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The place of detrusor and sphincter electromyography in the investigation of patients with urodynamic problems is discussed. The low-frequency component of the detrusor E.M.G. and the urethral sphincter recordings are of diagnostic value, and the pressure and flow recordings provide further useful diagnostic information. [ABSTRACT FROM AUTHOR]

A technique is described for investigating in conscious female patients both the low-frequency (wave) and high-frequency (spike) components of the detrusor E.M.G. The low-frequency component appears to be of value in assessing the chemotherapy by antispasmodic drugs in urgency of micturition. [ABSTRACT FROM AUTHOR]

The effects of urethral dilatation have been investigated in girls with recurrent urinary infection. About 65 per cent of girls showed some improvement when this procedure was combined with long-term antibiotic therapy, provided that there was no serious vesico-ureteric reflux. However, the results were unpredictable, and in a controlled prospective trial the preliminary results of dilatation did not differ significantly from those obtained with cystoscopy alone. Nevertheless, improvement after dilatation did seem to be associated with a high urethral pressure profile, high bladder pressure, small bladder capacity and marked detrusor irritability; it is suggested that this 'dysfunctional bladder syndrome' may be the cause of recurrent infections in these cases, and that improvement may be anticipated after urethral dilatation, which should be combined with anti-cholinergic drug therapy if day wetting is a co-existing problem. [ABSTRACT FROM AUTHOR]

The concentration of prostaglandin E (PGE) was measured in the semen of 5 men of proven fertility and in 12 men of couples who were infertile but in whom no abnormality had been detected by conventional semen analysis, postcoital test of sperm motility, endometrial biopsy, and laparoscopic dye insufflation of the fallopian tubes. In the fertile men the mean PGE concentration was 52.7 +/- 9.9 mug/ml, and in infertile men the concentration was 22.1 +/- 2.76 mug/ml; the difference between the two groups was highly significant (P less than 0.001). In five of the infertile men attempts were made to raise the PGE concentration by the administration of either corn oil, which contains the prostaglandin precursor linoleic acid, or caffeine, which inhibits prostaglandin degradation; the response to both agents was insignificant.

An investigation has been made into the form of the EMG signals from the human bladder and urethral and anal sphincters. A buildup of the low frequency detrusor EMG before micturition occurs in some patients and this is more marked in patients with urgency. A good correlation occurs between the amount of EMG activity and bladder activity as assessed by the cystometrogram. Marked spike activity has been seen in the detrusor EMGs of patients with irritable bladders. The comparison of anal and urethral sphincter EMGs is of interest from the viewpoint of the anatomy of the urethral sphincter and the mechanism of micturition.

In order to diagnose and treat patients with micturitional disturbances it is necessary to obtain as much information as possible about the function of the lower urinary tract in each case. We studied 70 female patients with micturitional disturbances by monitoring pulse, respiration, intrinsic bladder pressure, urine flow rate and volume, and detrusor and sphincter electromyograms during a 2 to 4-hour period. As earlier investigators have shown, there are 2 types of detrusor electromyograms: low frequency and high frequency activity. The low frequency activity is random in nature and has definite patterns in disturbed bladder function. It is a useful diagnostic parameter and, when considered with the results of the sphincter electromyograms and pressure recordings, it provides much diagnostic information in this group of patients. The high frequency activity is similar to that of striated muscle.