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Biomedical subjects

U Ulmsten

Publications and source records attributed to U Ulmsten.

At least 271 records · Page 15Linked to original sources
PubMed1978

Initiation of voiding in healthy women and those with stress incontinence.

Sixteen healthy women, and 13 with stress incontinence were investigated by simultaneous urethrocystometry during the initiation of voiding. In the healthy women, there was a decrease in the maximum intra-urethral pressure immediately before micturition. A few seconds later (mean 3.0 sec), the intravesical pressure increased. As a result, the urethral closure pressure decreased to zero, and urine started to escape from the urethra. In the patients with stress in continence, three different ways of initiating micturition were observed. Five patients initiated voiding by the Valsalva manoeuvre, 3 mainly by decreasing the maximum urthral pressure, and 5 mainly in the same way as the healthy women. The results suggest that preoperative analysis of the micturition pattern by means of simultaneous urethrocystometry can be of value for the choice of operative procedure, and thereby make it possible to avoid or reduce postoperative retention of urine.

Adult↗
PubMed1978

The effects of norephedrine and bethanechol on the human urethral closure pressure profile.

In twelve women with urinary stress incontinence simultaneous measurements were made of the intravesical and intra-urethral pressures, including the urethral closure pressure profile (UCPP), before and after oral administration of norephedrine or subcutaneous injection of bethanechol. The investigations were carried out at various bladder volumes in the supine position and at bladder volume 300 ml in erect position. Irrespective of bladder volume or body position, norephedrine caused a statistically significant rise in maximum urethral pressure (MUP) and in maximum urethral closure pressure (MUCP). The intravesical pressure was not affected. After intravenous injection of phentolamine, MUP and MUCP fell to levels below the original readings, but here too the intravesical pressure was unaffected. Injection of bethanechol was followed by significant increase in the intravesical pressure, irrespective of bladder volume or body position. There were no consistent changes in the intra-urethral pressure. As a consequence of the rise in intravesical pressure, however, the MUCP fell slightly. The results of the study suggest that orally administered norephedrine causes an increase in the MUCP in women with stress incontinence of urine, an increase that may prove therapeutically useful. Bethanechol, in doses that significantly increased intravesical pressure, did not alter the intra-urethral pressure.

Administration, Oral↗
PubMed1978

The effects of long-term treatment with norephedrine on stress incontinence and urethral closure pressure profile.

Twenty-five women with stress incontinence of urine were given an alpha-adrenoceptor stimulating agent (norephedrine) and a placebo during respective 14-day periods according to a double-blind cross-over schedule. The results were classified as the patient's own assessment of therapeutic effect and as change in urethral closure pressure profile measured by a microtransducer catheter. Norephedrine had a significant therapeutic effect on the symptom stress incontinence and produced significant increase in maximum urethral pressure and maximum urethral closure pressure in the lithotomy and the erect position. Reduction of incontinence was associated with increase in maximum urethral closure pressure. The sum therapeutic effect was of moderate degree.

Adult↗
PubMed1978

Percutaneous nephrostomy. Aspects on applications and technique.

Percutaneous nephrostomy was performed in 32 patients: in 8 patients for permanent and in 24 for temporary drainage. The most common indication was obstruction of the distal ureter due to malignancy. Puncture of the renal pelvis was performed with the aid of fluoroscopy and/or ultrasound. Change to larger catheters was achieved using the Seldinger technique. Complications in the form of bleeding occurred in 5 patients and were in conjunction with repuncture after the initial catheter had slipped out, or occured in connection with change to larger catheters. With the routine use of ultrasound and specially designed catheters the method should be an effective alternative to operative nephrostomy also in the nonemergency patient.

Adult↗
PubMed1978

Relaxing effects of Nifedipine on the nonpregnant human uterus in vitro and in vivo.

The effects of the calcium antagonist Nifedipine were investigated on isolated human myometrium and on uterine activity in healthy women during their first menstrual days. Nifedipine (0.01-1.0 microgram/ml) had a concentration-related inhibiting effect on spontaneous activity of the myometrial strips, and relaxed preparations contracted by potassium. In vivo, Nifedipine (20-30 mg) given orally, effectively and rapidly reduced uterine activity, decreasing both amplitude and frequency of uterine contractions, and reduced basal tone. A moderate increase in heart rate and a transient facial flushing were noted, but otherwise no side effects were observed. Calcium antagonists like Nifedipine represent a new approach to the problem of relaxing the myometrium, and might be an interesting therapeutic alternative in situations where inhibition of unwanted uterine activity is desirable.

