Micturition In Men Research Articles

Re: Comparison of Three Methods to Analyze Detrusor Contraction during Micturition in Men over 50 Years of Age.

Re: Comparison of Three Methods to Analyze Detrusor Contraction during Micturition in Men over 50 Years of Age.

PD24-04 NON INVASIVE VELOCITY-FLOW VIDEOURODYNAMICS USING DOPPLER ULTRASONOGRAPHY DETECTION OF PERIODIC DETRUSOR ARREST DURING MICTURITION IN MEN UNDERACTIVE BLADDER SYNDROME

You have accessJournal of UrologyUrodynamics/Incontinence/Female Urology: Incontinence: Evaluation (Urodynamic Testing)1 Apr 2015PD24-04 NON INVASIVE VELOCITY-FLOW VIDEOURODYNAMICS USING DOPPLER ULTRASONOGRAPHY DETECTION OF PERIODIC DETRUSOR ARREST DURING MICTURITION IN MEN UNDERACTIVE BLADDER SYNDROME Hideo Ozawa, Michael Chancellor, Atsushi Nagai, and Hiromi Kumon Hideo OzawaHideo Ozawa More articles by this author , Michael ChancellorMichael Chancellor More articles by this author , Atsushi NagaiAtsushi Nagai More articles by this author , and Hiromi KumonHiromi Kumon More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2015.02.1459AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES Underactive bladder syndrome (UAB) is urological condition characterized by bladder underactivity causing difficulty in voiding, resulting in incomplete bladder emptying. To assess the urodynamic function of patients with UAB, this study compares velocity-flow relation among patients with subjective voiding dysfunction. METHODS Sixty-six consecutive men with symptomatic voiding dysfunction (IPSS > 20) underwent transperineal Doppler urodynamics. Subjects were separated in BPE group (Prostate size>30cm3: n=21; age 72), in UAB group (Intermittent velocity curve peak observed: n=15; age 69) and miscellaneous group (n=30; age 65). In the lavatory chair, an ultrasound transducer (Prosound α6, Hitachi Aloka Med) was adjusted transperineally using robotic manipulator. Doppler ultrasound images were recorded during voiding. Urine velocities in distal prostatic urethra (V1) and at the membranous urethra (V2) were calculated and resulting graph can be seen on the monitor. A conversion on each measured velocity obtained from Doppler ultrasound waves were performed to produce the tangential velocity of the actual micturition flow. RESULTS Qmax in BPE group (7.5ml/s) was found to be significantly lower than that of UAB group (9.6ml/s) and miscellaneous group (11.1ml/s). V1 (40.4cm/s) was relatively larger than V2(43.2cm/s) for the BPE group, whereas for miscellaneous group V2(63.4 cm/s) was significantly larger than V1(35.9cm/s). Since for most of the BPE patients prostatic urethra was the narrowest and the fastest part of the urethra, velocity decreased along the sphincter. For UAB group, intermittent peaks in velocity curve and rising trend in flow rate curve were simultaneously observed (Figure 1). In most of the cases, peaks in V2 (69.3 cm/s) were larger than those in V1 (40.0cm/s), which suggest the absence of bladder outlet obstruction. This phenomenon could represent the periodic arrest of detrusor contraction during voiding. CONCLUSIONS We have demonstrated for the first time that non invasive velocity-flow urodynamics using Doppler ultrasound can assess velocity of flow in prostatic and membranous uretha region and aid in diagnosis of intermittent detrusor arrest for patients with underactive bladder syndrome. © 2015 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 193Issue 4SApril 2015Page: e487 Advertisement Copyright & Permissions© 2015 by American Urological Association Education and Research, Inc.MetricsAuthor Information Hideo Ozawa More articles by this author Michael Chancellor More articles by this author Atsushi Nagai More articles by this author Hiromi Kumon More articles by this author Expand All Advertisement Advertisement PDF downloadLoading ...

Supraspinal Control of Urine Storage and Micturition in Men--An fMRI Study.

Despite the crucial role of the brain in the control of the human lower urinary tract, little is known about the supraspinal mechanisms regulating micturition. To investigate the central regulatory mechanisms activated during micturition initiation and actual micturition, we used an alternating sequence of micturition imitation/imagination, micturition initiation, and actual micturition in 22 healthy males undergoing functional magnetic resonance imaging. Subjects able to micturate (voiders) showed the most prominent supraspinal activity during the final phase of micturition initiation whereas actual micturition was associated with significantly less such activity. Initiation of micturition in voiders induced significant activity in the brainstem (periaqueductal gray, pons), insula, thalamus, prefrontal cortex, parietal operculum and cingulate cortex with significant functional connectivity between the forebrain and parietal operculum. Subjects unable to micturate (nonvoiders) showed less robust activation during initiation of micturition, with activity in the forebrain and brainstem particularly lacking. Our findings suggest that micturition is controlled by a specific supraspinal network which is essential for the voluntary initiation of micturition. Once this network triggers the bulbospinal micturition reflex via brainstem centers, micturition continues automatically without further supraspinal input. Unsuccessful micturition is characterized by a failure to activate the periaqueductal gray and pons during initiation.

70 Supraspinal control of urine storage and micturition in men – an fMRI study

70 Supraspinal control of urine storage and micturition in men – an fMRI study

The discovery of the pontine micturition centre by F. J. F. Barrington

The discovery of the pontine micturition centre by F. J. F. Barrington

CORTICAL REPRESENTATION OF THE URGE TO VOID: A FUNCTIONAL MAGNETIC RESONANCE IMAGING STUDY

The urge to void generally increases with bladder distention but the relationship between the 2 factors is complex. When the bladder is moderately filled, the desire to void can be called forth deliberately but it can also be suppressed. To elucidate human brain mechanisms that are active during such intentional modulations of the desire to void we performed functional magnetic resonance imaging in healthy volunteers. Brain activity was studied in 22 young women. At moderate bladder filling (about 350 ml) they periodically suppressed or enhanced the urge to void without allowing urine to pass. A manual task with a dynamometer, in which the current urge to void was expressed as grip force, demonstrated that the intensity of sensations could be influenced voluntarily. We also examined brain activity during repetitive (1 Hz) contractions of pelvic floor muscles after the bladder was emptied. Significant brain activity associated with an increased urge to void was found in the insular cortex, frontal opercula, supplementary motor area (SMA), cingulate motor area (CMA), right posterior parietal cortex, left prefrontal cortex and cerebellum. Trends toward activation were detected in the thalamus, peri-aquaeductal gray matter and ventral pons. Suppression of the urge to void significantly activated the left superior frontal lobe. The SMA and CMA were active during voluntary rhythmical contractions of pelvic floor muscles. Sensation intensity of the desire to void can be influenced intentionally. Frontoparietal cortical areas and the SMA/CMA seem to be involved in this process.

▾ Pirenzepine: a selective anticholinergic for peptic ulcer

Anticholinergic drugs reduce gastric acid secretion and have been used in the treatment of peptic ulcer, but their use is limited by unwanted effects - dry mouth, blurred vision, constipation, difficulty in micturition in men and exacerbation of glaucoma. Pirenzepine (Gastrozepin - Boots) is an anticholinergic drug claimed to act selectively on the stomach, and therefore to promote healing of peptic ulcers whilst being well tolerated. It has been the subject of five sponsored supplements in the Scandinavian Journal of Gastroenterology,1–5 several reports at the XI and XIIth International Congresses of Gastroenterology (1980 and 1984), and at least two other international sponsored symposia.6,7 Our assessment is therefore based to a considerable extent upon papers in sponsored publications rather than on studies submitted to the full refereeing procedures of the specialist journals.