Removal of UroLume endoprosthesis: experience of the North American Study Group for detrusor-sphincter dyssynergia application.

Purpose: We present the experience of the North American UroLume Multicenter Study Group with removal of the UroLume endoprosthesis.

Materials And Methods: A total of 160 neurologically impaired patients were enrolled in the North American UroLume Multicenter Study Group for detrusor external sphincter dyssynergia application. Analysis was performed in 2 groups of patients in which the device was removed during insertion and after implantation, respectively.

Long-term followup of the North American multicenter UroLume trial for the treatment of external detrusor-sphincter dyssynergia.

Purpose: We determine the long-term efficacy and safety of the UroLume stent as minimally invasive treatment for external detrusor-sphincter dyssynergia in spinal cord injured men.

Materials And Methods: A total of 160 spinal cord injured men with a mean age plus or minus standard deviation of 36.3 +/- 12.

Bladder cancer risk in patients with spinal cord injury.

Bladder cancer (BC) is the fourth most common cancer in men. It is associated with several risk factors (RF), of which only a few have been evaluated in previous studies. Models incorporating only one or a severely restricted number of RFs did not predict BC well.

Polyethylene glycol versus vegetable oil based bisacodyl suppositories to initiate side-lying bowel care: a clinical trial in persons with spinal cord injury.

Introduction: Neurogenic bowel dysfunction resulting from spinal cord injury (SCI) frequently requires bowel care (BC) with stimulant suppositories for initiation of effective defecation. The excessive time required for BC and bowel complications have limited quality of life after SCI.

Objective: To test the hypothesis that: the time required for bowel care with bisacodyl suppositories can be reduced by substituting a polyethylene glycol base (PGB) for the traditional hydrogenated vegetable oil base (HVB) in the suppository.

From time dependent intermittent selfcatheterisation to volume dependent selfcatheterisation in multiple sclerosis using the PCI 5000 Bladdermanager.

The use of portable, patient controlled, ultrasound device for the measurement of the bladder volume (PCI 5000, Bladdermanager) in the management of neurogenic bladder dysfunction in Multiple Sclerosis is presented. Twenty-three patients were transferred from time dependent intermittent catheterisation to volume dependent intermittent catheterisation using this device. Evaluation of the accuracy of the measurements showed an accuracy of 91.

Paradigm for SCI nurse competency on adult-geriatric SCI rehabilitation unit.

This article is based upon an SCI Model Project, funded by the American Association of Spinal Cord Injury Nurses (AASCIN). The purpose of this project was to develop a model to validate theoretical and practical knowledge of Registered Nurses and Licensed Practical Nurses/Licensed Vocational Nurses in an SCI rehabilitation setting. The investigators were direct care providers in a 68 bed SCI rehabilitation service at the James A.

Intermittent catheterization the right way! (Volume vs. time-directed).

Intermittent catheterization (ICP) is a well-proven effective means of urologic management for spinal cord diseased (SCD) persons who meet the following criteria: adequate low pressure bladder capacity (350-400 cc minimum), adequate hand function, unobstructed urethra and compliant, understanding, continent, cooperative patients. Time-directed (Q4 H-Q6 H), ICP-obtained volumes on twenty-one patients revealed a majority of early, unnecessary as well as some late over-distended bladder catheterizations. The PCI 5000 or "Bladder Manager", a miniaturized ultrasonic bladder volume measuring device developed by Diagnostic Ultrasound of Seattle, was evaluated.

Magnetic resonance imaging examinations of gluteal decubitus ulcers in spinal cord injury patients.

The purpose of our study was to use magnetic resonance imaging (MRI) to determine deep changes in soft tissues and bones underlying decubitus ulcers which occur in spinal cord injury (SCI) patients. By diagnosing these deep changes adjacent to decubitus ulcers, MRI can facilitate proper clinical management and prevent contraindicated surgery. MRI evaluation was performed on 37 male SCI patients for a total of 44 diagnostic studies.

Selective permeability of [3H]-D-mannitol and [14C]-carboxyl-inulin across the blood-brain barrier and blood-spinal cord barrier in the rabbit.

