• Title/Summary/Keyword: Urinary sphincter

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Cell Versus Chemokine Therapy Effects on Cell Mobilization to Chronically Dysfunctional Urinary Sphincters of Nonhuman Primates

  • Williams, J. Koudy;Mariya, Silmi;Suparto, Irma;Lankford, Shannon S.;Andersson, Karl-Erik
    • International Neurourology Journal
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    • v.22 no.4
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    • pp.260-267
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    • 2018
  • Purpose: A major question remaining in approaches to tissue engineering and organ replacement is the role of native mobilized native cells in the regeneration process of damaged tissues and organs. The goal of this study was to compare the cell mobilizing effects of the chemokine CXCL12 and cell therapy on the urinary sphincter of nonhuman primates (NHP) with chronic intrinsic urinary sphincter dysfunction. Methods: Either autologous lenti-M-cherry labeled skeletal muscle precursor cells (skMPCs) or CXCL12 were injected directly into the sphincter complex of female NHPs with or without surgery-induced chronic urinary sphincter dysfunction (n=4/treatment condition). All monkeys had partial bone marrow transplantation with autologous lenti-green fluorescent protein (GFP) bone marrow cells prior to treatment. Labeled cells were identified, characterized and quantified using computer-assisted immunohistochemistry 6 months posttreatment. Results: GFP-labeled bone marrow cells (BMCs) were identified in the bone marrow and both BMCs and skMPCs were found in the urinary sphincter at 6-month postinjection. BMCs and skMPCs were present in the striated muscle, smooth muscle, and lamina propria/urothelium of the sphincter tissue. Sphincter injury increased the sphincter content of BMCs when analyzed 6-month postinjection. CXCL12 treatment, but not skMPCs, increased the number of BMCs in all layers of the sphincter complex (P<0.05). CXCL12 only modestly (P=0.15) increased the number of skMPCs in the sphincter complex. Conclusions: This dual labeling methodology now provides us with the tools to measure the relative number of locally injected cells versus bone marrow transplanted cells. The results of this study suggest that CXCL12 promotes mobilization of cells to the sphincter, which may contribute more to sphincter regeneration than injected cells.

Cystopexy to Treat Urinary Incontinence Due to Urethral Sphincter Mechanism Incompetence in a Male Dog (수컷 개에서 발생한 요도 조임근 기능 부전에 의한 배뇨실금의 방광 고정술을 이용한 외과적 치료 증례)

  • Yoon, Hun-Young;Shin, Dong-Wook;Jeong, Soon-Wuk
    • Journal of Veterinary Clinics
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    • v.31 no.6
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    • pp.515-518
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    • 2014
  • A castrated male Yorkshire Terrier dog was presented for urinary incontinence and constipation. On physical examination, the dog showed difficult urination. There were no neurological abnormalities and no bacterial detection on urinalysis. Rectal examination revealed a regular, normal-sized prostate. Urethral catheterization was performed easily. Excretory urography and retrograde positive contrast urethrocystography showed displacement of the urinary bladder to the intrapelvic region. There was no evidence of an ectopic ureter. A tentative diagnosis of urethral sphincter mechanism incompetence accompanied with a pelvic bladder was made. Cystopexy was decided to place the urinary bladder to its normal position. The neck of the urinary bladder was anchored to the body wall and prepubic tendon using mattress sutures. Additional sutures were placed to appose the lateral part of the urinary bladder and abdominal wall. A simple interrupted suture was placed to tack the apex of the urinary bladder on the abdominal incision line. A urinary catheter was placed in the urinary bladder to provide post-operative evacuation. The catheter was removed when the dog was able to urinate with minimal straining at 3 days post-operatively. The owner reported that the dogs showed normal urination without straining at 3 days after the catheter was removed. Excretory urography revealed that the urinary bladder was located on its normal position at 2 months post-operatively. Subsequent communication with the owner by telephone revealed that the dog was in good urination at 3 years 11 months post-operatively.

Voiding Difficulty in Herpetic Neuralgia Patient -Two cases report- (대상포진 환자에서 발생한 배뇨곤란 -증례 보고-)

  • Lee, Young-Bok;Yoon, Kyung-Bong;Lim, Young-Su
    • The Korean Journal of Pain
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    • v.9 no.2
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    • pp.412-414
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    • 1996
  • Herpes zoster is an infection by the varicella zoster virus in a partly immune compromised person such as old age, cancer, immune deficiency disease. When either the upper lumbar or sacral segments are involved, serious urinary retention caused by central spread of herpes zoster from dorsal root ganglion can occur. The urinary disturbance appears to have been due to motor dysfunction of detrusor muscle, trigone muscle, and internal sphincter. We experienced two cases of zoster affecting different segments of the spinal cord and resulting in urinary retention.

