RESUMEN
Detrusor instability is a syndrome of urinary frequency, urgency and urge incontinence which can be demonstrated using urodynamic studies to document uninhibited bladder contractions. Idiopathic cases account for 90% and 10% are related to neurologic disorders. Several different treatment modalities are available, including bladder training/drill, electrical stimulation, medical and surgical therapies.
Asunto(s)
Hipertonía Muscular/complicaciones , Incontinencia Urinaria/etiología , Diagnóstico Diferencial , Terapia por Estimulación Eléctrica , Terapia por Ejercicio , Femenino , Humanos , Incontinencia Urinaria/fisiopatología , Incontinencia Urinaria/terapia , Urodinámica , Procedimientos Quirúrgicos Urogenitales/métodosRESUMEN
The effect of Voltarol, administered routinely, in reducing the postoperative requirement for opioid drugs was monitored using patient-controlled analgesia. Omnopon consumption was recorded together with pain scores. The significance of the results is discussed with reference to the dosage and timing of analgesia and to nursing practice.
Asunto(s)
Analgesia Controlada por el Paciente/métodos , Diclofenaco/uso terapéutico , Enfermedades de los Genitales Femeninos/cirugía , Opio/uso terapéutico , Dolor Postoperatorio/tratamiento farmacológico , Adolescente , Adulto , Anciano , Analgesia Controlada por el Paciente/enfermería , Femenino , Humanos , Persona de Mediana Edad , Dolor Postoperatorio/etiología , Dolor Postoperatorio/enfermeríaRESUMEN
A new method for controlling the symptoms and objective signs of detrusor instability was investigated in a pilot study. The method uses the activity of the bladder neck, monitored by a conductivity catheter, as a biofeedback signal. Voluntary closure of the bladder neck mechanism abolishes abnormal detrusor activity. Ten severely symptomatic women with detrusor instability were assessed clinically and urodynamically before and after a course of biofeedback. Statistically significant improvements in the symptoms of urgency and urge incontinence were found. Five of the seven women who agreed to have repeat cystometry had stable cystometrograms. There was a statistically significant fall in the mean maximum deflection at rest from 41.5 to 16.5 microA (P less than 0.05) measured during bladder neck electrical conductivity tests before and after treatment.
Asunto(s)
Biorretroalimentación Psicológica , Vejiga Urinaria/fisiopatología , Incontinencia Urinaria/terapia , Conductividad Eléctrica , Femenino , Humanos , Proyectos Piloto , Cateterismo Urinario , Incontinencia Urinaria/fisiopatologíaRESUMEN
Measurement of urethral electric conductance can be used to detect the movement of urine along the urethra by registering a change in conductivity reading. This technique has been employed in patients complaining of urge incontinence and has shown movements at the bladder neck when urgency is appreciated. Patients with sensory urgency have been successfully managed by learning to control the movements at the bladder neck during a conductivity recording.
Asunto(s)
Vejiga Urinaria/fisiopatología , Incontinencia Urinaria/fisiopatología , Biorretroalimentación Psicológica , Conductividad Eléctrica , Femenino , Humanos , Pronóstico , Cateterismo Urinario/instrumentación , Incontinencia Urinaria/terapiaRESUMEN
Biofeedback training has been used to treat 27 female patients suffering from symptoms associated with detrusor instability Re-education to auditory and visual stimuli took place during 4 to 8 one-hour sessions at weekly intervals. Using subjective and objective methods of assessment 81% of the patients were improved following treatment.
Asunto(s)
Biorretroalimentación Psicológica , Enfermedades de la Vejiga Urinaria/terapia , Adolescente , Adulto , Estudios de Evaluación como Asunto , Femenino , Humanos , Persona de Mediana EdadRESUMEN
Detrusor instability has remained resistant to conventional forms of treatment. An attempt to use biofeedback methods in its management is described. Six female patients with symptoms of frequency, urgency and urge incontinence due to detrusor instability were conditioned to auditory and visual stimuli for 6 to 8 1 h sessions. They were assessed clinically and urodynamically. The results are presented as well as detailed case studies of 3 patients. Subjectively, 3 were cured, 2 improved and 1 remained the same; objectively, 3 were cured, 1 improved and 2 remained the same. No significant side effects were encountered.