Detrusor underactivity: A plea for new approaches to a common bladder dysfunction

Koeveringe, Gommert van; Vahabi, Bahareh; Andersson, Karl‐Erik; Kirschner-Herrmans, R.; Oelke, Matthias

doi:10.1002/nau.21097

Cited by 135 publications

(106 citation statements)

References 55 publications

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“…This case means that the nerves signal (S 1 ) that controls the contraction of the bladder muscle had been sent weak [8] within time (T) as shown in Fig.6 . The mathematical functions which describing the nerve signal disorder is given as constant function (10), whose (output) value is the same within time (t) .…”

Section: Absence Bladder Contraction Caused By Nervous Signals Disordermentioning

confidence: 99%

Development of mathematical model for lower urinary tract dysfunctions

Deaf¹,

El-Garhy²,

Gomma³

et al. 2014

International Journal of Innovative Research in Electrical, Ele

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Abstract:The main objective of this paper is to simulate different types of diseases that cause deformities which occur in the lower urinary tract system together with abnormal micturition , which results from these diseases. To achieve this a modified version of the normal micturition process model proposed by William Fletcher [1] was developed and simulated using MATLAB. The new model is assuming abnormal nerve signals and bladder, ureteral muscles disorders The newly developed model allows to simulate six types of lower urinary tract system (LUTS) disorders caused by dysfunctions in bladder, urethral muscles and nerves control system and gives mathematical representation for abnormal micturition process. Moreover, the simulation developed has got a wide number of advantages in the medical sector such as design intelligent control scheme to correct any deformations that occur in lower urinary tract system, and can be allowed to test the system safely before trial with humans.

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Section: Absence Bladder Contraction Caused By Nervous Signals Disordermentioning

confidence: 99%

Development of mathematical model for lower urinary tract dysfunctions

Deaf¹,

El-Garhy²,

Gomma³

et al. 2014

International Journal of Innovative Research in Electrical, Ele

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“…Risk factors for DU include drugs, prolonged untreated BOO, constipation, immobility, recurrent UTI and anaesthesia [22].…”

Section: R-restricted Mobilitymentioning

confidence: 99%

“…Drugs with parasympathetic activities are not widely used because of poor efficacy and poor side effect profile. New treatment modalities like neuromodulation, neurostimulation or reconstruction with muscle transposition have been explored but data is limited for the elderly [22].…”

Section: Catheterisation For Detrusor Under-activitymentioning

confidence: 99%

Managing the Elderly with Urinary Incontinence and Dementia

Lim¹

2017

Int Arch Urol Complic

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The elderly patients with dementia are often challenging to manage, especially if they have urinary incontinence. There are many causes for urinary incontinence and among the elderly with dementia, the problem is often not related to abnormalities of the lower urinary tract. Treatment options are limited by the multiple comorbidities, cognitive issues, medication side effects and limited efficacy among this group of frail elderlies. KeywordsElderly, Urinary incontinence, Dementia, Functional incontinence cognitive impairment and more frequent reports of behavioural symptoms of dementia [5]. Despite this, the causes of UI among the elderly with dementia are not well studied because of multiple confounding factors like cognitive and physical disabilities.This article reviews the common causes of UI among the elderly, especially the elderly with dementia and management strategies for UI among the elderly with dementia. Basic Neurophysiology of MicturitionThe bladder is innervated by the autonomic nerves as well as the somatic nerves. The sympathetic innervation originates at T11-L2, supplying the bladder via the Hypogastric nerve. The parasympathetic nerves originate at S2-S4 and innervate the bladder via the Pelvic and Pudendal nerves.The sensation of bladder fullness as it fills ascends via the spinal cord to be conveyed to the Pontine Micturition Centre, which promotes micturition via the parasympathetic supply to the urinary bladder. However, micturition may not be appropriate at all times. The central nervous system determines the "correct timing" of micturition, taking into account the social and behavioural part of micturition. Micturition is coordinated and triggered through simultaneous activities of the bladder contraction with relaxation of the urethral sphincters via the somatic and autonomic nerves.As the bladder fills, the sympathetic innervation promotes bladder wall relaxation and distension with efferent input to the urethral sphincters to cause sphincter contraction. The Frontal Micturition Centre, basal ganglia and the Pontine Micturition Centre actively inhibit RESEARCH ARTICLE

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“…Az öregedés a detrusor izom aktivitásának hanyatlásával hozható összefüggésbe, bár más is befolyásolja az izom gyengülését, mint a myogen és neurogen faktorok [13]. Egy 2010-ben végzett tanulmányban Smith rávilágított arra, hogy a funkcioná-lis és szerkezeti változások befolyással vannak a hólyag afferens funkciójára, így annak kiürülésére is [6].…”

Section: Megbeszélésunclassified

A hólyagkontraktilitási index meghatározásának fontossága a csökkent hólyagműködés kezelésében

et al. 2017

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Célkitűzés: A hólyagkontraktilitási index (BCI) fontosságának felmérése a csökkent hólyagműködés kezelésében. Betegek és módszer: Retrospektív tanulmányunkban 2013. január és 2016. szeptember közötti, detrusor-alulműködés-sel (BCI<100) kórismézett beteg adatait dolgoztuk fel (BCI = PdetQmax+5Qmax). Eredmények: A tanulmányozott betegek (férfi 38, nő 53) esetében a BCI átlagértéke 55 volt (17-110), urodinámiás vonatkozásban: átlag-Qmax 7 ml/s, átlag-Pdet 14 H 2 O-cm. A BCI csökkenő tendenciát mutat az életkor előreha-ladtával, valamint összefüggés mutatható ki a BCI, a diabetes (p = 0,003), illetve a neurológiai betegségek (p = 0,015) között. Következtetések: A csökkent hólyagműködés kórismézése igazi kihívás az urológus számára, az urodinámiás vizsgála-tok (a residuum értéke, Qmax, PdetQmax) és a BCI értéke nagyban elősegítik a megfelelő kezelési terv felállítását. Orv Hetil. 2017; 158(31): 1222-1227. Kulcsszavak: urodinámiás, detrusor-alulműködés, hólyagkontraktilitási index The importance of Bladder Contractility Index in the management of underactive bladderAim: To evaluate the importance of BCI in the management of underactive bladder (UB). Material and method: A retrospective study over a period of 3 years and 9 months (January 2013-September 2016 in Mureş County Hospital, Clinic of Urology, including 91 patients. Detrusor underactivity was defined by BCI less than 100 using the formula: PdetQmax+5Qmax. Results: The median of Qmax value was 7 ml/s and the median value of Pdet was 14 cm H 2 O. The median value of BCI was 55 with extremities between 17 and 110. BCI tends to decrease with age and there is a relation between value of BCI and diabetes (p = 0,003) and neurological diseases (p = 0,015). Conclusions:The UB diagnosis represents a real challenge for the urologist, so that, urodynamical findings such as absence of bladder obstruction, post-void residual urine, Qmax, together with BCI value, helps in setting the proper management.

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Detrusor underactivity: A plea for new approaches to a common bladder dysfunction

Cited by 135 publications

References 55 publications

Development of mathematical model for lower urinary tract dysfunctions

Development of mathematical model for lower urinary tract dysfunctions

Managing the Elderly with Urinary Incontinence and Dementia

A hólyagkontraktilitási index meghatározásának fontossága a csökkent hólyagműködés kezelésében

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