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A Case of Hinman Syndrome Complicated by Chronic Renal Failure (만성 신부전을 초래한 Hinman 증후군 1례)

  • Lee Gyeong-Hoon;Lee Eun-Sil;Park Yong-Hoon
    • Childhood Kidney Diseases
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    • v.2 no.1
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    • pp.90-94
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    • 1998
  • Hinman syndrome is a condition representing urinary voiding dysfunction in the neurologically intact child. The syndrome is probably caused by acquired behavioral and psychosocial disorders manifested by bladder and/or bowel dysfunction mimicking neurologic disease. Clinically, the symptom complex may include day and night time enuresis, encopresis, constipation, and recurrent urinary tract infections. Cystoscopy frequently demonstrates normal vesicourethral anatomy. Voiding films usually demonstarate a carrot-shaped proximal urethra with a persistent narrowing at the external sphincter. The bladder is large and often appears trabeculated with a thickened wall and significant postvoid residual. A 13-year-old male child was admitted due to fever, urinary tract infection, enuresis and flank pain. His neurologic examination was normal. Renal sonograms showed moderate hydronephrosis. Voiding cystourethrograms showed a huge, trabeculated bladder without vesicourethral reflux and urethral valves. No abnormal findings was found in spinal MRI.

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Spay-Related Urethral Sphincter Mechanism Incompetence Concurrent with Pituitary-Dependent Hyperadrenocorticism in a Bitch (암캐에서 부신피질기능 항진증 및 난소제거 이후 발생한 요도 괄약근 기능부전 증례)

  • Kang, Min-Hee;Kim, Ju-Won;Park, Hee-Myung
    • Journal of Veterinary Clinics
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    • v.28 no.2
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    • pp.258-261
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    • 2011
  • An 8-year-old spayed female, Yorkshire terrier dog was presented with a urinary incontinence. Unaware urine dribbling during sleeping was observed eight months after spaying. Polyuria and polydipsia were also reported. Physical examination revealed obesity and hypertension. Characteristic laboratory findings in this dog were polycythemia, hyperlipidemia and elevated hepatic enzyme. Other causes of the urinary incontinence were ruled out through further diagnostic tests and spay-related urethral sphincter mechanism incompetence (USMI) was made as a presumptive diagnosis. In addition, the dog was also diagnosed with pituitary-dependent hyperadrenocorticism. Both conditions can cause urinary incontinence in dogs; therefore, definite diagnosis was made through a therapeutic approach. The synthetic estrogen, diethylstilbesterol, was initially administered and successfully managed the urinary incontinence in this dog. To the best of the author's knowledge, this is the first case report describing the clinical and laboratory features of spay-related USMI concurrent with hyperadrenocorticism and treatment outcomes in our country.

Development of Pocket Insertion style Magnetic Curer that Apply $2^{loop}\;3^{pulsed}$ Variable Magnetic type Probe for Urinary Treatment

  • Kim, Whi-Young
    • Journal of information and communication convergence engineering
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    • v.6 no.1
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    • pp.73-79
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    • 2008
  • Result that study magnet nerve curer for treatment induced current generation and current of ion for development in main point incontinence, prostate, sphincter, nervous system, rigidity, headache, retrogression arthritis, ligament damage, Rheumatism arthritis, peripheral nerve etc., can classify by 4. Embodied do first, full bridge magnet occurrence chapter, and communication with PC is available, confirmed various action loops an experiment. Could confirm correct treatment probe second, woman and man disease person. Third, derived so that healing may be possible naturally by addition of apron form according to disease. Because composition of finally, treatment probe composes by act of negative plate form, manufacture is easy and cooling designed for easy direction. More superior result of cooling appeared than existing in incidental and ingredients, cooling efficiency, composition, complexity, convenience etc. that expense and composition manufacture very straightforwardly and experimental by 2 - Tank ways.

Modified Urethral Graciloplasty Cross-Innervated by the Pudendal Nerve for Postprostatectomy Urinary Incontinence: Cadaveric Simulation Surgery and a Clinical Case Report

  • Hisashi Sakuma;Masaki Yazawa;Makoto Hikosaka;Yumiko Uchikawa-Tani;Masayoshi Takayama;Kazuo Kishi
    • Archives of Plastic Surgery
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    • v.50 no.6
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    • pp.578-585
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    • 2023
  • An artificial sphincter implanted in the bulbous urethra to treat severe postprostatectomy urinary incontinence is effective, but embedding-associated complications can occur. We assessed the feasibility, efficacy, and safety of urethral graciloplasty cross-innervated by the pudendal nerve. A simulation surgery on three male fresh cadavers was performed. Both ends of the gracilis muscle were isolated only on its vascular pedicle with proximal end of the obturator nerve severed and transferred to the perineum. We examined whether the gracilis muscle could be wrapped around the bulbous urethra and whether the obturator nerve was long enough to suture with the pudendal nerve. In addition, surgery was performed on a 71-year-old male patient with severe urinary incontinence. The postoperative 12-month outcomes were assessed using a 24-hour pad test and urodynamic study. In all cadaveric simulations, the gracilis muscles could be wrapped around the bulbous urethra in a γ-loop configuration. The length of the obturator nerve was sufficient for neurorrhaphy with the pudendal nerve. In the clinical case, the postoperative course was uneventful. The mean maximum urethral closure pressure and functional profile length increased from 40.7 to 70 cm H2O and from 40.1 to 45.3 mm, respectively. Although urinary incontinence was not completely cured, the patient was able to maintain urinary continence at night. Urethral graciloplasty cross-innervated by the pudendal nerve is effective in raising the urethral pressure and reducing urinary incontinence.

