Simultaneous measurements of the intravesical pressure, electromyographic activity of the anal sphincter and the urinary flow rate in 17 children with dysfunctional voiding problems have shown a variety of unusual patterns, each distinct for the particular child but all with the common denominator of failure to coordinate detrusor and sphincter activity. We postulate that these patterns represent persistence of the transitional phase in the development of micturitional control whereby the child learns to prevent involuntary wetting by forceful contraction of the external urethral sphincter.
There were 142 consecutive patients with post-traumatic hematuria evaluated prospectively during a 7-month period. Of these 142 cases 22 involved penetrating injuries and 120 were secondary to blunt trauma. There were 19 patients with 24 demonstrable genitourinary injuries at urologic injury. Only 8 of the 142 patients required an operation for the urologic injuries. The degree of hematuria did not correlate with the severity of injury. Liberal use of arteriography and renal scanning is proposed to delineate precisely the urologic injury.
The urethral pressure profile is an artifactual assessment of urethral response to physiologic distension. It is a reproducible clinical tool used to evaluate numerous disease states. Examples of its usefulness are presented to illustrate the wide variety of clinical uses. The urethral pressure profile assists the clinician in the selection of the proper form of management in difficult cases of urinary incontinence or obstruction.
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