Adult↗
PubMed1977

Evaluation of catheter-manometer systems for adequate intravascular blood pressure measurements in small animals.

Various catheter-manometer systems possible for intravascular blood pressure measurments on rats have been elaborated and tested in vitro and in vivo. Using a pressure-step calibrator, it was observed from in vitro studies that microtransducers had superior frequency response compared to conventional transducers. Of the catheters tested, Pe-90 tapered to a 40 mm tip with an inner diameter of 0.3 mm had the best frequency response as judged from fall and settling times. Because of the damping effect, tapering increased fall time to 1.8 ms, which was still quite acceptable. By the same token settling time was minimized to 22.4 ms. With a special calculation method the theoretical percentile fault of the recordings was estimated to be 9.66%. When the measurement error was calculated from the actual in vivo recordings, it was found to be no more than 2.7%. These results show that the technique described is adequate for continuous intravascular blood pressure recordings on small animals. Finally it is emphasized that careful handling of the catheters and avoidance of stopcocks and air bubbles are essential for obtaining accurate and reproducible values.

Amplifiers, Electronic↗
PubMed1977

Diagnostic and therapeutic aspects of urge urinary incontinence in women.

Under standardized conditions, simultaneous urethrocystometry and recording of urethral pressure profile were performed in 10 healthy volunteers and 20 patients suffering from urge incontinence. In the normal subjects, desire to void occurred at a bladder volume of about 300 cm3. At maximum bladder capacity (approximately 500 cm3), variations in intraurethral pressure were recorded at a time when the intravesical pressure remained stable. Immediately before voiding, there was a marked reduction in intraurethral pressure and then the intravesical pressure increased. In 10 of the patients with symptoms of urge incontinence, the findings did not differ from those in the normal subjects. In the other 10 patients, urgency was reported at bladder volumes between 125 and 150 cm3, and the maximum bladder capacity did not exceed 200 cm3. In 8 of them, marked variations in intraurethral pressure were recorded when urge was experienced, whereas the bladder pressure remained stable. In 2 of the patients, variations in intraurethral and intravesical pressure occurred simultaneously. The role of the urethra in urge incontinence is discussed.

Adult↗
PubMed1977

A new technique for simultaneous urethrocystometry including measurements of the urethral pressure profile.

A new standardized technique for continuous recording of the urethral pressure profile simultaneously with intravesical pressure has been developed. The pressure are recorded using two microtransducers enclosed in a thin Dacron catheter. The catheter is moved at a constant speed through the urethra with the aid of a specially designed withdrawal instrument. Using electronic subtraction the closure pressure can easily be measured simultaneously with the intravesical and intraurethral pressure. About 900 investigations have been performed with this technique. It has been testified that very detailed information about normal micturition as well as stress and urgency incontinence can be obtained. The functional as well as the absolute length of the urethra can be estimated within half a millimeter.

Female↗
PubMed1977

Functional role of an adrenergic sphincter in the female urethra of the guinea-pig.

By means of a microtransducer catheter, the urethral pressure profile was recorded in female guinea-pigs. The maximum urethral pressure averaged 24 mmHg (range 18-27 mmHg) and was found 4 to 7 mm from the vesico-urethral junction. Fluorescence microscopy of the urethra showed an irregular distribution of fluorescent nerve terminals in the most proximal part of the organ. In a distal direction, there was a continuous increase in the number of adrenergic nerves, with a maximum 4 to 6 mm from the internal meatus, corresponding to the maximum intraurethral pressure point. In this region, a dense plexus of nerves supplied thick muscle coats of smooth muscle having an outer circular and an inner longitudinal orientation. The findings suggest that a specific region of the female guinea-pig urethra may serve as an "internal sphincter".

Animals↗
PubMed1977

Intra-urethral and intra-vesical pressure in continent women.

Two age-groups of continent women were examined regarding the pressures in the urethra and the bladder, using a standardized recording technique with a microtransducer catheter elaborated in 1974 by Ulmsten-Asmussen. The two groups of women (mean age 28 and 54 years respectively) were examined concerning their urethral pressure profile at every 100 ml bladder filling until the maximal bladder capacity had been reached. The functional length of the urethra and the bladder pressure were the same for all women but the maximal urethral pressure decreased significantly with age (mean 61.5 and 39 mmHg in the two groups respectively). At increasing bladder filling only the younger group was able to respond with an increase in the maximal urethral pressure. The bladder volume at which severe tenesmi occurred was significantly higher in the elderly group.

