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Biomedical subjects

U Ulmsten

Publications and source records attributed to U Ulmsten.

At least 253 records · Page 14Linked to original sources
PubMed1979

The urethral pressure profiles in continent and stress-incontinent women.

Simultaneous urethrocystometry, including recording of the urethral pressure profile, was performed in 127 women aged 30 to 69 years; 42 of the women were free from urologic disorders and 85 had stress incontinence of urine. Both groups were subgrouped according to age. The results in the continent and the incontinent women were analyzed separately, in order to disclose any age-related changes. The data within each decade of age were also comparatively analyzed. In the bladder pressure at rest no age-related changes were found, and the readings were similar in the continent and the incontinent women. The maximum urethral pressure fell significantly with rising age in both groups and was significantly reduced in stress incontinence. The urethral closure pressure showed variations similar to those in the maximum urethral pressure. No lower limit of urethral closure pressure that definitely predisposed to stress incontinence could be established. The functional length of the urethra diminished significantly with rising age in the continent, but not in the incontinent women. The absolute length of the urethra did not show such diminution. Both the functional and the absolute urethral length were significantly less in the incontinent than in the continent women in the age groups between 30 and 49 years.

Adult↗
PubMed1979

Comparison of prostaglandin E2 and intravenous oxytocin for induction of labor.

One hundred nulliparas at term were randomly given oxytocin intravenously or prostaglandin E2 (PGE2) gel (0.5 mg PGE2) intracervically in order to study the effect on cervical ripening and the frequency of successful inductions. In the presence of a favorable cervix both methods seemed equally efficacious in inducing labor. However, when the cervix was unfavorable, 53% of the patients could be delivered with PGE2 gel, compared with 31% when oxytocin was given. In patients with a highly unfavorable cervix this difference was significant (P less than 0.02). In patients not induced into labor, PGE2 gel caused a considerable ripening of the cervix, with a change in Bishop score from 2.9 to 6.3. In patients undelivered after oxytocin stimulation, no change in Bishop score occurred. This effect of locally applied PGE2 gel on cervical ripening was highly significant (P less than 0.001). No adverse maternal or perinatal effects were observed, irrespective of the mode of treatment.

Administration, Topical↗
PubMed1979

Urodynamic studies of women with prolapse and stress incontinence before and after surgical repair.

Twenty-one women, 11 suffering from both prolapse and stress incontinence and 10 with prolapse only were investigated before and at different intervals after surgical repair of the disorders. The investigations comprised a gynaecological examination, urine culture, observation of residual urine and simultaneous urethro-cystometry including measurement of the urethral pressure profile.--The prolapse patients were operated upon by conventional Manchester technique. The patients suffering from both prolapse and stress incontinence were operated with a combined vaginal-abdominal repair using Lyodura slings.--It was found that the pre-operative urethral pressure at rest was lower in the inconinent-prolapse patients compared with that in patients suffering from prolapse only. After surgery the urethral pressure at rest was significantly decreased in the incontinent-prolapse patients whereas it did not change in patients operated because of prolaspe only.--Prior to the operation, all incontinent-prolapse women had a negative urethral closure pressure at stress. After surgery the closure pressure became positive in all patients and none complained about urinary incontinence. In all patients suffering from prolapse only the urethral closure pressure was positive at stress before as well as after surgery. The functional and the absolute urethral lengths increased in both categories of patients after the operation.

Adult↗
PubMed1978

Esophageal manometry in pregnant and nonpregnant women.

Esophageal and gastric tone was recorded in six pregnant and six nonpregnant women by means of a new technique for intraluminal pressure recordings. The recordings were performed in supine and standing positions, at rest, and during swallowing of saliva or water. It was found that the pregnant women had lower intraesophageal pressures but higher intragastric pressures compared to the nonpregnant women. In one of the pregnant women a negative pressure situation was recorded between the stomach and lower esophagus. This patient also complained of severe heartburn when she was lying down. Gastroesophageal reflux seems to be aggravated in pregnant women since esophageal peristalsis in these patients has lower wave speed and lower amplitude compared to nonpregnant women.

Adult↗
PubMed1978

Effects of nifedipine on myometrial activity and lower abdominal pain in women with primary dysmenorrhoea.