Selective permeability across the blood-brain and blood-spinal cord barriers was studied in a rabbit experimental model. To maintain steady state levels of the tracers in the circulation, 50muCi each of [3H]-D-mannitol and [14C]-carboxyl-inulin were administered as a bolus and by slow intravenous infusion for 60, 90 and 120 minutes; 90 min proved to be the optimal equilibration time for uptake of radioactive tracers into central nervous system (CNS) regions. Kinetic transfer of [3H]-D-mannitol and [14C]-carboxyl-inulin from blood into CNS was computed as apparent transfer constant (KD).

Multicenter trial in North America of UroLume urinary sphincter prosthesis.

We investigated the effectiveness and associated complications of treatment with an endoluminal urethral sphincter prosthesis in 153 spinal cord injury men (mean age 36 years, range 16 to 74 years) with urodynamically diagnosed detrusor-external sphincter dyssynergia. These patients were prospectively treated with a urethral sphincter stent at 15 centers in North America. Followup ranged from 2 to 33 months.

Low prevalence of prostatic cancer among myelopathy patients.

To test the hypothesis that carcinoma of the prostate (CAPR) is uncommon among patients previously paralyzed due to myelopathy, the prevalence of CAPR in patients with high grade (severe) paralysis was compared to that in patients with low grade paralysis. Sixty-six records of patients with CAPR following myelopathy were recalled from the Department of Veterans Affairs medical database for a seven-year period, 1986-1992. Thirty-four patients were unable to stand (high grade paralysis) and 32 patients could stand (low grade paralysis).

Randomized comparison of balloon dilation and transurethral incision for treatment of symptomatic benign prostatic hyperplasia.

The concept of relieving the symptoms of benign prostatic hyperplasia (BPH) by dilating the urethral has existed for centuries. Thirty patients with a clinically estimated prostate gland size of 25 g or less were randomized to either balloon dilation (BDP) or transurethral incision of the prostate (TUIP). The mean pretreatment Madsen-Iverson symptom scores in the two groups were 15.

Toward the design of a new bowel care chair for the spinal cord injured: a pilot study.

Bowel care is a critical aspect of daily living for person with disabilities; ineffective bowel care can lead to severe and costly complications. Staff, patients, and caregivers have often found existing bowel care chairs to be inadequate. These chairs are frequently unsafe, inconvenient, and ineffective for showering and bowel elimination.

Descriptive study of bowel care practices and equipment in spinal cord injury.

46% of the 277 SCI veterans responding to the survey used bowel care/shower chairs at home. Of those who regularly used these chairs (N = 147), over 66% felt their safety was compromised by their use. Caregivers reported similar dissatisfaction with existing bowel care/shower chairs.

Balloon dilation of the prostate. Critical evaluation.

We describe the results of prostatic balloon dilation in 7 patients with a follow-up of 9 months. Symptom scores dramatically fell in 5 patients (success rate 71%), which is confirmed by a significant improvement in peak flow in 4 of them. Two patients failed to improve and needed a subsequent intervention which revealed a stage A2 prostatic carcinoma in one.

Balloon dilatation of the external urethral sphincter: a case study.

A new and simple endoscopic treatment procedure of external urethral sphincters is described. The external urethral sphincter was dilated with a balloon catheter 25mm in diameter in a multiple sclerosis patient; the sphincter spasticity made intermittent catheterization impossible. Post dilatation, the resistance to catheterization completely disappeared and the urethral pressure profile showed a dramatic fall in sphincteric pressure.

Transurethral sphincteric stimulation.

Electrical stimulation of the external urethral sphincter is a valuable aid in teaching sphincterotomies and transurethral procedures. It helps accurately locate the external urethral sphincter which should be transected totally during a sphincterotomy and left intact in a transurethral procedure.

[Effect of synthetic progestogens on endometrial cancer. Cytochemical criteria].

1) Well-differentiated carcinomas of the endometrium contain acid mucins with carboxyl or, more rarely, sulphated radicals. The latter are found in certain hypersecretory papillary tumours. 2) The neoplastic cells are surrounded by a border rich in acid muco-substances, including sialic acid.