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Urinary retention due to fecal impaction in children
585
ABSTRACTS
recurrent favorable VOIDING
urinary tract prognosis.-Bruce
have
a
M. Henderson
CYSTOURETHROGRAPHY UNDER AN-
ESTHESIA. J. Downing,
J.
infection
J.
Sanchez.
(March),
R.
Ural.
Mannion
and
103:357-358
1970.
Children in this study were evaluated by cystourethrography under anesthesia after instillation of dye into the bladder through a 14 French catheter at a filling pressure of 1 to 2 cm. When bladder capacity was reached, the flow was stopped and anesthesia was lightened sufficently to allow voiding. In each of the patients described there was vesicoureteral reflux. In none of the children were any abnormalities found on IVP or cystoscopy. It is concluded that this is a safe and time-saving examination.-Bruce M. Henderson INITIATION OF VOIDING. E. A.
E. R.
Miller.
(April),
&it.
J. Urol.
Tanagho
and
Can it be positively harmful? Five different types of bladder function were found: (1) Normal pressure detrusor contractions and no outflow obstruction. Here the bladder empties and there is no need for expression. (2) Low pressure detrusor contractions and no outflow obstruction. Contractions are too weak to empty the bladder. Manual expression is indicated. (3) High pressure contractions and outflow obstruction. The detrusor contraction pressures exceed those achieved by suprapubic pressure. The obstruction must be relieved. (4) No detrusor contractures and no outflow obstruction. Expression is necessary and can empty the bladder. (5) No detrusor contractions and outflow obstruction. Expression cannot empty the bladder until the obstruction is relieved. There is no direct evidence that expression is harmful but where vesico-ureteric reflux exists the possibility of causing back pressure on the renal parenchyma must be borne in mind.-J. H. Johnston
42:175-183
1970.
URINARY
Anatomical studies have shown that there is no specific internal sphincter at the bladder neck. A sphincteric mechanism is offered by the intrinsic musculature of the whole urethra in the female and the prostatic urethra in the male. There is also a striated muscle sphincter which is part of a complex unit. the pelvic floor, which functions as one unit. The authors base their views on cineradiographic and physiological studies during voiding. A drop in urethra1 pressure and funnelling of the bladder outlet precede voiding and any detrusor contraction. These are due to relaxation of the pelvic floor and the external sphincter. The bladder base descends and starts bladder outlet funnelling with a change in the bladder-urethra relationship.-
RETENTION
DUE
PACTION IN CHILDREN.
Datnid
Presman.
(February),
TO
David
FECAL
IM-
Gallo
arzd
Pediatrics.
45 : 292
1970.
Idiopathic fecal impaction of a degree severe enough to cause urinary retention is presented. A plea is made to routinely examine each child rectally who presents with a main complaint of urinary retention. This simple procedure may avoid the needless expense of hospitalization and performing unnecessary diagnostic and surgical procedures.-Clifford L. Rubin DIFFICULTIES CHILDREN W. Ireland
341-342
WITH
VESICOSTOMIES
IN
WITH MENINGOMYELOCELE.
and R. W. Geisf.
(March),
15 G.
J. Ural. 103:
1970.
J. H. John.rtorz INDICATIONS
FOR MANUAL
THE NEUROGENIC
EXPRESSION
OF
BLADDER IN CHILDREN.
E. Pekarol+c. A. Robinson, R. B. Zachary arzd J. Lisfer. Brit. J. Urol. 42: 191-196
( April).
1970.
Employing a cystometrographic method of study, the authors set out to answer the following questions: (1) Is manual expression ltelpful or necessary in all cases? (2) If not. in which type of case is it useful? (3)
Fifteen children with meningomyelocele were studied. Cutaneous vesicostomy by the Lapides technique was performed. In five the urethra was not ligated. Most had urinary tract infections. Cutaneous vesicostomy proved to be a simple, safe procedure, but difficulities arose with the appliances. due to the joint contractures, abnormal spinal curvatures and flaccid abdominal wall associated with this anomaly. These included leakage, skin encrustations, bladder and kidney stones and hemorrhage. Nine patients
ABSTRACTS
recurrent favorable VOIDING
urinary tract prognosis.-Bruce
have
a
M. Henderson
CYSTOURETHROGRAPHY UNDER AN-
ESTHESIA. J. Downing,
J.
infection
J.
