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  • 1
    ISSN: 1433-3023
    Keywords: Bladder retraining ; Incontinence ; Outpatient ; Physiotherapy
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract Seventy-four patients presenting with a mixed pattern of urinary symptoms were randomly allocated to undergo either inpatient or outpatient continence programs as initial treatment, without prior urodynamic investigation. Both programs consisted of physiotherapy, bladder retraining, fluid normalization, dietary advice and general support and advice. Nine out of 39 in the outpatient group and 8 out of the 35 of the impatient group failed to complete the study. There was a significant decrease in frequency, nocturia, number of incontinent episodes and visual analog scores for both groups. In addition the outpatients had a significant reduction in loss on pad testing, and a significantly greater improvement in their visual analog score. In each group 63% were cured or improved to the extent that they did not require further treatment. Staff costs per outpatient were half those for an inpatient. We conclude that outpatient conservative treatment as detailed above is a successful first-line treatment of urinary incontinence in women. It is as successful and possibly better than inpatient treatment, and is significantly cheaper.
    Type of Medium: Electronic Resource
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  • 2
    ISSN: 1432-0878
    Keywords: Oxytocin ; Corpus luteum ; Luteinized cyst ; Immunocytochemistry ; Ewe (Romney Marsh)
    Source: Springer Online Journal Archives 1860-2000
    Topics: Biology , Medicine
    Notes: Summary Anoestrous Romney Marsh ewes with or without progesterone pretreatment were injected with multiple low-doses of gonadotrophin-releasing hormone followed by a single, larger bolus. Blood samples were taken at twelve-hourly intervals for progesterone radioimmunoassay. Ewes were slaughtered on day 3 or 5 after the bolus injection, and the ovaries were collected for histology and immunocytochemical examination for oxytocin-immunocreactivity. The corpora lutea of all ewes killed on day 3 had similar weights and morphology. The ovaries of those ewes which were not pretreated with progesterone also contained some luteinized cysts. Ewes slaughtered on day 5 were separated into 2 groups according to plasma progesterone profiles, which were either rising (‘normal’), or falling after a transitory rise (‘abnormal’). Those ewes pretreated with progesterone all had a ‘normal’ progesterone profile whereas, of 14 ewes not pretreated with progesterone, 6 were ‘normal’ and 8 ‘abnormal’. Corpora lutea were significantly lighter in the ‘abnormal’ group and the ovaries of most of these ewes also contained luteinized cysts. All corpora lutea and luteinised cysts showed staining for oxytocin-immunoreactivity although the staining intensity was variable. In corpora lutea from ‘normal’ ewes oxytocin was restricted to large luteal cells. In addition tissues from ‘abnormal’ ewes also contained many cells with an atypical elongated shape which stained for oxytocin-immunoreactivity. These results show that progesterone pretreatment is needed for both normal morphological and endocrine development of corpora lutea in anoestrous ewes stimulated with gonadotrophin-releasing hormone.
    Type of Medium: Electronic Resource
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  • 3
    ISSN: 1433-3023
    Keywords: Bladder retraining ; Incontinence ; Physiotherapy ; Urodynamics
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract Sixty patients complaining of frequency, urgency, nocturia, urge incontinence and stress incontinence were randomly allocated to either undergo conservative treatment by way of combined physiotherapy and bladder retraining as an inpatient without prior urodynamics, or to have urodynamic investigations and treatment tailored to the urodynamic diagnosis. The assessment period was 3 months and assessment was made pre- and posttreatment by urinary diary, pad testing and subjective questionnaire. There was a significant improvement posttreatment for each parameter studied, with the exception of pad testing. There was no significant difference between the two groups for any parameter. Two-thirds of patients were cured to the extent that they did not require further treatment, and again there was no difference between the two groups. We conclude that patients attending for the first time with an uncomplicated story of urinary incontinence can be effectively treated conservatively without prior urodynamics.
    Type of Medium: Electronic Resource
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