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Biomedical subjects

T Sundin

Publications and source records attributed to T Sundin.

At least 37 records · Page 2Linked to original sources
PubMed1984

Supersensitivity to carbachol in the parasympathetically decentralized feline urinary bladder.

We investigated the concentration-response relations for carbachol, the morphological characteristics and the mechanical properties of feline detrusor strips from 1) normal cats, cats subjected to 2) parasympathetic sacral decentralization, 3) urinary diversion followed by parasympathetic sacral decentralization and 4) urinary diversion only. Hypertrophy of the detrusor and supersensitivity to carbachol (a decrease of EC50) were found only after parasympathetic decentralization. No hypertrophy developed and no change in the EC50-value for carbachol was found if urinary diversion preceded the parasympathetic decentralization. A decreased ability of force production per unit cross sectional smooth muscle area was found in the decentralized bladders compared to the controls. However, the total ability of force production and hence also pressure production of the decentralized bladders would be expected to be enhanced due to a 4 to 5-fold increase of bladder weight (mainly muscle mass). No differences in the active length-tension relations were found in the 4 groups. It is suggested that parasympathetic decentralization per se does not give rise to detrusor hypertrophy or increased sensitivity to carbachol. Provided that the situation in man is comparable to that in the cat, it might be that the supersensitivity test a.m. Lapides-Glahn reflects the presence of detrusor hypertrophy rather than the presence of a neurogenic lesion.

Animals↗
PubMed1984

Continent caecal reservoir in urinary diversion.

Construction of a continent urinary reservoir was attempted in 18 patients with carcinoma of the bladder. The caecum was used as the reservoir and an intussuscepted ileal nipple was created to provide continence. Fifteen patients are alive and have been observed for 7 to 68 months. The most common complication was malfunction of the nipple valve with urinary leakage and/or difficulty in catheterisation. Revision of the outlet was performed one or more times in 11 cases. The technique of nipple valve construction was successively evolved, with improvement in the functional results. Stricture of one uretero-intestinal anastomosis occurred in three patients. Construction of a continent caecal reservoir is a complex procedure and the problem of a stable, continence-ensuring mechanism in the outlet has not been conclusively solved. The enhanced quality of life offered by a successful continent reservoir nevertheless warrants continued clinical trials in selected patients.

Adult↗
PubMed1984

Renal function after urinary diversion. A study of continent caecal reservoir, ileal conduit and colonic conduit.

Total and separate renal function, renal parenchymal thickness and dilatation of the upper urinary tract were studied in 40 patients preoperatively and 24 to 67 months after urinary diversion, using 51Cr-EDTA clearance test, scintillation camera renography and urography. In ten patients a continent caecal reservoir was used for diversion. In the other patients, an ileal or a colonic conduit (15 patients with each method) was used, one ureter being implanted with an anti-reflux method and the other with direct technique. Renal function following urinary diversion showed little or no deterioration in most patients. The functional outcome was not related to the method of diversion or, in the conduit groups, to the mode of ureteral implantation. Serum creatinine tests and urography were not adequate for determining loss of renal function. Radionuclide studies proved to be valuable for assessing renal function after urinary diversion.

Adult↗
PubMed1983

Island patch urethroplasty: effects on urinary flow and ejaculation.

Seventeen patients had a single-stage operation for urethral stricture. To avoid recurrence (which occurred in 2 patients) the urethra should be opened not only through the stricture but well beyond the pathological cavernous tissue. In 3 patients it was not possible to reconstruct the bulbocavernosus muscle over the bulb. This resulted in urethral pouching which did not interfere with micturition, except for after-dribbling, but prevented forceful ejaculation and the semen leaked slowly for several minutes. Excision of the apex of the scrotal skin flap to the island patch seems to prevent marginal skin necrosis.

Adolescent↗
PubMed1982

Severe bleeding from urinary conduits. A case report.

Repeated, often severe, bleeding occurred from conduits constructed for urinary diversion in a young man. Ileum, sigmoid colon and part of the gastric antrum were successively utilized for diversion of urine. Histologic studies showed inflammatory changes within the conduit loops. The cause of this rare condition is unknown. Various measures to control the bleeding were unsuccessful.

Adult↗
PubMed1982

Influence of the adrenergic nervous system on the lower urinary tract and its clinical implications.

