• Title/Summary/Keyword: Urodynamic function

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A New Approach Method of Measuring Abdominal Pressure for Urodynamic Monitoring System (요역동학 측정시스템을 위한 새로운 복압측정 기법)

  • Seo, Jeong-Hwan;Kim, Keo-Sik;An, Yang-Su;Kim, Kyeong-Seop;Song, Chul-Gyu
    • The Transactions of The Korean Institute of Electrical Engineers
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    • v.56 no.6
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    • pp.1170-1176
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    • 2007
  • The conventional urodynamic monitoring is fulfilled by artificially filling a bladder with saline. Generally. it is difficult to evaluate the physiological functions of the storage and voiding of a bladder. With this aim, we constructed an ambulatory urodynamic monitoring (AUM) system and proposed a novel method estimating abdominal pressure by measuring bio-impedance variations. Our system was clinically evaluated for 10 patients. It turned out to be that as the intensity of the abdomen contraction increased, the amplitude of bio-impedance signal and the RMS value of EMG increased more as compared to those who observed during the rest mode. Also, we determined the optimum electrode pair for estimating the abdominal pressure using bio-impedance method and consequently compared with the conventional methods. Because impedance changes differ from a weight, a height, contractile force, volume of muscle and blood other or whatever of individuals, it was quantified in terms of impedance change, correlation coefficient and SNR Our results showed the optimum electrode pair (1,9) which could detect impedance changes due to the increase of the intensity in the abdominal pressure. The correlation coefficient and quadratic function between the RMS values of EMG and the impedance changes were 0.87 and $y=0.0014x^2+0.0620x+0.6958$, respectively. Thus, our system demonstrated that the abdominal pressure could be measured noninvasively and conveniently by simply estimating bio-impedance values. We propose that this optimum electrode configuration would be useful for the future studies involving the handy measurements of abdominal pressure with our suggested ambulatory urodynamics monitoring system.

Effect of Laparoscopic Nerve-sparing Radical Hysterectomy on Bladder Function, Intestinal Function Recovery and Quality of Sexual Life in Patients with Cervical Carcinoma

  • Chen, Long;Zhang, Wei-Na;Zhang, Sheng-Miao;Yang, Zhi-Hao;Zhang, Ping
    • Asian Pacific Journal of Cancer Prevention
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    • v.15 no.24
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    • pp.10971-10975
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    • 2015
  • Objective: To investigate bladder and intestinal function recovery and quality of sexual life after laparoscopic nerve-sparing radical hysterectomy (LNRH) for treatment of early invasive cervical carcinoma. Methods: Subjects included patients who underwent radical hysterectomy by laparotomy who were randomly assigned to 2 groups: 30 patients who underwent LNRH and 35 classical laparoscopic radical hysterectomy (LRH). We assessed the patients general clinical information, surgical characteristics, pathological findings, and adjuvant therapies. A urodynamic study was used to assess bladder function. Intestinal function recovery and quality of sexual life were evaluated by questionnaire. Results: No significant differences were found in age, surgery characteristics, pathological findings, adjuvant therapies, and main adverse effects between the 2 groups. The mean duration of the postoperative catheterization (DPC) in group LNRH was shorter than that in group LRH (P < 0.001). The maximum flow rate, maximum cystometric capacity, maximum detrusor pressure and urinary complications in group LNRH were better than those in group LRH. The quality of sexual life evaluated according to the female sexual function index (FSFI) was better in group LNRH than in those who underwent LRH. The intestinal function of patients in group LNRH also recovered better compared with patients in group LRH.

Estimation of compensatory hypertrophy in lower urinary system using void force measurement (배뇨력 측정을 통한 하부요로계의 보상성기능항진 평가)

  • Jeong, Do-Un;Jeon, Gye-Rok
    • Journal of Sensor Science and Technology
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    • v.15 no.6
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    • pp.449-456
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    • 2006
  • The purpose of urodynamic investigation is to obtain the information on the function of the urinary system. The aim of this study is to acquire the useful information of lower urinary tract symptom (LUTS) diagnosis through void force signal as noninvasive method. The system which could evaluate the function of compensatory hypertrophy with noninvasive and comfortable method was implemented to measure uroflow and void force during urination. The implemented system composes of the sensor parts, signal conditioning parts and PC monitoring program. For the evaluation of the implemented system, the simulation of control part of the system was performed and the model system for the lower urinary system was designed. The superiority of a measuring characteristic of the implemented system was verified using the model system. From the evaluation of the model system, we have found out that the void force was dependent on the occlusion degree and compensatory hypertrophy significantly.

Design of ambulatory urodynamics monitoring system (휴대용 하부요로기능 검사 장치의 설계)

  • Lee, S.O.;Kim, K.S.;Yoon, D.Y.;Seo, J.H.;Song, C.G.
    • Proceedings of the KIEE Conference
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    • 2005.05a
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    • pp.48-50
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    • 2005
  • Urodynamics describes a collection of tests designed to evaluate lower urinary tract function and can be performed using retrograde filling of the bladder within a room. In this study, we designed and calibrated the potable urodynamics monitoring system using DSP chip (TMS320VC33, Texas Instrument$^{TM}$, U.S.) and collected pressure and EMG using calibration kit (DPT9022K0122, Medtronics$^{TM}$, U.S.). This system can make patients more comportable and monitor spontaneous urination during daily life.