Cauda Equina Syndrome Following Intrathecal Hypertonic Saline Administration (자주막하강내 고장성 생리식염수 투여후 발생한 마비증후군)

  • Choe, Huhn
    • The Korean Journal of Pain
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    • v.3 no.1
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    • pp.55-58
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    • 1990
  • A case of severe complications following intrathecal administration of 45 ml of hypertonic saline solution for the treatment of postherpetic neuralgia was presented. Transient immediate complications included were tachycardia, hypertension, neck stiffness and muscle twitch. Pulmonary edema, paralytic intestinal obstruction, and the cauda equina syndrome including sphincter disorder with atonic urinary bladder developed shortly after the injection. Tenesmus and sensory abnormality around perineum and soles were the longlasting complications.

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Effects of Transcutaneous Electrical Stimulation on Physiological Symptoms and Psychological Satisfaction in Women With Stress Urinary Incontinence: A Preliminary Study

  • Kim, Ji-hyun;Kwon, Oh-yun;Jeon, Hye-seon;Hwang, Ui-jae;Gwak, Kyeong-tae;Yoon, Hyeo-bin;Park, Eun-young
    • Physical Therapy Korea
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    • v.26 no.3
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    • pp.67-75
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    • 2019
  • Background: Stress urinary incontinence (SUI) is an involuntary leakage of urine from the urethra when intra-abdominal pressure increases, such as from sneezing, coughing, or physical exertion. It is caused by insufficient strength of the pelvic floor and sphincter muscles, resulting from vaginal delivery, obesity, hard physical work, or aging. The pelvic floor electrical stimulator is a conservative treatment generally used to relieve the symptoms of urinary incontinence. it recommended to applied before surgery is performed. Objects: The purpose of this study was to determine if the transcutaneous electrical stimulation (TCES) would be effective for the physiological symptoms and psychological satisfaction of women with SUI for an 8-weeks intervention. Methods: Easy-K is a specially designed user-friendly TCES. Five female who were diagnosed with SUI by a gynecologist but who did not require surgical intervention were included in this study. Intervention was implemented over an 8-week period. Outcome measures included vaginal ultrasonography, Levator ani muscle (LAM) contraction strength, incontinence quality of life (I-QOL), and female sexual function index (FSFI) questionnaires. Results: The bladder neck position significantly decreased across assessment time. Funneling index and urethral width significantly decreased after 8 weeks of intervention (p<.05). The bladder necksymphyseal distance and posterior rhabdosphincter thickness statistically increased and the anterior rhabdosphincter thickness showed a tendency to increase. All participants demonstrated a significant increase in the LAM contraction score across three assessment times (p<.05). Although the total score of the I-QOL did not show significant improvement, it steadily increased and among I-QOL subscales, only the "avoidance" subscale showed statistical improvements (p<.05). The total score of the FSFI statistically improved and the "desire" score significantly changed (p<.05). Conclusion: The TCES is recommended for women who want to apply conservative treatments before surgery and who have suffered from SUI in aspects of sexual function and quality of life.

Effective Dosage of Intrathecal Morphine for Postoperative Pain Control of Perianal Surgery (항문 주위 수술후 통증관리를 위한 지주막하강내 Morphine의 유효량)

  • Won, Jong-In;Cho, In-Chan;Park, Young-Chul
    • The Korean Journal of Pain
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    • v.12 no.1
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    • pp.59-63
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    • 1999
  • Background: Contraction of anal sphincter muscle produces severe pain in perianal surgery postoperatively. Recent reports have indicated that effective and prolonged pain relief can be obtained by the injection of small doses of morphine into the subarachnoid space. We attempted to use this technique for perianal surgery and investigated postoperative pain control and its side effects. Methods: Forty five patients scheduled for hemorrhoidectomy and anal fistulectomy were studied to determine the minimal effective dose of intrathecal morphine for postoperative analgesia. In order to control the pain, 7 mg of 0.5% hyperbaric bupivacaine with 0.05 mg (group I), 0.1 mg (group II) and 0.15 mg (group III) of morphine hydrochloride was injected with a 25 gauge spinal needle into the subarachnoid space. We estimated the duration of analgesia until the pain score attained to above 3 in 10 cm VAS (visual analogue scale) and incidence of itching, nausea and vomiting by percentage, headache, backpain and respiratory depression by positive and negative. We also checked the time of self-voiding. Results: The mean time of analgesia was $10.3{\pm}1.54$, $19.7{\pm}2.22$ and $20.3{\pm}2.29$ hours in group I, II and III respectively. Urinary retention of group I, II and III after block persisted for an average of $20.3{\pm}2.31$, $21.2{\pm}2.51$ and $23.3{\pm}3.74$ hours. Nausea and vomiting were observed 33%, 53%, 67% and itching was observed 53%, 67%, 80% in group I, II and III respectively and respiratory depression did not occur in all groups. Conclusions: It is not necessary to use more than 0.1mg of intrathecal morphine in perianal surgery because analgesia is not prolonged and side effects are increased.

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