Adult↗
PubMed1977

Abnormal ureteral peristaltic activity during pregnancy.

Ureteral peristalsis in five pregnant patients with signs of acute renal outflow obstruction was studied with the aid of a new technique for recording intraureteral pressure (ureterometry). With this technique it is possible to record the intraureteral pressure at three different levels in the ureter simultaneously. The rate of propagation and direction of the peristaltic waves can thus be determined. Retrograd peristalsis was found in three of the five patients and in one patient and in one patient no peristaltic activity was present at all. The fifth patient demonstrated normal antegrade peristalsis. The findings at renography in the acute stage were in accordance with the ureterometric data.

Acute Disease↗
PubMed1977

Lateral-hole catheters compared with shielded-hole catheter systems in oesophageal manometry.

Water-filled catheters with lateral holes in the distal ends are frequently used in oesophageal manometry. However, the outward position of the recording holes makes mucosal interference a possible risk. A pilot study of oesophageal manometry was performed in five healthy volunteers comparing a conventional lateral-hole catheter with the orifices directed to the centre of the catheter bundle, protected from the mucosa. The centre-hole catheter curves showed a lower resting pressure in the upper oesophageal sphincter (UOS) showed a lower resting pressure in the upper oesophageal sphincter (UOS) and a more rapid decline of the UOS peristaltic wave. The motility curves of the oesophageal body were identical with both catheters.

Adult↗
PubMed1977

The effects of emeprone on intravesical and intra-urethral pressure in women with urgency incontinence.

By use of a sensitive technique, simultaneous registration of intravesical and intra-urethral pressure changes was performed in 14 patients with urgency incontinence before and after intramuscular or oral administraiton of emeprone. The serum concentrations of the drug at different times after administration were also measured. After intramuscular injection, emeprone caused an increased bladder capacity in all the patients, and they experienced urge at larger bladder volumes. The urethral pressure was little affected. Thus, there were no significant changes of the maximum urethral pressure or of the functinal length of the urethra. Eight out of nine patients got a residual urine. After oral administration of emeprone, two out of five patients got an increased bladder capacity, and experienced urge at a larger bladder volume. They had no residual urine. In the patients receiving emeprone intramuscularly, the maximum plasma concentrations ranged from 1171 ng/ml to 378 ng/ml; they were found after 15 or 30 min. After oral intake, the maximum concentrations ranged from 36 ng/ml to 64 ng/ml and were found after 60 to 180 min. The results suggest that emeprone has actions mainly on the bladder; the effects on the urethra seem to be small.

Administration, Oral↗
PubMed1977

The effects of some anticholinergic compounds on the rabbit ureter.

Atropine, emeprone, and PR 197--a new anticholinergic compound--were examined for their possible effects on the rabbit ureter in situ. Ureteral pressure, recorded at two levels simultaneously, and intravesical pressure were studied. The effects of the substances were recorded in both normal (unobstructed) and obstructed ureters. It was found that all the substances, but especially PR 197, produced a fall in the basic intra-ureteral pressure, which was most pronounced in animals with obstructed ureters. PR 197 also temporarily abolished the ureteral peristalsis, while atropine and emeprone did not have this effect.

Animals↗
PubMed1977

The effect of changes of posture on the urethral closure pressure in healthy women.

The effect of changes of posture on hydrodynamic parameters considered important for the maintenance of urinary continence was investigated in 14 healthy women. The subjects were investigated in the supine and erect positions using a previously described technique for simultaneous urethrocystometry, including recording of the urethral pressure profile. It was found that a change from the supine to the standing position increased the maximum intravesical pressure from a mean value of 13 mmHg to 22 mmHg. There was a simultaneous increase in the maximum intra-urethral pressure from a mean of 66 mmHg to 82 mmHg. As a consequence, the urethral closure pressure increased from a mean of 53 mmHg to 60 mmHg. The functional length of the urethra increased from 25 mm to 28 mm, and the absolute length from 28 mm to 36 mm. It is concluded that in healthy women, a change from the supine to the standing position causes a rise in the maximum intra-urethral pressure and an increase in the absolute and functional lengths of the urethra. These effects counteract the simultaneous increase in bladder pressure, and can be regarded as compensatory mechanisms for the maintenance of continence.

Adult↗