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Diagnosis of voiding dysfunction by pressure-flow study in women

World Journal of Clinical Urology 2016年第1期5卷 29-36页

作者： Juan Pablo Valdevenito Annerleim Walton-Diaz urodynamics unit Department of Urology Hospital Clinico Universidad de Chile

Pressure-flow study(PFS) of micturition is the best method to quantitatively analyse voiding function. It allows us to distinguish voiding lower urinary tract symptoms and low urine flow rate caused by bladder outlet obstruction(BOO) from those caused by detrusor underactivity(DU). Voiding dynamics are significantly different in men and women and the established criteria for urodynamic diagnosis in men do not apply to women. Basic principles of voiding mechanics and voiding patterns in asymptomatic women are analyzed. Although attempts have been made to establish a consensus for diagnosis of BOO in women with pressure-flow cutoff, video-urodynamics criteria and nomograms, currently there is no consensus. There is no standard urodynamic test to diagnose and quantify DU in women for which further investigations are needed. Modified projected isovolumetric pressure(to assess detrusor contraction strength) and pressure-flow cutoff criteria have been used. The diagnosis of voiding dysfunction in women is challenging, requiring PFS with very good quality control and often involves integrating clinical and radiographic data to make the final assessment.

关键词： Bladder outlet obstruction Pressure-flow studies urodynamics Women Detrusor underactivity

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Semi-Solid and Solid Bolus Swallows in High-Resolution Oesophageal Manometry for the Detection of Motility Disorders

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Open Journal of Gastroenterology 2018年第1期8卷 1-16页

作者： Jerry Zhou Catherine Sykes Vincent Ho School of Medicine Western Sydney University Sydney Australia Gastrointestinal Physiology and urodynamics Royal Infirmary of Edinburgh Edinburgh Scotland Gastroenterology Campbelltown Hospitals Campbelltown Australia

Background/Aims: High-resolution oesophageal manometry utilises water swallows to evaluate oesophageal function. However, small volumes of water are not representative of normal eating and as a result often produce normal manometry studies in patients with dysphagia. This study sets out to establish optimal diagnostic thresholds for semi-solid solid swallows and evaluate their ability to uncover motility abnormalities in patients with motility disorders. Method: Manometry was performed using ten 5-mL single water swallows followed by two semi-solid and two solid swallows in the upright position. Normative values for the adjunctive tests were obtained from patient controls while patients with major motility disorders were used to establish the optimal diagnostic thresholds. Diagnostic thresholds identified were prospectively tested in patients with normal water swallows but oesophagus related symptoms and in those with minor and major motility disorders. Results: Normal values for semi-solid and solid were determined in patient controls (n = 100). Development of diagnostic thresholds included 120 patients with major motility disorders. Optimal diagnostic thresholds identified for oesophagogastric junction dysfunction in semi-solid and solid swallows (IRP > 15.5 mmHg). Hypercontractilty and spasm used existing thresholds (>8000 mmHg-s-cm and < 4.5 s, respectively) but modified frequency of ≥50% of adjunctive swallows. Diagnostic thresholds were applied to symptomatic patients with normal water swallows (n = 70) identifying 12/70 (17%) to have abnormal adjunctive swallows. One of 30 patients (3%) with ineffective motility had abnormal adjunctive swallow and 12 patients with oesophageal spasm, oesophagogastric junction obstruction, and hypercontractility had abnormal adjunctive swallows that moved them up the motility disorder hierarchy. Conclusions: Semi-solid and solid challenge increase diagnostic yield of motility disorders.

关键词： High-Resolution Manometry Oesophagus Motility Diagnostic Classification Bolus Type

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Female Urology 3rd ed

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2008年

作者： Shlomo Raz Larissa V. Rodríguez

ISBN: (纸本)9781416023395

Completely reorganized and updated, the 3rd Edition of this best-selling reference presents comprehensive coverage of all aspects of female urology, making it easy to implement today’s best approaches for every patient, both surgical and non-surgical. A bonus DVD includes video clips of surgical procedures to further enhance your surgical repertoire.

关键词： Urologic Diseases.

来源：畅想之星图书光盘版（南... 评论

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Human primary muscle stem cells regenerate injured urethral sphincter in athymic rats

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Animal Models and Experimental Medicine 2022年第5期5卷 453-460页

作者： Biniam M.Bekele Verena Schöwel-Wolf Janine Kieshauer Andreas Marg Andreas Busjahn Sarah Davis Gayle Nugent Anne-Karoline Ebert Simone Spuler Muscle Research unit Experimental and Clinical Research Centera cooperation between the Max-Delbrück-Center for Molecular Medicine in the Helmholtz Association and the CharitéUniversitätsmedizin BerlinBerlinGermany CharitéUniversitätsmedizin BerlinGermany Max-Delbrück-Center for Molecular Medicine in the Helmholtz Association BerlinGermany Berlin Institute of Health at CharitéUniversitätsmedizin BelrinGermany HealthTwist GmbH BerlinGermany Charles River Laboratories MattawanMichiganUSA Department of Urology and Pediatric Urology University Hospital UlmUlmGermany

Background:The aim of the study was to demonstrate the efficacy of human muscle stem cells(MuSCs)isolated using innovative technology in restoring internal urinary sphincter function in a preclinical animal ***:Colonies of pure human MuSCs were obtained from muscle biopsy *** rats were subjected to internal urethral sphincter damage by *** days after injury,2×105 muscle stem cells or medium as control were injected into the area of sphincter damage(n=5 in each group).Peak bladder pressure and rise in pressure were chosen as outcome *** repeatedly obtain the necessary pressure values,telemetry sensors had been implanted into the rat bladders 10 days prior to ***:There was a highly significant improvement in the ability to build up peak pressure as well as a pressure rise in animals that had received muscle stem cells as compared to control(p=0.007)3 weeks after the cells had been *** mini-mal histologic evidence of scarring was observed in treated ***:Primary human muscle stem cells obtained using innovative technology functionally restore internal urethral sphincter function after *** into use in clinical settings is foreseeable.

关键词： human muscle stem cells sphincter injury telemetry urinary incontinence urodynamics

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