Urethral pressure reflectometry during intra-abdominal pressure increase-an improved technique to characterize the urethral closure function in continent and stress urinary incontinent women

2013 ◽  
Vol 32 (8) ◽  
pp. 1103-1108 ◽  
Author(s):  
Marie-Louise Saaby ◽  
Niels Klarskov ◽  
Gunnar Lose
Keyword(s):  
Pressure Increase ◽  
Abdominal Pressure ◽  
Urethral Pressure ◽  
Urethral Pressure Reflectometry ◽  
Urethral Closure ◽  
Closure Function ◽  
Improved Technique

Urethral closure mechanisms during sneezing-induced stress in anesthetized female cats

2007 ◽  
Vol 293 (3) ◽  
pp. R1357-R1367 ◽  
Author(s):  
V. Julia-Guilloteau ◽  
P. Denys ◽  
J. Bernabé ◽  
K. Mevel ◽  
E. Chartier-Kastler ◽  
...  
Keyword(s):  
Open Abdomen ◽  
Levator Ani ◽  
Urinary Continence ◽  
Abdominal Pressure ◽  
External Urethral Sphincter ◽  
Relevant Model ◽  
Induced Stress ◽  
Pharmacological Studies ◽  
Urethral Closure ◽  
Lower Urinary

During stress-induced increase in abdominal pressure, urinary continence is maintained by urethral closure mechanisms. Active urethral response has been studied in dogs and rats. Such an active urethral response is also believed to occur in humans during stress events. We aimed to investigate urethral closure mechanisms during sneezing in cats. Urethral pressures along the urethra (UP1–UP4), with microtip transducer catheters with UP4 positioned in the distal urethra where the external urethral sphincter (EUS) is located, and intravesical pressure were measured, and abdominal wall, anal sphincter (AS), levator ani (LA), and EUS electromyograms (EMGs) were recorded during sneezing under closed-abdomen and open-abdomen conditions in eight anesthetized adult female cats. Proximal and middle urethral response induced by sneezing was not different from bladder response. Distal urethral response was greater compared with proximal and middle urethral and bladder response. In the open-abdomen bladder, proximal and middle urethral responses were similarly decreased and distal urethral response was unchanged compared with the closed-abdomen bladder. Bladder and urethral responses were positively correlated to sneeze strength. EUS, LA, and AS EMGs increased during sneezing. No urine leakage was observed, regardless of the strength of sneeze. In cats urethral closure mechanisms are partly passive in the proximal and middle urethra and involve an active component in the distal urethra that is believed to result from EUS and possibly LA contractions. Because central serotonin exerts similar effects on the lower urinary tract in cats and humans, the cat may represent a relevant model for pharmacological studies on continence mechanisms.

Comparative study of urodynamic tests after AMS 800 and ZSI 375 insertion

2017 ◽  
Vol 85 (1) ◽  
pp. 15-18 ◽  
Author(s):  
Thomas Ripert ◽  
Jean Pierrevelcin
Keyword(s):  
Comparative Study ◽  
Cuff Pressure ◽  
Urethral Pressure ◽  
Urinary Flow ◽  
Single Centre ◽  
Urethral Closure ◽  
Single Centre Study ◽  
Male Patients ◽  
The Difference ◽  
Very High

Study design: Retrospective, non-randomised, single-centre study. Objectives: Comparative study of urodynamic tests in patients presenting social continence after AMS 800 or ZSI 375 insertion. Materials and methods: Study was open to patients with social continence, implanted with AMS 800 or ZSI 375. Vesical pressure (VP), urethral functional length (FL), maximal urethral pressure (MUP), maximal urethral closure pressure (MUCP), maximal urinary flow rate (Qmax) were registered with standard urodynamic equipment. Results: From March 2012 to September 2014, 27 male patients with AMS 800 and 28 with ZSI 375 were recruited. In the AMS 800 group mean VP was 25.03 cmH2O (range 13-47), mean FL 31.96 mm (range 20-52), mean MUCP 88.29 cmH2O (range 32-160), mean MUP 119.55 cmH2O (range 77-180), mean Qmax 22.86 mL/s (range 5.6-54.6). In the ZSI 375 group, mean VP was 24.89 cmH2O (range 6-40), mean FL 30.53 mm (range 12-87), mean MUCP 70.11 cmH2O (range 38-108), mean MUP 99.89 cm H2O (range 63-134), and mean Qmax 19.25 mL/s range (7.3-39.6). Discussion: Results of urodynamic tests are similar for both artificial urinary sphincters. AMS 800 cuff pressure over 70 cmH2O could be explained by the pelvis pressure and the difference of altitude between the pressure-regulating balloon (PRB) and the cuff. ZSI 375 pressure-regulating tank (PRT) is not influenced by these factors. Very high MUP could be explained with too tightened cuffs. Conclusions: AMS 800 and ZSI 375 urodynamic tests are similar. Pressure of the pelvis and difference of altitude between the AMS balloon and the cuff can lead to high MUP.

The effect of single oral doses of duloxetine, reboxetine, and midodrine on the urethral pressure in healthy female subjects, using urethral pressure reflectometry

2017 ◽  
Vol 37 (1) ◽  
pp. 244-249 ◽  
Author(s):  
Niels Klarskov ◽  
Dirk Cerneus ◽  
William Sawyer ◽  
Donald Newgreen ◽  
Olivier van Till ◽  
...  
Keyword(s):  
Urethral Pressure ◽  
Urethral Pressure Reflectometry ◽  
Healthy Female ◽  
Oral Doses ◽  
Female Subjects

Role of vasopressin V1A receptor in the urethral closure reflex in rats

2011 ◽  
Vol 300 (4) ◽  
pp. F976-F982 ◽  
Author(s):  
Hiroyuki Ueno ◽  
Masako Kuno ◽  
Yasushi Shintani ◽  
Izumi Kamo
Keyword(s):  
Spinal Cord ◽  
Pressure Rise ◽  
Physiological Role ◽  
Female Rats ◽  
Reflex Response ◽  
Abdominal Pressure ◽  
Intravesical Pressure ◽  
Urethral Closure ◽  
Urethral Resistance ◽  
Vasopressin V1a Receptor

An enhanced urethral closure reflex via the spinal cord is related to urethral resistance elevation during increased abdominal pressure. However, with the exception of monoamines, neurotransmitters modulating this reflex are not understood. We investigated whether the vasopressin V1A receptor (V1AR) is involved in the urethral closure reflex in urethane-anesthetized female rats. V1AR mRNA was highly expressed among the vasopressin receptor family in the total RNA purified from lamina IX in the spinal cord L6–S1 segment. In situ hybridization analysis of the spinal L6–S1 segment confirmed that these positive signals from the V1ARs were only detected in lamina IX. Intrathecally injected Arg8-vasopressin (AVP), an endogenous ligand, significantly increased urethral resistance during an intravesical pressure rise, and its effect was blocked by the V1AR antagonist. AVP did not increase urethral resistance in rats in which the pelvic nerves were transected bilaterally. Urethral closure reflex responses to the intravesical pressure rise increased by up to threefold compared with the baseline response after AVP administration in contrast to no increase by vehicle. In addition, intravenously and intrathecally injected V1AR antagonists decreased urethral resistance. These results suggest that V1AR stimulation in the spinal cord enhances the urethral closure reflex response, thereby increasing urethral resistance during an abdominal pressure rise and that V1AR plays a physiological role in preventing urine leakage.

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