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  • 1
    Electronic Resource
    Electronic Resource
    Oxford, UK : Blackwell Publishing Ltd
    BJOG 106 (1999), S. 0 
    ISSN: 1471-0528
    Source: Blackwell Publishing Journal Backfiles 1879-2005
    Topics: Medicine
    Type of Medium: Electronic Resource
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  • 2
    Electronic Resource
    Electronic Resource
    Oxford, UK : Blackwell Publishing Ltd
    BJOG 107 (2000), S. 0 
    ISSN: 1471-0528
    Source: Blackwell Publishing Journal Backfiles 1879-2005
    Topics: Medicine
    Notes: Objective The aims of this study were to establish prospectively the prevalence of objective bladder dysfunction before and after delivery by means of urodynamic investigations and to assess the effect of obstetric variables on bladder function.Design Prospective longitudinal study. Twin channel subtracted cystometry was performed in the standing and sitting position, with a cough stress test at the end of filling. The investigations were repeated three months postpartum.Participants Two hundred and eighty-six nulliparae with singleton pregnancies who were delivered between April 1996 and November 1997 attended for antenatal assessment after 34 weeks of gestation and 161 who returned postpartum.Setting Department of Obstetrics and Gynaecology in a London teaching hospital.Results The mean urodynamic values both in pregnancy and postpartum lower than values defined in a non-pregnant population. The prevalence of genuine stress incontinence and detrusor instability were antenatally 9% and 8%, respectively, and postpartum 5% and 7%, respectively. Obstetric and neonatal factors were not related to urodynamic variables.Conclusions Despite the reported high prevalence of urinary incontinence related to pregnancy and childbirth, neither pregnancy nor delivery resulted in any consistent effects on objective bladder function. Postpartum urodynamic measurements were not related to either obstetric or neonatal variables, but were dependent on antenatal values.
    Type of Medium: Electronic Resource
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  • 3
    Electronic Resource
    Electronic Resource
    Oxford, UK : Blackwell Publishing Ltd
    BJOG 105 (1998), S. 0 
    ISSN: 1471-0528
    Source: Blackwell Publishing Journal Backfiles 1879-2005
    Topics: Medicine
    Type of Medium: Electronic Resource
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  • 4
    Electronic Resource
    Electronic Resource
    Oxford, UK : Blackwell Publishing Ltd
    BJOG 96 (1989), S. 0 
    ISSN: 1471-0528
    Source: Blackwell Publishing Journal Backfiles 1879-2005
    Topics: Medicine
    Notes: Summary. Thirty-nine consecutive women, referred because of lower urinary tract symptoms of stress incontinence, urgency and urge incontinence, were interviewed and their symptoms were graded using a standardized questionnaire. They were investigated with conventional, fast-fill cystometry and with a new bladder neck electrical conductivity (BNEC) test which measures bladder neck activity. A highly significant correlation between the symptoms of urgency and urge incontinence and the maximum amplitude of bladder neck activity was found with the new test. The correlation of the maximum deflection at rest with the symptom of urgency was significantly better than the best correlation found with the cystometric measurements. The values for sensitivity and specificity of cystometry for the detection of an abnormality associated with urgency were 58% and 92% respectively, and the corresponding values for a positive BNEC test (as defined by a maximum deflection at rest 〉13 μA) were 100% and 77%.
    Type of Medium: Electronic Resource
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  • 5
    Electronic Resource
    Electronic Resource
    Oxford, UK : Blackwell Publishing Ltd
    BJOG 95 (1988), S. 0 
    ISSN: 1471-0528
    Source: Blackwell Publishing Journal Backfiles 1879-2005
    Topics: Medicine
    Notes: Summary. A set of weighted vaginal cones designed to exercise the pelvic floor muscles was used by a group of 39 premenopausal patients with genuine stress incontinence who were awaiting corrective surgery. The effectiveness of the exercises in reducing urinary loss was assessed with a standard urine pad test before and after 1 month of training. Of the 30 women who completed 1 month of the exercises 70% felt they were improved or cured and 90% found it an acceptable method of treatment. Of the 30 women only 11 (37%) opted for surgery after training. There was a highly significant correlation (P〈0·001, rs= -0·21) between decreased urine loss and increase in retained cone weight.
