Objective To investigate the video-urodynamics indication of upper urinary tract dilation secondary to neurogenic bladder that may be resolved only by intermittent catheterization. Methods From January, 2008 to August, 2016, twelve cases of upper urinary dila-tion secondary to neurogenic bladder were treated by intermittent catheterization only. Their clinical data was reviewed. Results The mor-phology and function index of upper urinary tract were improved gradually during the regular follow-ups. The common video-urodynamics characteristics include no detrusor overactivity, no vesicoureteral reflux, cysctometry volume larger than 300 ml and detrusor presser at the capacity lower than 40 cmH2O, poor voiding efficiency with residual volume larger than 150 ml. Conclusion For upper urinary tract dilation secondary to neurogenic bladder characterized as passable storage and poor voiding, intermittent catheterization may be enough to resolve the dilation.

Earthquake may result in various urologic problems by direct injury of urologic organs or by spinal cord injury.This article introduces the main urologic problems after earthquake,classified into early and long-term.Such as urinary retention,oliguria or anuria,renal injury,bladder and urethra injury,neurogenic bladder caused by spinal cord injury,et al.We analyze the causes of the problems and discuss the correct management principle,all kinds of rehabilitation measures to reduce the complication and sequela,also the problems should be cautioned during the long term follow-up.

Objective To explore the videourodynamic manifestation of neurogenic bladder after operation for lumbar intervertebral disk hernia. Methods A consecutive series of 25 patients with neurogenic bladder dysfunction after operation for lumbar intervertebral disk hernia were analysed retrospectively. They were respectively divided into L4-5 and L5-S1 groups according to the focus, or normal, injured and no-drawn groups according to saddle sensation. Their videourodynamic manifestation were analyzed statistically. Results Videourodynamic manifestation including bladder sensation,bladder compliance, stability, bladder neck's opening extent, bladder capacity and urethral pressures were not significantly different between the group L4-5 and L5-S1 (P>0.05), nor was the saddle sensation (P=0.51). But the bladder sensation and urethral pressures were related with the saddle sensation (P<0.05). Conclusion The videourodynamic changes may not be related with the focus, but the saddle sensation in patients after operation for lumbar intervertebral disk hernia, which need further elucidation.

ObjectiveTo explore the video-urodynamic characteristics of neurogenic bladder caused by suprapontine neuropathy.Methods65 patients with neurogenic bladder caused by suprapontine neuropathy were involved from February 2004 to May 2009. The data were analyzed retrospectively, including clinical manifestation, diagnosis, voiding management, ultrasound, uroflow, post void residual, filling cystometry, pressure-flow study and the radiology. The results were compared with those of the suprasacral spinal cord injury.ResultsNo significant difference was found in the urodynamic parameters between various kinds of suprapontine neuropathy. Compared with suprasacral spinal cord injury, suprapontine neuropathy had less detrusor-sphincter dyssynergia, less reflux and upper urinary tract dilation but more normal micturiton reflex.ConclusionThe main video-urodynamic characteristic of neurogenic bladder caused by suprapontine neuropathy is detrusor overactivity, and the detrusor-sphincter dyssynergia, reflux and upper urinary tract dilation are rare.

ObjectiveTo recognize the features of genitourinary dysfunction in multiple system atrophy (MSA) and the importance of videourodynamics.Methods5 cases of MSA were reviewed.ResultsGenitourinary dysfunction in MSA included voiding problem, nocturnal urinary frequency, urgency, impotence and so on. The characteristic appearance of videourodynamics was that postvoiding volume more than 100 ml, detrusor-external sphincter dyssynergia (DESD) and open bladder neck at the start of bladder filling. The abnormal sphincter electromyography comprised of abnormal spontaneous activity, motor unit potentials (MUPs) more than 13 ms, polyphasic potentials more than 60%. MRI showed brain atrophy and the "hot cross bun" signal in the pontocerebellar degeneration.ConclusionMSA is a disorder characterized by progressive neuronal atrophy at certain sites of the central nervous system that control the urogenital function. MSA-related urological symptoms are analogous with symptoms of bladder outlet obstruction. It is necessary to take some reasonable investigations for avoiding misdiagnosis and unnecessary surgery.

