Serum calcium and magnesium levels in women with detrusor overactivity.

The aim of this study was to determine whether abnormal serum levels of magnesium and calcium occur in women with detrusor overactivity. These were compared with the serum level of magnesium and calcium ions in women with urodynamic stress incontinence as controls to see whether alteration of these levels offer a further therapeutic option. The study included 20 women with urodynamically proven detrusor overactivity compared with 20 women with urodynamic stress incontinence as controls. A blood test was taken to determine serum levels of total magnesium phosphate together with free and corrected calcium. In addition, the calcium and magnesium ratio (Ca:Mg) and calcium corrected and magnesium ratio (Ca Corr:Mg) were calculated. Both parametric and non-parametric tests were used to compare the two groups with respect to these variables. The mean, median and standard deviation of the two groups are very similar for each of the variables. There is no evidence to suggest that there is any difference between detrusor overactivity and urodynamic stress incontinence with respect to these variables. This study has shown that there is no abnormal correlation between serum calcium and magnesium ions in women with detrusor overactivity. There appears to be no therapeutic benefit in calcium and/or magnesium supplements for detrusor overactivity.

Antioxidant deficiency following clam enterocystoplasty.

OBJECTIVE: To assess whether there is a reduction in serum antioxidant activity in patients who have undergone a clam enterocystoplasty procedure. PATIENTS AND METHODS: Serum glutathione peroxidase (GPase) activity was measured in 20 patients who had undergone clam enterocystoplasty. Serum selenium concentration was also measured in 62 similar patients and compared with 56 healthy controls and 44 patients with a neuropathic bladder, mainly patients with spinal cord injuries who had not undergone surgery. RESULTS: GPase activity correlated well with serum selenium measurement. There was a significant reduction (P < 0.001) in serum selenium level in young (< 50 years old) non-neuropathic bladder patients following clam enterocystoplasty. This reduction in serum selenium was similar to that found in both unoperated patients with a neuropathic bladder (who are known to have an increased risk of developing bladder cancer) and those patients with a neuropathic bladder who had undergone augmentation. This reduction was not related to urinary tract infection nor the time since surgery. CONCLUSION: A reduction in serum selenium has been shown to increase susceptibility to bladder cancer following carcinogenic exposure to compounds such as nitrosamines. This study suggests that patients with idiopathic and congenital instability may be at an equally high risk as a result of undergoing this procedure.

Pentosanpolysulphate for interstitial cystitis.

Interstitial Cystitis (IC) is a chronic disease of unknown etiology which primarily affects women aged 40-60 years. Many plausible theories for the development of IC have been postulated, and one current theory is that these patients have a quantitative and qualitative defect in the glycosaminoglycan (GAG) layer of the urothelium. Such a defect may allow toxic substances in the urine to gain access to the lamina propria and initiate a chronic inflammatory process. Pentosanpolysulphate (PPS) is a sulphated proteoglycan similar in structure to heparin sulphate, which is quantitatively the major GAG on cell surfaces. Exogenously administered PPS has been shown in several studies to decrease bladder pain and urinary frequency and to increase the voided volume. Further studies are required to evaluate the role of PPS in the management of IC patients, with particular emphasis on dosage, route of administration and combination with other compounds.

Reduction of urinary basic fibroblast growth factor using pentosan polysulphate sodium.

OBJECTIVE: To evaluate the use of pentosan polysulphate sodium (PPS) to reduce the level of urinary basic fibroblast growth factor (bFGF). PATIENTS AND METHODS: Forty-one patients with a clam enterocystoplasty were randomized to receive either 200 mg three times daily of oral PPS (n = 21) or placebo (n = 20) for 6 weeks. Three patients acted as a cross-over study. Urinary bFGF was measured before and after treatment and the degree of symptomatic benefit assessed using a questionnaire. RESULTS: There was no reduction in bFGF in the patients receiving placebo (P = 0.235) but there was a statistically significant reduction in bFGF (P = 0.0251) in the patients receiving PPS, most of whom were symptomatically improved, especially with regard to mucus production. CONCLUSION: PPS may have a role in reducing urinary bFGF in patients with bladder tumours or following an enterocystoplasty and also in improving the quality of life of patients with a clam enterocystoplasty.

Selenium deficiency and miscarriage: a possible link?

OBJECTIVE: To investigate a possible relationship between a deficiency in serum selenium concentration and first trimester miscarriage. DESIGN: An observational study. SETTING: A teaching hospital in South Wales. PARTICIPANTS AND METHODS: Serum selenium, albumin and total protein concentration were measured in 40 women admitted with first trimester nonrecurrent miscarriage. The results were compared with an equal number of age-matched nonpregnant healthy volunteers, and also from 40 pregnant women attending the antenatal clinic for booking in the first trimester. RESULTS: A reduction in serum selenium normally occurs in the first trimester of pregnancies that progress to term. However, a further statistically highly significant decrease in serum selenium was observed in those women who miscarried. CONCLUSION: Further studies are required to assess the potential benefits of selenium supplements.