The effectiveness of terazosin, an α1‐blocker, on bladder neck obstruction as assessed by urodynamic hydraulic energy

Yamanishi, Tomonori; Yasuda, Kosaku; Sakakibara, Ryuji; Hattori, Takamichi; Tojo, Masaki

doi:10.1046/j.1464-410x.2000.00418.x

Cited by 27 publications

(20 citation statements)

References 28 publications

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“…The bladder neck, also known as the internal (smooth) sphincter, is a component in the maintenance of continence and has an abundance of α1-adrenergic receptors 43. Because open bladder neck is common in patients with myelodysplasia26 or lower thoracic cord lesion at T12-L244 (where sympathetic intermediolateral nuclei are located) and is reproduced by systemic or intraurethral application of α1-adrenergic blockers,43 it is likely that the open bladder neck reflects sympathetic (hypogastric nerve) denervation 45.…”

Section: Discussionmentioning

confidence: 99%

Videourodynamic and sphincter motor unit potential analyses in Parkinson's disease and multiple system atrophy

Sakakibara

Hattori²,

Uchiyama³

et al. 2001

Journal of Neurology, Neurosurgery &Amp; Psychiatry

187

147

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Objectives-Urinary dysfunction is a prominent autonomic feature in Parkinson's disease (PD) and multiple system atrophy (MSA), which is not only troublesome but also a cause of morbidity in these disorders. Recent advances in investigative uroneurology oVer a better insight into the underlying pathophysiology and appropriate management for urinary dysfunction. Methods-twenty one patients with PD (15 men, six women, mean age 64 (49-76), mean disease duration 4 years (1-8 years), median Hoehn and Yahr grade 3 (1-4), all taking 300 mg/day of levodopa (100-500 mg)) and 15 with MSA (eight men, seven women, mean age 59 (48-72), mean disease duration 3 years (0.5-6 years)) were recruited. Videourodynamic and sphincter motor unit potential analyses in the patients with PD and MSA were carried out, looking for distinguishing hallmarks that might be useful in the diVerential diagnosis of these two diseases. Results-Urinary symptoms were found in 72% of patients with PD and in 100% with MSA. Filling phase abnormalities in the videourodynamic study included detrusor hyperreflexia in 81% of patients with PD and 56% with MSA, and uninhibited external sphincter relaxation in 33% of patients with PD and 33% of those with MSA. However, open bladder neck at the start of filling was not seen in patients with PD but was present in 53% of those with MSA, suggestive of internal sphincter denervation. Sphincter motor unit potential analysis showed neurogenic motor unit potentials in 5% of patients with PD and in 93% of those with MSA, suggestive of external sphincter denervation. On voiding, detrusor-external sphincter dyssynergia was not seen in patients with PD but was present in 47% of those with MSA. Pressure-flow analysis showed that the Abrams-GriYths number, a grading of urethral obstruction (outflow obstruction >40), in PD (40 in women and 43 in men) was larger than that in MSA (12 in women and 28 in men). Weak detrusor in PD (66% of women and 40% of men) was less common than that in MSA (71% of women and 63% of men). Postmicturition residuals >100 ml were absent in patients with PD but were present in 47% of patients with MSA.Conclusion-Patients with PD had less severe urinary dysfunction with little evidence of internal or external sphincter denervation, by contrast with the common findings in MSA. The findings of postmicturition residuals >100 ml, detrusorexternal sphincter dyssynergia, open bladder neck at the start of bladder filling, and neurogenic sphincter motor unit potentials are highly suggestive of MSA. (J Neurol Neurosurg Psychiatry 2001;71:600-606)

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Section: Discussionmentioning

confidence: 99%

Videourodynamic and sphincter motor unit potential analyses in Parkinson's disease and multiple system atrophy

Sakakibara

Hattori²,

Uchiyama³

et al. 2001

Journal of Neurology, Neurosurgery &Amp; Psychiatry

187

147

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“…The drug had no effect on these parameters in healthy control subjects. Although control subjects had significantly larger bladder neck diameter and higher membranous urethra hydraulic pressure before treatment, post-treatment values in PBNO patients were similar to control subjects [24].…”

Section: Treatment Of Primary Bladder Neck Obstructionmentioning

confidence: 67%

Diagnosis and treatment of primary bladder neck obstruction in men

Huckabay

Νitti

2006

Curr Bladder Dysfunct Rep

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“…Next, we studied the extent of energy loss due to alteration of the channel shape in each of the models. Fluid energy per unit volume (E) was calculated using Bernoulli's equation, 17,18 In the formula, E,h v.h zt and Pt represent the average fluid energy, average velocity, height from the reference point in the direction of gravity and average static press ure, respectively, i indicates per unit volume at any given cross-section in the fluid region. The average (bulk average) flow velocity and static pressure were calculated at five cross-sectional planes in the models (inflow boundary: B, BO, PU, V, outflow boundary: S).…”

Section: R E Su Ltsmentioning

confidence: 99%

Urine Flow Dynamics Through the Urethra in Patients With Bladder Outlet Obstruction

Ishii

Naya

Yamanishi

et al. 2014

J. Mech. Med. Biol.

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Voiding dysfunction is a common disease among the elderly male population. However, few studies have elucidated the flow dynamics of the disease mechanism. We attempted to clarify the fluid dynamics of urine in the prostatic urethra (PU) in patients with bladder outlet obstruction (BOO), a common disease associated with voiding dysfunction. A model of normal PU and three phase models following the BOO progression were prepared using 3D CAD software tracing cystourethroscopic images. In fluid dynamics computation, the normal detrusor pressure was applied to the bladder side in each model. Results of fluid simulation were compared for flow trajectory line, fluid energy dynamics using Bernoulli's principle and pressure loss coefficient. In the BOO model, a large vortex was observed adjacent to the bladder outlet (BO) with increased hydraulic energy loss during the passage through the tract. In contrast, opening of the BO eliminated the vortex with reduction of hydraulic energy loss. These results corresponded with clinical data measured by catheterized pressure sensors inserted into the urethra, and those of urethral diameter measured by urethrography. Fluid dynamics simulation using CAD models can clarify the mechanism of voiding dysfunction in a less invasive and more acceptable way in patients with BOO.

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The effectiveness of terazosin, an α1‐blocker, on bladder neck obstruction as assessed by urodynamic hydraulic energy

Cited by 27 publications

References 28 publications

Videourodynamic and sphincter motor unit potential analyses in Parkinson's disease and multiple system atrophy

Videourodynamic and sphincter motor unit potential analyses in Parkinson's disease and multiple system atrophy

Diagnosis and treatment of primary bladder neck obstruction in men

Urine Flow Dynamics Through the Urethra in Patients With Bladder Outlet Obstruction

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