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  • 1
    Electronic Resource
    Electronic Resource
    Denervation and re-innervation of the urethral sphincter in the aetiology of genuine stress incontinence: an electromyographic study (1993)
    Oxford, UK : Blackwell Publishing Ltd
    BJOG 100 (1993), S. 0 
    Details
    ISSN: 1471-0528
    Source: Blackwell Publishing Journal Backfiles 1879-2005
    Topics: Medicine
    Notes: Objective To investigate the role of altered innervation of the urethral sphincter in the genesis of genuine stress incontinence.Design Prospective observational study.Setting Tertiary referral centre urodynamics unit.Subjects Sixty-eight women, 33 with urodynamically proven pure genuine stress incontinence and 35 controls without urinary symptoms.Interventions Concentric needle electromyography of the urethral striated sphincter.Main outcome measures The means of motor unit potential duration, number of changes in polarity and the amplitude of individual motor unit potentials were compared between the two groups.Results There was no statistically significant difference in motor unit potential duration (P= 0.87) or in the number of changes in polarity (P= 0.85). There was a trend towards a higher amplitude of motor unit potentials in the control group (P= 0.07).Conclusions Our findings suggest that denervation and re-innervation of the striated urethral sphincter following trauma to the pelvic floor, such as that occurring during childbirth, is not a major aetiological factor in the development of genuine stress incontinence.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1111/j.1471-0528.1993.tb14267.x
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  • 2
    Electronic Resource
    Electronic Resource
    A comparison of bioelectrical and mechanical activity of the female urethra (1993)
    Oxford, UK : Blackwell Publishing Ltd
    BJOG 100 (1993), S. 0 
    Details
    ISSN: 1471-0528
    Source: Blackwell Publishing Journal Backfiles 1879-2005
    Topics: Medicine
    Notes: Objective To determine the relationship between mechanical function and innervation of the urethra in order to clarify the effect of denervation and re-ennervation on urethral function.Design Prospective observational study.Setting Tertiary referral urodynamics unit.Subjects Thirty-six women, 21 with urinary symptoms and urodynamically proven genuine stress incontinence and 15 without urinary symptoms.Interventions All women underwent concentric needle electromyography of the urethral sphincter and urethral pressure profilometry at rest and during cough induced stress.Results Significant correlations were found between variables indicating denervation and reinnervation and improved resting urethral function. No correlation was found between these variables and urethral function under stress.Conclusions Our findings contradict current opinion that denervation of the urethral sphincter is associated with a reduction in the sphincteric function of the urethra, at rest or during stress, and suggest that denervation cannot therefore be a major aetiological factor in the development of genuine stress incontinence.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1111/j.1471-0528.1993.tb14268.x
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  • 3
    Electronic Resource
    Electronic Resource
    The treatment of detrusor instability in postmenopausal women with oxybutynin chloride: a double blind placebo controlled study (1990)
    Oxford, UK : Blackwell Publishing Ltd
    BJOG 97 (1990), S. 0 
    Details
    ISSN: 1471-0528
    Source: Blackwell Publishing Journal Backfiles 1879-2005
    Topics: Medicine
    Notes: Summary. Idiopathic detrusor instability is a common cause of incontinence in the elderly for which anticholinergic agents arc regularly prescribed. Oxybutynin chloride combines anticholinergic action with direct muscle relaxant properties. We performed a double blind placebo controlled fixed dose cross over study of oxybutynin chloride in postmenopausal women suffering from detrusor instability. We found oxybutynin chloride significantly more effective than placebo at reducing the symptoms of urgency and urge incontinence and more effective at reducing the height of the highest unstable detrusor contraction. This was at the expense of an increased residual urine and considerable side effects.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1111/j.1471-0528.1990.tb02523.x
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  • 4
    Electronic Resource
    Electronic Resource
    Outcome of spontaneous labour in multigravidae (1982)
    Oxford, UK : Blackwell Publishing Ltd
    BJOG 89 (1982), S. 0 
    Details
    ISSN: 1471-0528
    Source: Blackwell Publishing Journal Backfiles 1879-2005
    Topics: Medicine
    Notes: Summary. From a study of 2000 consecutive labours, the outcome of 847 multigravid patients admitted in spontaneous labour was examined. Labour was classified according to the cervimetric pattern, and response to oxytocin given according to a strict protocol with the use of a nomogram and partogram. The mean ‘observed first stage’ was 3·4 h, and the caesarean section rate 1·4%. Normal labour occurred in 88·5%, with a vaginal delivery rate of 99·5% in this group. Stimulation was indicated in 98 patients (11·6%), augmentation improving the rate of progress in 86 (87·8%) of these, with vaginal delivery occurring in all but one. Successful accelerated labour was not associated with any increase in neonatal morbidity as judged by Apgar scores, intubation or transfer to the special care baby unit. Twelve patients did not have improvement following augmentation and seven were delivered by caesarean section, including one following a potentially preventable uterine rupture. The greatest neonatal morbidity was in the group with primary dysfunctional labour that did not improve with augmentation. It may be that this was related to the mode of delivery rather than augmentation, as there was no significant difference in neonatal condition between normal and abnormal labour if vaginal delivery occurred.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1111/j.1471-0528.1982.tb05095.x
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  • 5
    Electronic Resource
    Electronic Resource
    Social and obstetric features associated with smoking in pregnancy (1982)
    Oxford, UK : Blackwell Publishing Ltd
    BJOG 89 (1982), S. 0 
    Details
    ISSN: 1471-0528
    Source: Blackwell Publishing Journal Backfiles 1879-2005