    Type of Medium: Electronic Resource
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  • 6
    Electronic Resource
    Electronic Resource
    Oxford, UK : Blackwell Publishing Ltd
    BJOG 90 (1983), S. 0 
    ISSN: 1471-0528
    Source: Blackwell Publishing Journal Backfiles 1879-2005
    Topics: Medicine
    Notes: Summary. Ten women presenting with symptoms of post-menopausal urogenital oestrogen deficiency, including atrophic vaginal changes and a variety of urinary symptoms, were studied urodynamically and shown to have genuine stress incontinence. Their urethral function was assessed by resting and stress pressure profiles before and after treatment with an intravaginal oestrogen cream. A reduction in the severity of symptoms of stress incontinence, urgency and voiding difficulties was found. No significant changes were induced in the resting urethral pressure profile although the maximum urethral closure pressure on stress was significantly increased as a consequence of improved pressure transmission in mid-urethra. The distribution of pressure transmission suggests that the effect of oestrogen therapy may be due to improved efficiency of urethral closure by the pelvic floor in response to stress.
    Type of Medium: Electronic Resource
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  • 7
    Electronic Resource
    Electronic Resource
    Oxford, UK : Blackwell Publishing Ltd
    BJOG 83 (1976), S. 0 
    ISSN: 1471-0528
    Source: Blackwell Publishing Journal Backfiles 1879-2005
    Topics: Medicine
    Notes: Forty-two patients with urinary incontinence and related symptoms were treated by colposuspension. Two patients were lost to follow-up and the results of surgery in the remaining 40 patients are presented and discussed. The place of vaginal surgery in women with urinary symptoms is also discussed.
    Type of Medium: Electronic Resource
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  • 8
    Electronic Resource
    Electronic Resource
    Oxford, UK : Blackwell Publishing Ltd
    BJOG 96 (1989), S. 0 
    ISSN: 1471-0528
    Source: Blackwell Publishing Journal Backfiles 1879-2005
    Topics: Medicine
    Notes: Summary. Forty-four elderly women underwent the Stamey procedure for urethral sphincter incompetence; six had coincidental detrusor instability. All had pre- and postoperative urodynamic assessment. At follow-up, 15 patients continued to complain of stress incontinence and 11 of urge incontinence. Overall, 27 patients still had objective evidence of genuine stress incontinence, and 15 had evidence of detrusor instability. Although the operation has minimal operative and postoperative morbidity, we do not consider its success rate satisfactory for use in the elderly.
    Type of Medium: Electronic Resource
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  • 9
    Electronic Resource
    Electronic Resource
    Oxford, UK : Blackwell Publishing Ltd
    BJOG 96 (1989), S. 0 
    ISSN: 1471-0528
    Source: Blackwell Publishing Journal Backfiles 1879-2005
    Topics: Medicine
    Notes: Summary. A new method for controlling the symptoms and objective signs of detrusor instability was investigated in a pilot study. The method uses the activity of the bladder neck, monitored by a conductivity catheter, as a biofeedback signal. Voluntary closure of the bladder neck mechanism abolishes abnormal detrusor activity. Ten severely symptomatic women with detrusor instability were assessed clinically and urodynamically before and after a course of biofeedback. Statistically significant improvements in the symptoms of urgency and urge incontinence were found. Five of the seven women who agreed to have repeat cystometry had stable cystometrograms. There was a statistically significant fall in the mean maximum deflection at rest from 41·5 to 16·5 μA (P〈0·05) measured during bladder neck electrical conductivity tests before and after treatment.
    Type of Medium: Electronic Resource
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  • 10
    Electronic Resource
    Electronic Resource
    Oxford, UK : Blackwell Publishing Ltd
    BJOG 90 (1983), S. 0 
    ISSN: 1471-0528
    Source: Blackwell Publishing Journal Backfiles 1879-2005
    Topics: Medicine
    Notes: Summary. Urethral pressure measurements were recorded at rest and during stress by a microtransducer technique in 20 women without urinary symptoms and 120 women with urodynamically proven genuine stress in-continence. In the symptom-free women the resting profile values were largely maintained during stress, as a consequence of 100% transmission of intra-abdominal pressure rises to the proximal three-quarters of the functional urethral length. Whilst the majority maintained continence at the bladder neck level, 25% of these controls showed evidence of bladder neck opening during stress. The stress-incontinent patients showed a deficiency of pressure transmission ratios which appeared to have an ‘all or none’ character in the determination of symptoms. The amplitude and stability of the maximum urethral closure pressure at rest, the extent of urethral closure pressure lost in response to stress, and the extent of intra-abdominal pressure rises interact to determine the severity of symptoms or ‘margin to continence’.
    Type of Medium: Electronic Resource
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