Invasive management of deep vein thrombosis.
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Biomedical subjects
Publications and source records attributed to W M Clow.
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A modification of the anal plug pelvic floor stimulator has been designed for the treatment of incontinence particularly due to bladder dysfunction. Using a surging intermittent train of impulses, the frequency and pulse width of which are 'tuned' to the individual patient, improved patient comfort and acceptance has been achieved. This has been partly due to the reduction or elimination of local electrolysis or electrophoresis.
25 pregnant women, 15 of whom developed stress incontinence in pregnancy, have been investigated by cystometry and urethrometry in both erect and supine posture. The resting bladder pressure rises throughout pregnancy in both erect and supine positions. Those who are not incontinent have normal bladder and urethral function. Incontinent patients show no residual urine, normal bladder capacity, and either detrusor instability and/or sphincter weakness. The stress of change of posture makes both bladder dysfunction and sphincter weakness more evident. Although the results of this investigation are not yet complete, there is a suggestion that detrusor instability may be produced by pregnancy in some patients and that in some instances recovery to normal bladder function occurs after delivery. It is postulated that these patients may be the ones who, in later life, develop stress incontinence due to bladder dysfunction.
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Despite contraceptive advice, a high proportion of patients who have had a pregnancy terminated by hysterotomy became pregnant again within a short space of time. Fifty-three such pregnancies have been studied, and a substantial risk of rupture of the uterus was demonstrated in 14 cases where the scar was thin. Rupture, impending rupture, or presumptive rupture occurred in three of these cases. Nevertheless successful vaginal delivery occurred in about 80% of cases. The infants so produced were often small for dates. Due weight should be given to the risks of subsequent early pregnancy and uterine rupture before terminating a pregnancy by the operation of hysterotomy without sterilization.
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