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Implementation and estimation of the noninvasive vesical pressure measurement system for diagnosis of lower urinary tract symptom (하부요로 폐색진단을 위한 비침습적 방광내압 계측 시스템의 구현 및 평가)

  • Jeong, Do-Un;Jeon, Gye-Rok
    • Journal of Sensor Science and Technology
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    • v.15 no.2
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    • pp.139-147
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    • 2006
  • Lower urinary tract symptoms (LUTS) affect self-assessed quality of life. The prevalence of LUTS is commonly high in the elderly. The purpose of urodynamic investigation is to obtain information on the function of the urinary system. One of the most frequently used measurement procedures in urodynamics is filling and voiding cystometry. But in this system transurethral catheter is used and it makes patients uncomfortable. The aim of this study is to implement the system that could evaluate noninvasively the function of urinary tract. A new system has been developed to analyze urine flow rate and vesical pressure during voiding. These signals were recorded simultaneously and transmitted to a PC. For system evaluation, a model for the lower urinary system of men was constructed. From the evaluation of the model, vesical pressure was correlated with the occlusion degree. In a pilot study with five male subjects, maximum of standard deviation was 1.26, error rate was 3.49 and coefficient of variation was 3.48.

Urological Evaluation of Tethered Cord Syndrome

  • Park, Kwanjin
    • Journal of Korean Neurosurgical Society
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    • v.63 no.3
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    • pp.358-365
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    • 2020
  • To describe how to perform urological evaluation in children with tethered cord syndrome (TCS). Although a common manifestation of TCS is the development of neurogenic bladder in developing children, neurosurgeons often face difficulty in detecting urological problems in patients with TCS. From a urological perspective, diagnosis of TCS in developing children is further complicated due to the differentiation between neurogenic bladder dysfunctions and transient bladder dysfunctions owing to developmental problems. Due to the paucity of evidence regarding evaluation prior to and after untethering, I have shown the purpose and tools for evaluation in my own practice. This may be tailored to the types of neurogenic bladder, developmental status, and risks for deterioration. While the urodynamic study (UDS) is the gold standard test for understanding bladder function, it is not a panacea in revealing the nature of bladder dysfunction. In addition, clinicians should consider the influence of developmental processes on bladder function. Before untethering, UDS should reveal synergic urethral movement, which indicates an intact sacral reflex and lack of TCS. Postoperatively, the measurement of post-void residual urine volume is a key factor for the evaluation of spontaneous voiders. In case of elevation, fecal impaction, which is common in spinal dysraphism, should be addressed. In patients with clean intermittent catheterization, the frequency-volume chart should be monitored to assess the storage function of the bladder. Toilet training is an important sign of maturation, and its achievement should be monitored. Signs of bladder deterioration should be acknowledged, and follow-up schedule should be tailored to prevent upper urinary tract damage and also to determine an adequate timing for intervention. Neurosurgeons should be aware of urological problems related to TCS as well as urologists. Cooperation and regular discussion between the two disciplines could enhance the quality of patient care. Accumulation of experience will improve follow-up strategies.

Implementation and Evaluation of the LUTS Diagnosis System Using FPGA (FPGA를 이용한 LUTS 진단 시스템 구현 및 평가)

  • Jeong, Do-Un;Chung, Wan-Young;Jeon, Gye-Rock
    • Journal of the Institute of Convergence Signal Processing
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    • v.8 no.1
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    • pp.6-14
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    • 2007
  • The purpose of urodynamic investigation is to determine information on the function of the urinary system. One of the most frequently used measurement procedures in urodynamics is filling and voiding cystometry using invasive method. But in this method transurethral catheter is use and it makes patients uncomfortable. The aim of this study was to implement the system that could evaluate the function of urinary tract with noninvasive and comfortable method. Therefor in this study, a sensor and measuring system were implemented to measure uroflow, urophonography and noninvasive bladder pressure signal during urination for diagnosing the LUTS(lower urinary tract symptoms) using noninvasive method. The implemented system compose of the sensor parts, signal conditioning parts, system control parts using FPGA and PC monitoring program. For the evaluation of the implemented system, the simulation of system's control part was performed and the model system for the lower urinary system was designed. From the evaluation of the model system, the mean error rate of the uroflow measurement part was 1.08% and coefficient of variation was 1,48. And the mean error rate of the noninvasive bladder pressure measurement part was 2.41% and coefficient of variation was 2.81. urophongraphy signal analysis was accomplished in a time domain and frequency domain. Average RMS power was used in a time domain analysis, and MF was used in a frequency domain analysis. From the evaluation of the model system average RMS power and MF was dependent on the occlusion degree significantly and median frequency range of $60{\sim}160Hz$ was correlated with the occlusion.