Sanchez.
(March),
R.
Ural.
Mannion
and
103:357-358
1970.
Children in this study were evaluated by cystourethrography under anesthesia after instillation of dye into the bladder through a 14 French catheter at a filling pressure of 1 to 2 cm. When bladder capacity was reached, the flow was stopped and anesthesia was lightened sufficently to allow voiding. In each of the patients described there was vesicoureteral reflux. In none of the children were any abnormalities found on IVP or cystoscopy. It is concluded that this is a safe and time-saving examination.-Bruce M. Henderson INITIATION OF VOIDING. E. A.
E. R.
Miller.
(April),
&it.
J. Urol.
Tanagho
and
Can it be positively harmful? Five different types of bladder function were found: (1) Normal pressure detrusor contractions and no outflow obstruction. Here the bladder empties and there is no need for expression. (2) Low pressure detrusor contractions and no outflow obstruction. Contractions are too weak to empty the bladder. Manual expression is indicated. (3) High pressure contractions and outflow obstruction. The detrusor contraction pressures exceed those achieved by suprapubic pressure. The obstruction must be relieved. (4) No detrusor contractures and no outflow obstruction. Expression is necessary and can empty the bladder. (5) No detrusor contractions and outflow obstruction. Expression cannot empty the bladder until the obstruction is relieved. There is no direct evidence that expression is harmful but where vesico-ureteric reflux exists the possibility of causing back pressure on the renal parenchyma must be borne in mind.-J. H. Johnston
42:175-183
1970.
URINARY
Anatomical studies have shown that there is no specific internal sphincter at the bladder neck. A sphincteric mechanism is offered by the intrinsic musculature of the whole urethra in the female and the prostatic urethra in the male. There is also a striated muscle sphincter which is part of a complex unit. the pelvic floor, which functions as one unit. The authors base their views on cineradiographic and physiological studies during voiding. A drop in urethra1 pressure and funnelling of the bladder outlet precede voiding and any detrusor contraction. These are due to relaxation of the pelvic floor and the external sphincter. The bladder base descends and starts bladder outlet funnelling with a change in the bladder-urethra relationship.-
RETENTION
DUE
PACTION IN CHILDREN.
Datnid
Presman.
(February),
TO
David
FECAL
IM-
Gallo
arzd
Pediatrics.
45 : 292
1970.
Idiopathic fecal impaction of a degree severe enough to cause urinary retention is presented. A plea is made to routinely examine each child rectally who presents with a main complaint of urinary retention. This simple procedure may avoid the needless expense of hospitalization and performing unnecessary diagnostic and surgical procedures.-Clifford L. Rubin DIFFICULTIES CHILDREN W. Ireland
341-342
WITH
VESICOSTOMIES
IN
WITH MENINGOMYELOCELE.
and R. W. Geisf.
(March),
15 G.
J. Ural. 103:
1970.
J. H. John.rtorz INDICATIONS
FOR MANUAL
THE NEUROGENIC
EXPRESSION
OF
BLADDER IN CHILDREN.
E. Pekarol+c. A. Robinson, R. B. Zachary arzd J. Lisfer. Brit. J. Urol. 42: 191-196
( April).
1970.
Employing a cystometrographic method of study, the authors set out to answer the following questions: (1) Is manual expression ltelpful or necessary in all cases? (2) If not. in which type of case is it useful? (3)
Fifteen children with meningomyelocele were studied. Cutaneous vesicostomy by the Lapides technique was performed. In five the urethra was not ligated. Most had urinary tract infections. Cutaneous vesicostomy proved to be a simple, safe procedure, but difficulities arose with the appliances. due to the joint contractures, abnormal spinal curvatures and flaccid abdominal wall associated with this anomaly. These included leakage, skin encrustations, bladder and kidney stones and hemorrhage. Nine patients