The effects of the calcium antagonist nifedipine on uterine activity and lower abdominal pain were studied during the first menstrual day in 10 women with severe primary dysmenorrhoea. Intrauterine pressure was recorded at three different levels by means of microtransducers. Nifedipine, 20 to 40 mg given orally, within 10 to 30 minutes effectively reduced the myometrial activity and relieved the pain. A moderate increase in heart rate, and a transient facial flushing were noted. In some patients receiving 30 or 40 mg this was associated with a slight headache. Otherwise no side effects were observed. It is suggested that calcium antagonists can be used to treat primary dysmenorrhoea and other conditions in which an inhibition of uterine activity is desirable.

Adolescent↗
PubMed1978

Effects of nifedipine on the smooth muscle of the human urinary tract in vitro and in vivo.

Smooth muscle preparations of the urethra, bladder, and ureter were obtained from patients undergoing operations for various urological disorders. The urethral preparations were contracted by noradrenaline (0.1-3 microgram . ml-1), prostaglandin F2alpha (1-10 microgram . ml-1), and potassium (127 mM), the bladder preparations by carbacholine (0.004-1 microgram . ml-1), prostaglandin F2alpha (1-10 microgram . ml-1), potassium (127 mM), and barium chloride (3 mM), and the ureter preparations by potassium (127 mM), and barium chloride (3 mM). Irrespective of the mode of activation, pretreatment with nifedipine (0.1 microgram . ml-1) for 10 min. reduced the responses. Nifedipine also relaxed preparations contracted by the contractile agents used. In 19 female patients, aged 20 to 73 years, undergoing investigation because of urgency and/or urge incontinence, simultaneous urethrocystometry at rest was performed before and after oral administration of 20 to 40 mg nifedipine. Bladder capacity and residual urine were also determined. Nifedipine did not affect the pressures within the bladder and urethra, nor did it increase the bladder capacity. However, after nifedipine intake there was a statistically significant increase in residual urine. The results suggest that nifedipine can inhibit contractile activity induced by drugs with different modes of action; the drug does not affect the tone in bladder and urethra.

Administration, Oral↗
PubMed1978

Aspects of present and future possibilities for intraluminal pressure recordings in the urogenital tract.

In this brief survey some aspects of present and future possibilities for intraluminal pressure recordings in the urogenital tract are considered. It is emphasized that present water-filled catheter-manometer systems are afflicted with several biotechnical disadvantages. Although the micro-transducers and centre-hole catheters seem to be superior to conventional pressure recording systems, they ought to be further improved. Feed-back pressure transducers, electronic compensation, and micro-manometers could be realistic alternatives for pressure recordings in the urogential tract in the future. Some results from pressure recordings obtained with different measuring systems are presented and discussed.

Catheterization↗
PubMed1978

Effect of the calcium antagonist nifedipine on uterine blood flow in non-treated and oestradiol-treated rats.

Organ blood flow, as estimated by the radioactive labelled microsphere technique, was studied in rats before and after intracaval administration of the calcium antagonist nifedipine. Intra-uterine and arterial blood pressures were registered simultaneously. Two groups of animals were investigated, one non-treated and one treated with oestradiol. After administration of nifedipine, an increase in the blood flow to the brain, the heart and the kidneys was seen in both groups of animals. However, in the uterus, blood flow was markedly increased in non-treated, but not so in oestradiol-treated animals. The arterial blood pressure and intra-uterine pressure were almost unaffected. The results suggest that nifedipine can markedly increase blood flow to the uterus of non-oestrogen-treated rats with only minor effects on intra-uterine and arterial blood pressures.

Animals↗
PubMed1978

Effects of prostaglandin E2 applied locally on intravesical and intraurethral pressures in women.

