xantogranulomatous pyelonephritis. After reviewing the existing literature, only 4 cases were found reporting this rare condition in a renal allograft.

Adult↗

PubMedDate not supplied

[Psychogenic urinary retention. Diagnostic-therapeutic approach].

OBJECTIVE: The influence of psychogenic factors on voiding generally manifests as an irritative syndrome and rarely in the form of acute or chronic urinary retention. The diagnosis and treatment of this uncommon urological pathology are reviewed and our experience is presented. METHODS: We conducted a retrospective study on 5 patients with psychogenic urinary retention (3 males and 2 females), aged 20 to 28 years (mean age 23.4), that had been treated at our urological services over the last 6 years. Three patients (2 males and 1 female) had a history of depression, one patient had a somatic form of disorder (mimicking) and one patient was diagnosed as having schizophrenia one year after he had presented with urinary retention. The physical and neurological examinations were normal in all 5 patients and the radiological evaluation was normal in all but one patient who had bilateral hydronephrosis. The pressure/flow test disclosed absence of detrusor muscle contraction in all 5 patients; 3 had incomplete voiding by abdominal pressure and had more than 500 ml residual urine. All patients received psychiatric therapy, and intermittent catheterization and urinary rehabilitation until residual urine less than 100 ml was achieved. CONCLUSIONS: The importance of the urodynamic study in the diagnosis of this condition is underscored. Definitive diagnosis can only be established after discarding other pathologies. The initial treatment must always be conservative; irreversible surgical procedures must not be performed. Treatment is by intermittent catheterization, urinary rehabilitation and supportive psychiatric therapy.

Adult↗