    Topics: Medicine
    Notes: Summary. The smoking habits of 2000 consecutive pregnant women have been analysed in relation to their race, social features and obstetric results. Only 60% of white patients were non-smokers compared with 80% of blacks and 90% of Asians, and whereas 20% of white patients smoked heavily only 3% of blacks or Asians did. Smokers booked later and were more frequently unsure of their dates, unemployed, unmarried and defaulters from the antenatal clinic. The incidence of antepartum haemorrhage was doubled amongst the heavy smoking multigravid patients in spite of a slightly decreased incidence of hypertensive disease. More non-smokers required induction of labour for raised blood pressure, and more smokers for fetal distress. The most significant differences between the smokers and non-smokers were the decrease in mean birth-weight associated with increased smoking (3.31 kg for non-smoking primi-gravidae compared with 3.14 kg for heavy smokers) and the threefold increased incidence of small-for-dates babies amongst the heavy smokers. There was no significant difference in the perinatal mortality.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1111/j.1471-0528.1982.tb04716.x
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  • 6
    Electronic Resource
    Electronic Resource
    Prolonged pregnancy: is induction of labour indicated? (1982)
    Oxford, UK : Blackwell Publishing Ltd
    BJOG 89 (1982), S. 0 
    Details
    ISSN: 1471-0528
    Source: Blackwell Publishing Journal Backfiles 1879-2005
    Topics: Medicine
    Notes: Summary. A prospective controlled study of 2000 patients to determine the incidence of postmaturity and the effect of a policy of non-induction of labour in prolonged pregnancy is reported.‘Certain postmaturity’ was identified in 4% of the patients and was associated with an increased incidence of babies with Apgar scores of 〈5 at 1 min; induction of labour at 42 weeks gestation did not affect the neonatal outcome compared with that in patients allowed to go into spontaneous labour. Induction of labour in patients designated as‘certain postmature’ and‘uncertain postmature’ reduced the number of vaginal deliveries and increased the caesarean section rate from 9.6 to 26.7 and from 2.2 to 31.2% respectively. The failure to improve the perinatal outcome does not support or justify induction of labour for uncomplicated postmaturity.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1111/j.1471-0528.1982.tb04698.x
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  • 7
    Electronic Resource
    Electronic Resource
    Author's reply (1990)
    Oxford, UK : Blackwell Publishing Ltd
    BJOG 97 (1990), S. 0 
    Details
    ISSN: 1471-0528
    Source: Blackwell Publishing Journal Backfiles 1879-2005
    Topics: Medicine
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1111/j.1471-0528.1990.tb02486.x
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  • 8
    Electronic Resource
    Electronic Resource
    Predictive value of cervimetric labour patterns in primigravidae (1982)
    Oxford, UK : Blackwell Publishing Ltd
    BJOG 89 (1982), S. 0 
    Details
    ISSN: 1471-0528
    Source: Blackwell Publishing Journal Backfiles 1879-2005
    Topics: Medicine
    Notes: Summary. From a study of 2000 consecutive labours the outcome of the 684 primigravid patients admitted in spontaneous labour has been examined according to their cervimetric progress during the first stage of labour. A partogram and labour stencil were used to identify dysfunctional labour which was treated with a standard protocol of augmentation by oxytocin. This policy achieved labours with a mean‘observed first stage’ of 6.3 h and a caesarean section rate of 8.7%. There was one stillbirth due to multiple congenital abnormalities and no increase in perinatal morbidity. Our data show that the type of first stage cervimetric pattern is helpful in predicting the outcome of labour. A normal cervimetric pattern resulted in a vaginal delivery rate of 98.4%; primary dysfunctional labour, which could be improved by oxytocin, had a 93.8% incidence of vaginal delivery, but if there was no improvement in the rate of cervical dilatation when this was administered the vaginal delivery rate was only 22.7%. A prolonged latent phase was associated with a caesarean section rate of 16.7% and the incidence of neonatal intubation was nearly as high as that found in uncorrected primary dysfunctional labour. The neonatal asphyxia in secondary arrest was minimal with an overall caesarean section rate of 28.4%; there was no increased incidence of neonatal morbidity with this cervimetric type.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1111/j.1471-0528.1982.tb04631.x
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  • 9
    Electronic Resource
    Electronic Resource
    Assessment of urinary symptoms in early pregnancy (1991)
    Oxford, UK : Blackwell Publishing Ltd
    BJOG 98 (1991), S. 0 
    Details
    ISSN: 1471-0528
    Source: Blackwell Publishing Journal Backfiles 1879-2005
    Topics: Medicine
    Notes: Objectives— To determine the correlation between lower urinary tract symptoms and urodynamic findings in early pregnancy.Setting— The termination clinic and gynaecology ward at King's College Hospital.Design— Observational study.Subjects— 47 women before termination of pregnancy at between 6 and 15 weeks.Interventions— Women filled in symptom questionnaires and then had urodynamic investigations, consisting of uroflowmetry and subtracted provoked cystometry.Main outcome measures— The occurrence of lower urinary tract symptoms and their association with urodynamic findings.Results— Lower urinary tract symptoms were fairly common but there was poor correlation with the urodynamic findings.Conclusions— The findings suggest that lower urinary tract symptomatology alone is insufficient to study lower urinary tract dysfunction in pregnancy.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1111/j.1471-0528.1991.tb15403.x
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  • 10
    Electronic Resource
    Electronic Resource
    Retention of the second twin: a viable option? Case reports (1991)
    Oxford, UK : Blackwell Publishing Ltd
    BJOG 98 (1991), S. 0 
    Details
    ISSN: 1471-0528
    Source: Blackwell Publishing Journal Backfiles 1879-2005
    Topics: Medicine
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1111/j.1471-0528.1991.tb15407.x
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