A new technique of measuring bladder wall thickness using transvaginal ultrasound is described. Measurement of the bladder wall using ultrasound was found to have a good intra- and interobserver reproducibility. Measurements of the bladder wall thickness were altered if more than 50 ml of fluid was within the bladder. Forty-five women with urinary symptoms were recruited from the urodynamic clinic; those with urodynamically diagnosed detrusor instability were found to have significantly thicker bladder walls than women with urodynamically diagnosed genuine stress incontinence. Application of this technique may be useful in the diagnosis of detrusor instability.
Objective To assess the efficacy of oral oestriol in the prevention of recurrent Urinary tract infections in Design Double-blind, randomised, parallel group, placebo controlled trial Setting Urogynaecology Unit at King's College Hospital with some women recruited from the geriatric Participants Seventy-two postmenopausal women older than 60 years of age (mean 73.2 years) suffering Intervention Oral oestriol(3 mg per day) or placebo for six months. Main outcome measures Urinary tract infection rates.Results The study was difficult to conduct because of its design and the age of the participants. Oral oestriol(3 mg per day) was not shown to be superior to placebo in the prevention of recurrent urinary tract infections, but both oestriol and placebo improved urinary symptoms during the trial. ConclusionThe power of the study might have been too low to detect a significant difference between the groups, or oral oestriol(3 mg per day) may have been either the wrong dose or the wrong route of administration for this indication.elderly women.units of St. Pancras Hospital and Dulwich Hospital, London (UK).from recurrent urinary tract infections.
Objective To determine the efficacy of GAX collagen in the treatment of elderly women with genuine Design A single centre prospective study.Setting A London teaching hospital.Participants Thirty-four women older than 60 years of age with genuine stress incontinence diagnosed Interventions Up to three paraurethral injections of GAX collagen. Main outcome measuresstress incontinence. on videocystourethrography.Subjective and pad test assessments performed pre-operatively, after one month, one year and two years after the first injection of collagen. Videocystourethrography and urethral pressure profilometry were carried out pre-operatively, after three months and one year.Results There was a reduction in urinary leakage as measured on pad testing. After two years 77% of the surviving 26 women were symptomatically cured. Objectively after two years 48% of the women were cured and 9% were improved over their initial pre-treatment level of incontinence. The cure rate was the same whether or not the women had undergone previous vaginal surgery. The maximum urethral closure pressure was not increased with treatment indicating that collagen injections do not act by producing obstruction, but this should be interpreted with caution due to the small sample size.Conclusion GAX collagen is an effective method of treating urinary incontinence in the elderly and especially women who have undergone previous continence procedures. The technique is easy to perform and particularly suitable in those who are frail, but if failure occurs after two years consideration needs to be given to its cost effectiveness.
Objective To assess the efficacy of oral oestriol in the prevention of recurrent Urinary tract infections in Design Double-blind, randomised, parallel group, placebo controlled trial Setting Urogynaecology Unit at King's College Hospital with some women recruited from the geriatric Participants Seventy-two postmenopausal women older than 60 years of age (mean 73.2 years) suffering Intervention Oral oestriol(3 mg per day) or placebo for six months. Main outcome measures Urinary tract infection rates. ResultsThe study was difficult to conduct because of its design and the age of the participants. Oral oestriol(3 mg per day) was not shown to be superior to placebo in the prevention of recurrent urinary tract infections, but both oestriol and placebo improved urinary symptoms during the trial. ConclusionThe power of the study might have been too low to detect a significant difference between the groups, or oral oestriol(3 mg per day) may have been either the wrong dose or the wrong route of administration for this indication. elderly women. units of St. Pancras Hospital and Dulwich Hospital, London (UK).from recurrent urinary tract infections.
Glibenclamide therapy is associated with greater responses of blood pressure and forearm vascular responses to infusion of angiotensin and higher nocturnal blood pressures. This effect appears to be influenced by concomitant angiotensin converting enzyme inhibition.
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