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Tethered Cord Syndrome; Surgical Indication, Technique and Outcome

  • Kang, Joon-Ki;Lee, Kwan-Sung;Jeun, Sin-Soo;Kang, Seok-Gu;Lee, Il-Woo;Yoon, Kang-Jun;Ha, Sang-Soo
    • Journal of Korean Neurosurgical Society
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    • v.42 no.2
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    • pp.77-82
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    • 2007
  • Objective : The authors tried to reveal some unique features of lipomeningomyelocele (LMMC), including clinical presentation, factors precipitating onset of symptoms, pathologic entities of LMMC associated with tethered cord syndrome, and surgical outcome in LMMC patients. Methods : Seventy-five patients with LMMC were enrolled in this study. Neuro-imaging and intraoperative findings allowed classification of LMMC into three Types. The patients were divided into two groups by age : A (51 patients), from birth to 3 years, and B (24 patients), from 3 to 24 years. For prevention of retethering of the cord, a mega-dural sac rebuilding procedure was performed in 15 patients. Results : During a mean postoperative follow-up period of 4 years, the surgical outcome was satisfactory in terms of improved pain and motor weakness, but disappointing with reference to the resolution of bowel and bladder dysfunction. Among these 75 patients with LMMC, preoperative deficits were improved after surgery in 29 (39%), remained stable in 28 (37%), changed slightly in 13 (17%), and worsened in 5 (7%). Patients in group A achieved better outcomes than those in group B. Depending on the type of lesion, patients with types I and II LMMC have better outcomes than those with type III LMMC. Finally, retethering of the cord with neurological deterioration occurred in 4 (5.3%) of the 75 patients, but no retethering was found in the 15 patients who were recently treated with a mega-dural sac rebuilding procedure. Conclusion : Our data continue to support the opinion that early diagnosis and optimal surgery are still essential for the treatment of patients with LMMC, since there is a high likelihood of residual neurological functions that can be preserved. Based on our surgical experience of untethering and decompression of lipomas, a mega-dural sac repair is useful to prevent retethering of the cord.

The Effects of Ginseng Saponin on Relaxation of Smooth Muscle in the Lower Urinary Tract and the Corpus Cavernosum (인삼 사포닌이 하부요로와 음경해면체 평활근의 이완작용에 미치는 효과)

  • Jung, Hee-Chang;Oh, Tae-Hee
    • Journal of Yeungnam Medical Science
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    • v.23 no.1
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    • pp.52-61
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    • 2006
  • Background: Korean ginseng (KG) has been used as a general tonic, and for voiding dysfunction for a long time in oriental society. However, scientific basic studies on the use of KG, have been rare, especially for voiding and erectile dysfunction. This study was performed to investigate the effects of KG on voiding and erectile function by examining the effects of total saponin (TS) on the bladder, urethral and penile cavernosal smooth muscle. Materials and methods: To examine the effects of TS, NewZeland white rabbits were used to obtain tissue strips from the smooth muscle of the bladder, proximal urethra and corpus cavernosum. Adult Sprague Dawley rats were used to examine the changes in urodynamic findings and penile erection after administration of TS. Results: In proximal urethral strips, the rate of relaxation of the proximal urethra was increased from $9.0{\pm}2.9$ to $33.7{\pm}4.8%$ in a dose-dependent manner when the concentration of TS was added accumulatively from 0.25 mg/ml to 4.0 mg/ml (p<0.05). However, no significant response was observed in the bladder strips within these concentration ranges. For the corpus cavernosal strips, the rate of relaxation ranged from $5.8{\pm}2.1$ to $36.7{\pm}5.8%$, increasing in a dose-dependent manner when TS was increased from 1.0 mg/ml to 4.0 mg/ml (p<0.05). After administration of 0.1 ml of TS (32 mg/ml) in the rat, the bladder pressure was $37.5{\pm}8.5$ mmHg at $52.1{\pm}7.0$ sec. during isovolumetric bladder contraction, showing no significant differences from $35.7{\pm}7.8mmHg$ and $50.7{\pm}7.2$ sec, respectively, before treatment. However, when 0.1 ml of TS (32 mg/ml) was administered, the relative reduction of urethral pressure was $6.9{\pm}0.5mmHg$ at $62{\pm}7.5$ sec, which was significantly higher compared to $4.6{\pm}1.1mmHg$ at $45{\pm}10$ sec before treatment (p<0.05). For the cavernosal injection study, the change in intracavernosal pressure (${\Delta}ICP$) was examined after administering 0.1 ml of TS. The cumulative additions of TS at concentrations from 0.5 mg/ml to 32 mg/ml increased ${\Delta}ICP$ from $1.3{\pm}0.5$ to $21.3{\pm}7.8mmHg$ in a dose-dependent manner (p<0.05). The duration of tumescence was from $0.3{\pm}0.1$ to $5.2{\pm}0.2$ min, showing dose-dependent increase (p<0.05). Furthermore, the cumulative addition of TS at concentrations from 0.5 mg/ml upto 32 mg/ml did not cause any significant change in systemic blood pressure. Conclusion: These results suggest that ginseng improves voiding functions, which is mainly achieved by TS relaxing the proximal urethra, the most important part of the bladder outlet function. In addition, ginseng safely induced a penile erection hemodynamically by relaxing the corpus cavernosum.

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