In 21 women undergoing simultaneous urethrocystometry because of dysuria, urge, and difficulties to empty the bladder, the effects of prostaglandin E2 (PGE2) applied locally in the bladder and urethra were investigated. In all 9 patients receiving PGE2 intravesically, the bladder pressure increased. Simultaneously, there was a signficant decrease in maximum urethral pressure (p less than 0.05), and in urethral closure pressure (p less than 0.005). Residual urine decreased in the 4 patients, in whom it exceeded 50 ml before administration. All 12 patients receiving PGE2 intraurethrally showed a decrease in maximum urethral pressure). There was a significant increase in bladder pressure (p less than 0.05); urethral closure pressure decreased in all patients. Bladder capacity decreased significantly (p less than 0.01). Residual urine exceeding 50 ml was found in 6 patients; it decreased in 4 after PGE2 administration. It is concluded that PGE2 applied intraurethrally can decrease the intraurethral pressure and increase the bladder pressure without side effects. By these actions, the drug might be useful for facilitating bladder emptying in patients with acute retention of urine.

Adult↗
PubMed1978

Urethral pressure profile before, during and after pubococcygeal repair for stress incontinence.

In two groups of women the urethral pressure profile was recorded using a microtransducer catheter. Both groups were of approximately the same age, one consisting of continent women, the other of women with severe stress incontinence. Sixteen stress incontinent woman were examined before and after pubococcygeal repair and 10 of these were also examined during the operation. The two groups were compared for differences in the urethral pressure profile in the continent and incontinent states. The stress incontinent women had a significantly shorter functional length of the urethra (10 mm) but the same maximal urethral pressure as continent women. Remarkable changes in these parameters were seen during the operation. However, at the examination 3 months postoperatively, they had totally disappeared. The only change in the urethral pressure profile which persisted after the operation was a higher pressure in the proximal part of the urethra so that a urethral maximal pressure plateau had been established. This plateau was also seen, on a higher level, in the continent state.

Female↗
PubMed1978

Some methodiological aspects on the measurement of intraluminal pressures in the female urogenital tract in vivo.

This short survey presents some methodological aspects on intraluminal pressure recordings in vivo from the female urogenital tract. The importance of adequate calibration is stressed and a calibration unit for different types of recording equipments is described. Calculations of measuring errors are outlined. The selection of recording catheters is disucssed from both the theoretical and the practical point of view. Finally some practical aspects are considered on pressure recordings in vivo from the ureter, the bladder, the urethra and the uterus. This discussion is illustrated by pressure diagrams obtained with different recording techniques from the actual organs.

Female↗
PubMed1978

Ripening of the uterine cervix and induction of labour at term with prostaglandin E2 in viscous gel.

In order to achieve ripening of the uterine cervix or induce labour in patients at term with an unfavourable cervical state, 1 mg of prostaglandin E2 (PGE2), suspended in a viscous gel, was instilled into the cervical canal. In a pilot study, 41 patients received the PGE2-gel. Twenty-three of these, (56%), went into labour, and delivery occurred without further stimulation within 15 hours. In the remaining 18 patients, there was a marked improvement of the cervical state, which changed from an average (modified) Bishop score of 2.5 to 6.1 within 24 hours. In a double-blind study comprising 20 nulliparae, 10 received gel containing PGE2 and 10 gel without prostaglandin. Cervical state did not change significantly (Bishop score 3.6 and 4.0) after 24 hours in patients receiving placebo gel. In those receiving PGE2 gel, 8 went into labour and were delivered without further induction within 13 hours. Two patients showed an increase in Bishop score from 3 to 6 and 7, respectively, after 24 hours. They were then induced by oxytocin and delivery occurred after 8 and 10 hours. The results suggest that administration of PGE2 intracervically can induce ripening of the cervix in patients at term with an unfavourable cervical state, and thus facilitate delivery.

Adolescent↗
PubMed1978

Recording of myometrial activity in the non-pregnant human uterus by a micro-transducer catheter.

A micro-transducer catheter was tested in vitro and in vivo for recording of myometrial activity in the non-pregnant human uterus and was also compared with conventional fluid-filled, open end catheters previously used for recording intra-uterine pressures. The micro-transducer catheter had a frequency response far above that of fluid-filled, open end catheters. It was easily introduced through the uterine cervix and was never obstructed. Provided that the sensory surface of the micro-transducer was kept from direct contact with the uterine wall by some special arrangement it gave recordings of the intra-uterine pressure, that were practically identical with those obtained by an open end catheter.

Catheterization↗