The morphology of the adrenergic nervous systems as well as adrenoceptor functions of the human lower urinary tract are outlined and compared to some animal studies. Special emphasis is given to the altered adrenergic innervation and adrenoceptor function after parasympathetic decentralization. Pharmacological treatment affecting adrenoceptors is described in different disturbances of lower urinary tract function and some evidence for adrenergic mechanisms working in intravaginal electrical stimulation is presented. The importance of the sympathetic nervous system for the normal function of the human lower urinary tract is still unclear. Nevertheless, clinical data obtained by treatment with agents influencing this system indicate that the contractory alpha-adrenoceptors of the human urethra can be stimulated or blocked pharmacologically producing significant changes in intraurethral pressure. On the other hand, the relaxatory effect on the human detrusor obtained by stimulation of the beta-adrenoceptors seems to be negligible.

Electric Stimulation↗
PubMed1980

Evaluation of a synthetic vasopressin analogue for treatment of nocturia in benign prostatic hypertrophy. A double-blind study.

A double-blind study of nocturia due to benign prostatic hypertrophy is reported. The 21 patients received 0.2 ml of an antidiuretic hormone analogue, desamino-D-arginine vasopressin (Minirin) intranasally prior to evening bedtime. Though the frequency of nocturnal micturition fell in 13 patients, only 7 were considered to give a good clinical response. This drug can be tried in patients with benign prostatic hypertrophy if nocturia is distressing and the patient is unsuitable or disinclined for surgery.

Administration, Intranasal↗
PubMed1978

beta-Adrenoceptor stimulation of the human urinary bladder in vivo.

The effect of beta-adrenorecptor stimulation on the volume of the urinary bladder in 16 neurologically normal humans without symptoms of micturition disturbances was investigated. Terbutaline, a selective beta2-adrenoceptor stimulating agent, was tested in 9 persons and isoprenaline, a general beta-adrenoceptor stimulating agent, was tested in 7 persons. After terbutaline the maximum increase in the bladder volume was 10% and on an average aroung 5%. After isoprenaline the maximum increase in the bladder volume was 15% and on an average around 5%. Terbutaline as well as isoprenaline administration resulted in tachycardia and an increased pulse pressure. The tachycardia was somewhat more marked after isoprenaline. In conclusion, only a small increase in the volume of the urinary bladder was noted after beta-adrenoceptor stimulation in neurologically normal humans without symptoms of micturition disturbances, in contrast to effects achieved in some patients with urgency. Terbutaline seems to have less cardiac effects compared to isoprenaline and is therefore to be preferred when beta-adrenoceptor stimulation is required in patients with urgency.

Adolescent↗
PubMed1978

alpha-Adrenolytic treatment in patients with autonomous bladders.

The effect of alpha-adrenolytic treatment (phenoxybenzamine) was studied in 8 patients with lower motor neuron lesions (autonomous bladders). In the cystometrograms, the bladders were more hypotonic and the "autononous waves" appeared at a higher level of filling or were totally extinguished after this pharmacological treatment. With an isotonic volume registration method, a bladder volume increase was recorded after alpha-adrenergic blockage. Using spincterometry or urethral pressure profile studies, a decrease in the urethral resistance was observed after alpha-adrenolytic treatment, resulting in a decrease in residual urine. This decrease in bladder wall tension and in residual urine effected an increased functional bladder capacity in patients with autonomous bladders.

Adult↗
PubMed1978

Effect of beta-adrenoceptor stimulation on the human bladder in vivo.

The effect of beta-adrenoceptor stimulation on the volume of the urinary bladder in 16 neurologically normal humans without symptoms of micturition disturbances was investigated into. Terbutaline, a selective beta2-receptor-stimulating agent, was tested in 9 persons and isoprenaline, a general beta-receptor-stimulating agent, was tested in 7 persons. After terbutaline the maximum increase in the bladder volume was 10% and on an average around 5%. After isoprenaline the maximum increase in the bladder volume was 15% and on an average around 5%.

Adolescent↗
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↗
PubMed1978

Ureteral reflux from ileal conduit.

In 14 patients with ileal conduit urinary diversion the frequency of ureteral reflux was studied and the intraluminal conduit pressure was registered. Reflux was found in 20 (67%) of the 30 ureters (2 patients with 3 ureters each). The frequency was approximately the same in the erect and supine body positions. Low pressure reflux (less than or equal to 12 cm H2O) was observed in about 50%. No correlation between the conduit pressure and the occurrence of ureteral reflux was found.

Aged↗