Objective To investigate the neuronal nitric oxide synthase (nNOS) distribution in intramural striated sphincter of female rats. Methods 4 female Wistar rats were anesthetized with chloral hydrate. The whole bladder and urethra specimen were harvested, fixed in formalin and imbedded in paraffin wax. Longitudinal and transverse sections were developed with 2 urethra respectively. Routine HE staining and Mallory phosphotungstic acid-hematoxylin staining were used for observation of urethral microstructure. nNOS distribution in intramural striated sphincter was determined with immunohistochemical staining. Results The urethras of female Wistar rat were tubular structure about 1.5～2.0 cm long. From outside inward,the structure included circular striated muscle layer,circular smooth muscle layer,longitudinal smooth muscle layer,dense connective tissue and epithelium. The longitudinal sections showed intramural striated muscle predominates the middle and distal third,not the whole urethral length. The transverse sections showed intramural striated muscle is closed ring shape,about 5～10 layers uneven distributed with more layers in the posterior wall than in the front wall. Strong positive expression of nNOS immunoreactivity was found in some intramural striated muscle fiber. Conclusion nNOS expresses in some intramural striated muscle fiber, surggesting nitric oxide may play an important role on intramural striated sphincter.

Objective To investigate the actualities about bladder management in patients with spinal cord injury. Methods 76 spinal cord injured patients were investigated with questionnaire. Results 61 patients adopted the bladder management methods recommended by their doctors, the other 15 refused the doctor's suggestion. In frequency order, bladder management methods used by spinal cord injured patients were intermittent catheterization (43.4%),triggering voiding or bladder expression(34.2%),indwelling catheter (2.6%), urine collection device 3.9% and others (15.8%). The female were more likely to adopt intermittent catheterization. The general satisfaction was 77.63%. Conclusion Medical staffs should recommend appropriate bladder management method for spinal cord injured patients not only considering their medical conditions bur also their psychological and social conditions.

Objective To study the effects of nitroglycerin on leak point pressure of chronic complete spinal cord injury female rats. Methods Models of chronic complete spinal cord injury in female rats were established. Changes of leak point pressure were investigated following nitroglycerin 3 mg intraperitoneal injection. Results Leak point pressure decreased from (32.27±15.00) cmH2O to (23.29±9.46) cmH2O. Conclusion There was obvious descent of leak point pressure of chronic complete spinal cord injury female rats following nitroglycerin intraperitoneal injection.

Objective To study the effects of nitroglycerin on urethral sphincter of chronic complete spinal cord injury female rats in vitro. Methods 30 SD female rats with 3 months old were transected at T10 spinal cord. After 8 weeks, the 10 rats with BBB scores ≤5 were selected as experimental group, and other 10 normal rats as control group. The difference of tension in both proximal segment (urethral smooth muscle strips) and distal segment (external urethral sphincter muscle strips) were surveyed before and after nitroglycerin 0.5 mg administration in bath. Results The tension of distal segment in control group reduced from (640.50±91.79) mg to (597.50±92.61) mg, and from (485.50±68.94) mg to (459.90±69.51) mg in experimental group. The difference between proximal segment and distal segment were (222.30±12.14) mg and (42.00±7.86) mg before and after administration in control group, and were (223.00±15.78) mg and (25.60±5.17) mg in experimental group. Conclusion The administration of nitroglycerin 0.5 mg in bath can reduce the tension of both urethral smooth muscle and external urethral sphincter in both normal and spinal cord injured rats. The relaxative effect on external urethral sphincter muscle of normal rats exceed that of injured ones, but approximate on urethral smooth muscle.

Objective To determine the effects of pudendal ncrve stimulation with different frequency(5 Hz,20 Hz) on bladder dysfunction dogs after spinal cord injury.Methods The study was done in 4 dogs which chronic spinal cord transection at T9-T10 level.All the dogs underwent electrical stimulation of pudendal nerve (5 Hz,20 Hz).Then,bladder capacity,compliance,non-voiding contraction number (NVC) and voiding efficiency before and during stimulation were compared.Results The bladder capacity and the compliance was increased ( 58.9 ± 17.4) ％ and (53.1 ± 4.9 ) ％ ( P ＜ 0.05 ) by pudendal nerve stimulation with low frequency (5 Hz).Detrusor overactivity can be inhibited and the NVC decreased from 1.7 ± 1.3 to 0.9 ± 1.1.Pudendal nerve stimulation with medium frequency ( 20 Hz) can induce bladder contraction and increased voiding efficiency from (5.8 ± 1.0) ％ to ( 16.3 ± 2.6 ) ％ ( P ＜0.05).Conclusions Pudendal nerve stimulation with low frequency can inhibit detrusor overactivity and increase the bladder capacity and compliance in spinal cord injury dogs.Pudendal nerve stimulation with medium frequency can induce bladder contraction and increased voiding efficicncy.