Simultaneous Cine-Urographic and Manoflowmetric Evaluation of the Neurogenic Component in Incontinence

A urodynamic analysis was performed on 1,300 patients to precise typical psychogenic voiding patterns. Only 2.7% of this selected group showed voiding alterations derived from a psychosis or neurosis. The psychosomatic voiding alterations were to some degree similar to the alterations which were provoked by exogenous or iatrogenic influences. The voiding pattern of young children differs from that of adults when comparing psychosomatic symptoms such as prostatitis or enuresis. Urine retention and megalocystis were characteristic findings of psychotic patients whereas a polyphasic flow pattern, a delay of micturition and increased sacral reflex activity were typical findings of psychosomatic disorders. The denervation supersensitivity test is a reliable test to differentiate neurogenic from psychogenic voiding patterns.

Section: Methods and Patientsmentioning

confidence: 99%

Psychogenic Voiding Patterns

Palmtag¹,

Riedasch²

1980

“…247 patients with a neurogenic bladder dysfunction, additionally 70 girls (18 o f whom showed a W BNA) were investigated by synchronous video/pressure/flow cystourethrography (7,8). The etiology o f the neurogenic lesion was a traumatic spinal cord injury in 80% o f all patients.…”

Section: Methodsmentioning

confidence: 99%

Bladder Neck Hypertrophy and Wide Bladder Neck Anomaly (WBNA)

Palmtag¹,

Güllich²,

Heering³

1978

Self Cite

The urodynamic findings of 247 patients with a neurogenic bladder dysfunction were analyzed to evaluate factors which influence the X-ray picture of the bladder neck and urethra. Patients were classified according to the classification of Bors and Comarr, additionally different types of reflex detrusor activity could be differentiated in cases suffering from a supranuclear lesion. As the micturition cystourethrography of female patients with a supranuclear lesion looks similar to the X-ray picture of young girls with a WBNA a second analysis was made to compare the urodynamics of both groups. It is to note that in supranuclear lesions detrusor-sphincter dyssynergia and the type of reflex detrusor activity mainly form the shape of the posterior urethra, neither the duration of the lesion nor the level of spinal cord injury have any influence.

“…The investigations included cine/pressure/ flow/cystourethrographic measurements. The recording apparatus has already been described elsewhere [2,11]. We studied the act of voiding as well as the filling peri od of the bladder in a sitting position.…”

Section: Methodsmentioning

confidence: 99%

Detrusor Activity and Outflow Resistance in Stress Incontinence

Palmtag¹,

Schneider²

1976

Self Cite

The successful treatment of urinary stress incontinence in females depends on a careful study of urodynamics. Preoperative measurements of urine flow rate and residual urine can be useful only in differentiating compensated from decompensated micturition. However, some selected problems require a more detailed investigation. Therefore synchronous cine/pressure/flow/cystourethrographic studies were performed in 20 stress-incontinent women. In some of them, an increased outflow resistance was thus demonstrated. Any type of operation for stress incontinence which raises outflow resistance must be avoided in these cases. Long-distanced urethrocystopexy which permits to avoid an unwanted increase of outflow resistance with following retention of urine should be preferred.