• 제목/요약/키워드: Urinary sphincter

검색결과 11건 처리시간 0.023초

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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    • 제22권4호
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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.

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

  • 윤헌영;신동욱;정순욱
    • 한국임상수의학회지
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    • 제31권6호
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    • pp.515-518
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    • 2014
  • 배뇨실금, 변비를 보이는 중성화된 수컷 요크셔테리어가 내원하였다. 신체검사에서 배뇨곤란 증상이 확인되었고 신경학적 이상은 발견되지 않았다. 또한 요검사에서 세균이 확인 되지 않았으며 직장 검사에서 정상 크기의 전립선을 확인 할 수 있었다. 요도 카테터는 저항감 없이 삽입 되었으며 비뇨기계 조영 촬영에서 골반강 내에 위치한 방광이 확인 되었다. 이소성 요관과 같은 선천적 이상은 확인 되지 않았으며 골반강 내 방광을 동반한 요도 조임근 기능 부전증이 진단 되었다. 방광을 복강내 정상 위치로 환납하기 위한 방광 고정술이 결정 되었다. 와욕 봉합을 이용 방광목 부분을 복벽 및 치골 앞 인대에 고정하였으며 추가적으로 방광 외측 부분을 복벽에 고정하였다. 방광 상단 부위는 복벽 절개창 부위에 고정 하였다. 수술 후 배뇨를 돕기 위해 방광내 카테터를 장착하였으며 수술 후 3일 째 제거하였다. 카테터 제거 후 3 일째 정상 배뇨가 확인되었으며 수술 후 2 달째 방광 조영 촬영을 통해 방광이 복강 내에 정상적으로 위치한 것을 확인하였다. 보호자와의 지속적인 전화 통화를 통해 수술 후 3년 11개월까지 정상 배뇨를 확인하였다.

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

  • 이영복;윤경봉;임영수
    • The Korean Journal of Pain
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    • 제9권2호
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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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만성 신부전을 초래한 Hinman 증후군 1례 (A Case of Hinman Syndrome Complicated by Chronic Renal Failure)

  • 이경훈;이은실;박용훈
    • Childhood Kidney Diseases
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    • 제2권1호
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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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암캐에서 부신피질기능 항진증 및 난소제거 이후 발생한 요도 괄약근 기능부전 증례 (Spay-Related Urethral Sphincter Mechanism Incompetence Concurrent with Pituitary-Dependent Hyperadrenocorticism in a Bitch)

  • 강민희;김주원;박희명
    • 한국임상수의학회지
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    • 제28권2호
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    • pp.258-261
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    • 2011
  • 8연령의 암컷 요크셔 테리어견이 요실금을 주증으로 내원하였다. 환축은 요실금 증상이 나타나기 이전부터 다음다뇨 증상을 가지고 있었으며, 난소제거 8개월 이후 야뇨증이 나타났다. 신체검사 상에서 비만과 고혈압이 확인되었다. 실험실 검사에서 적혈구증가증, 지질혈증 및 간수치 증가가 관찰되었다. 다양한 검사를 통하여 난소제거 이후 발생한 요도 괄약근 기능부전증이 가장 의심되었다. 이와 더불어 본 환축은 부신피질기능 항진증을 가진 것으로 진단되었다. 합성 에스트로겐인 디에틸스틸베스테롤을 통한 치료적 접근에서 요실금 증상의 개선이 확인 되었으며, 이를 통하여 요도 괄약근 기능부전증이 요실금의 원인으로 확진 되었다. 결론적으로 본 증례는 부신피질기능 항진증과 더불어 암캐의 난소 제거 이후 발생한 요도 괄약근 기능부전의 임상증상과 실험실 검사 결과 그리고, 치료 반응에 대한 국내 첫 증례보고이다.

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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    • 제6권1호
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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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    • 제50권6호
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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.

Effect of Non-invasive Transcutaneous Electrical Stimulation in Women With Stress Urinary Incontinence: A Prospective Study

  • Ji-hyun Kim;Hye-seon Jeon;Oh-yun Kwon;Ui-jae Hwang;Eun Young Park;Su-jin Kim
    • 한국전문물리치료학회지
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    • 제31권2호
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    • pp.167-173
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    • 2024
  • Background: Stress urinary incontinence (SUI) impacts the social, physical, and psychological well-being and quality of life of the patient. Several techniques exist for its management, including transcutaneous electrical stimulation (TES). Objects: We aimed to demonstrate the effects of TES on ultrasonographic variables and quality of life in women with SUI. Methods: This prospective study recruited 21 women who had been diagnosed with grade 1 or 2 SUI between July 2018 and March 2019. The exclusion criteria were pregnancy and a history of urogenital surgery. All participants were assessed at baseline and 8 weeks after intervention initiation. The bladder neck position (BNP), length of the urethra (LU), funneling index (FI), and rhabdosphincter thickness (RT) were measured. The Incontinence-Quality of Life (I-QOL) was used to assess incontinence-specific quality of life. Statistical significance level was set at p < 0.05. Results: Twenty-one patients with SUI used TES for 8 weeks. BNP and FI significantly decreased after intervention (p < 0.05). LU, anterior and posterior RT (indicators of external sphincter hypertrophy) significantly increased post-intervention (p < 0.05). The total I-QOL score increased from 64.81 to 71.86 after the intervention (p < 0.05). Conclusion: This intervention improved BNP, LU, FI, RT, and subjective indicators such as quality of life in women with SUI. Therefore, TES can be an effective non-surgical treatment method for improving SUI symptoms and quality of life in these patients.

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

  • 최훈
    • The Korean Journal of Pain
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    • 제3권1호
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    • pp.55-58
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    • 1990
  • 대상포진 후 신경통은 통증치료실에서 당면하는 가장 치료하기 어려운 질환중의 하나로서 현재까지 교감신경 차단, 경피적 전기자극, 약물요법 등 여러 방법이 소개되어 있으나 어느것이나 만족스럽지 못하다. 저자는 상기의 모든 방법을 동원하여 통증의 제거에 실패한 60세의 여자환자에 지주막하로 45 ml의 냉식염수를 주입하여 폐부종, cauda equina syndrome 등을 포함한 심한 합병증을 경험하였기에 문헌과 함께 고찰해 보고자 한다.

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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
    • 한국전문물리치료학회지
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    • 제26권3호
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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.