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Biomedical subjects

O A Lukkarinen

Publications and source records attributed to O A Lukkarinen.

6 recordsLinked to original sources
PubMed1992

Voiding dysfunction and urodynamic findings in patients with cervical spondylotic spinal stenosis compared with severity of the disease.

A group of 30 consecutive patients (26 men and 4 women, mean age 51 years), with clinically and radiologically verified cervical spondylosis causing radiculopathy and/or myelopathy, were questioned about voiding symptoms, examined urodynamically and subjected to tests of tibial somatosensory evoked potentials (SEP). Seventeen patients (61%) complained of irritative bladder symptoms and detrusor hyperactivity was demonstrated urodynamically in 13 (46%). Three (11%) experienced difficulty in emptying the bladder, and all of these had a hypotonic detrusor. The bladder was insensitive to cold in 36%, this and SEP abnormalities being more common in the patients with clinically severe myelopathy, whereas detrusor hyperactivity was found equally in all patients. Urodynamic investigation seems to provide additional information on the severity of the disease and is therefore recommended for wider use in these patients.

Adult↗
PubMed1991

The bladder cooling test for urodynamic assessment: analysis of 400 examinations.

The clinical significance of the bladder cooling test as one part of a standard urodynamic examination was studied in 375 consecutive patients and 25 controls. Inability to perceive cold sensation in the bladder was common in cases of neurogenic lesions and present in nearly half of the patients with outlet obstruction, some with no urodynamic abnormalities and some of the normal subjects. The bladder contractions provoked by the test were clearly associated with detrusor overactivity, as in those patients with upper motor neuron lesions of motor urgency, but 27% of such patients showed no response. In 7 cases the iced water provoked detrusor contractions when cystometry showed no overactivity. This clinical series confirms that the cold receptors found recently in animal experiments are also present in the human urinary bladder. The bladder cooling test is not an alternative to cystometry, but its inclusion as an integral part of the urodynamic examination seems to be useful, especially in cases where there is also a need to study the sensibility of the bladder at the same time.

Adolescent↗
PubMed1991

Functional and urodynamic characteristics of bladder substitution with detubularised right colonic segment.

A total of 19 patients underwent bladder replacement with a detubularised right colonic segment; 14 males underwent complete substitution after cystoprostatectomy and 5 females had augmentation after subtotal cystectomy. The mean follow-up time was 20 months. Urodynamic evaluation showed a low pressure reservoir with a mean capacity of 580 ml and normal closure pressure. Sensitivity of the bladder to cold was normal in the augmentation group but was lacking in all patients in the total substitution group. In all except 1 patient the neobladder emptied effectively upon straining without significant residual urine. Seventeen patients were completely continent by day and 10 by night; 1 patient developed hyperchloraemic acidosis requiring treatment. Bladder substitution is superior to the standard ileal or colonic conduits with regard to quality of life, and the use of a right colonic segment is functionally comparable with neobladders composed of the ileum or a combination of the right colon and ileum. The latter are more difficult to fabricate and so may have more complications.

Adult↗
PubMed1991

Colocystoplasty for the treatment of severe interstitial cystitis.

Twelve patients with end-stage interstitial cystitis and intractable symptoms resistant to conservative measures underwent supratrigonal cystectomy and colocystoplasty, comprising 7 right colocystoplasties and 5 open-loop sigmoidocystoplasties. Mean follow-up was 4.7 years. Ten patients had complete relief of pain and a decrease in frequency, while 2 patients required cystectomy and urinary diversion because of persistent symptoms or infection and incontinence. Bladder function was evaluated urodynamically in 11 patients. The bladder capacities in the right colocystoplasties were between 325 and 800 ml (mean 495), compared with 180 and 500 ml (mean 345) in the sigmoideocystoplasties. Two patients suffered from mild urge incontinence. All the patients retained their sensation of bladder fullness and voided without difficulty. In only 3 cases was a procedure needed to lower the bladder outflow tract resistance. Most patients did not need long-term antibiotics. No impairment in renal function was noted. In view of the good results achieved colocystoplasty can be recommended more often for the treatment of interstitial cystitis, detubularized right colocystoplasty being the operation of choice.

Adult↗
PubMed1989

Treatment of urinary incontinence with an implantable prosthesis.

Experiences with various types of implantable urinary incontinence prostheses based on two principles, passive compression of the urethra (Kaufman) or artificial dynamic sphincter (Scott) are recounted. The series consists of 40 patients, 3 women and 37 men. The cause of incontinence was transurethral resection of the prostate or open prostatectomy in 29 cases, radical prostatectomy in 3 cases, neurogenic bladder in 7 cases and urethroplasty in 1 case. The success rate with the Kaufman prosthesis was 50% and that with the Scott artificial sphincter 91% with an average follow-up of 2 years. Mechanical complications or infection requiring surgical intervention occurred in 42% cases. Careful patient selection and meticulous surgical technique are essential. The artificial urinary sphincter (type AMS 800) appears to be the best treatment modality for urethral sphincter deficiency. In the selected cases the Kaufman prosthesis still has a place for the treatment of elderly men with poor cortical and manual control, making them incapable of managing the AMS 800 prosthesis.

Adult↗