Background: Although not a life threatening condition, UI is a common problem in women that produ... more Background: Although not a life threatening condition, UI is a common problem in women that produces embarrassing and debilitating symptoms, severely affects the quality of life and represents a significant public health problem. The bladder and urethra in women constitute a functional unit that is controlled by a complex interplay between the central and peripheral cholinergic and noradrenergic nervous systems and local regulatory factors. A substantial part of urethral tone in women is also mediated through the effect of estrogen on urethral mucosal function. Theoretically, detrusor instability can be improved by agents that decrease detrusor contractility and genuine stress incontinence by agents that increase outlet resistance. Objective: To review the use of various drugs in treatment of female urinary incontinence [UI] and present the current evidence-based recommendations. Methods: Systematic review of literature. Results: The strength of evidence for the use of such agents, however, varies from data obtained from pharmacological and physiological experiments to those derived from clinical studies. Hence, the use of some of the currently prescribed drugs for treatment of female UI is founded more on tradition than on evidence based on results from controlled clinical trials. There is also an urgent medical need for a new smooth muscle agent for treating UI in women because current drug therapy of UI is either inadequate or ineffective. Therefore, further clinical experience with drugs that selectively modulate the electrophysiological properties and the intracellular pathways of the smooth muscles of the lower urinary tract in women as therapeutic agents for UI is awaited with interest.
Objective: To conduct a study of maternal and fetal outcome in pregnant women with transfusion-de... more Objective: To conduct a study of maternal and fetal outcome in pregnant women with transfusion-dependent beta-thalassemia major. Study design: The course and outcome of pregnancy were studied prospectively in 32 pregnant women with transfusion-dependent beta-thalassemia major, of which 10 were HIV 1 positive, at Sanjay Gandhi Hospital, Manipur, India, from January 1990 to July 1996. Results: Over a period of six years, 32 women with transfusion-dependent beta-thalassemia major conceived. Twenty conceptions were spontaneous (63%), and 12 (37%) followed induction of ovulation. There were 24 (75%) singleton vaginal deliveries, all of which were term. At term, eight (25%) women delivered by elective cesarean section due to cephalopelvic disproportion. All the women remained well throughout pregnancy. Despite increased blood transfusion requirements during pregnancy to maintain the hemoglobin level > 10 g/dL, serum ferritin levels remained stable in all patients. Conclusion: Successful outcomes of pregnancy occurred in some women with transfusion-dependent beta-thalassemia major.
ABSTRACT Urolithiasis is the most common cause of urological-related abdominal pain in pregnant w... more ABSTRACT Urolithiasis is the most common cause of urological-related abdominal pain in pregnant women after urinary tract infection. The disease is not uncommon during pregnancy occurring in 1/200 to 1/2,000 women, which is not different from the incidence reported in the nonpregnant female population of reproductive age. During pregnancy, the frequency of stone localization is twice as higher in the ureter than in the renal pelvis or calyx, but there is no difference between the left and right kidney or ureter. Urinary stones during pregnancy are composed mainly of calcium phosphate (hydroxyapatite) in 74% of cases and calcium oxalate in the remaining 26% (Ross et al., Urol Res 36:99-102, 2008). In conclusion, urolithiasis during pregnancy can be serious, causing preterm labor in up to 40% of affected women. The pathogenesis, diagnosis, and management are analyzed.
Background: Although not a life threatening condition, UI is a common problem in women that produ... more Background: Although not a life threatening condition, UI is a common problem in women that produces embarrassing and debilitating symptoms, severely affects the quality of life and represents a significant public health problem. The bladder and urethra in women constitute a functional unit that is controlled by a complex interplay between the central and peripheral cholinergic and noradrenergic nervous systems and local regulatory factors. A substantial part of urethral tone in women is also mediated through the effect of estrogen on urethral mucosal function. Theoretically, detrusor instability can be improved by agents that decrease detrusor contractility and genuine stress incontinence by agents that increase outlet resistance. Objective: To review the use of various drugs in treatment of female urinary incontinence [UI] and present the current evidence-based recommendations. Methods: Systematic review of literature. Results: The strength of evidence for the use of such agents, however, varies from data obtained from pharmacological and physiological experiments to those derived from clinical studies. Hence, the use of some of the currently prescribed drugs for treatment of female UI is founded more on tradition than on evidence based on results from controlled clinical trials. There is also an urgent medical need for a new smooth muscle agent for treating UI in women because current drug therapy of UI is either inadequate or ineffective. Therefore, further clinical experience with drugs that selectively modulate the electrophysiological properties and the intracellular pathways of the smooth muscles of the lower urinary tract in women as therapeutic agents for UI is awaited with interest.
Objective: To conduct a study of maternal and fetal outcome in pregnant women with transfusion-de... more Objective: To conduct a study of maternal and fetal outcome in pregnant women with transfusion-dependent beta-thalassemia major. Study design: The course and outcome of pregnancy were studied prospectively in 32 pregnant women with transfusion-dependent beta-thalassemia major, of which 10 were HIV 1 positive, at Sanjay Gandhi Hospital, Manipur, India, from January 1990 to July 1996. Results: Over a period of six years, 32 women with transfusion-dependent beta-thalassemia major conceived. Twenty conceptions were spontaneous (63%), and 12 (37%) followed induction of ovulation. There were 24 (75%) singleton vaginal deliveries, all of which were term. At term, eight (25%) women delivered by elective cesarean section due to cephalopelvic disproportion. All the women remained well throughout pregnancy. Despite increased blood transfusion requirements during pregnancy to maintain the hemoglobin level > 10 g/dL, serum ferritin levels remained stable in all patients. Conclusion: Successful outcomes of pregnancy occurred in some women with transfusion-dependent beta-thalassemia major.
ABSTRACT Urolithiasis is the most common cause of urological-related abdominal pain in pregnant w... more ABSTRACT Urolithiasis is the most common cause of urological-related abdominal pain in pregnant women after urinary tract infection. The disease is not uncommon during pregnancy occurring in 1/200 to 1/2,000 women, which is not different from the incidence reported in the nonpregnant female population of reproductive age. During pregnancy, the frequency of stone localization is twice as higher in the ureter than in the renal pelvis or calyx, but there is no difference between the left and right kidney or ureter. Urinary stones during pregnancy are composed mainly of calcium phosphate (hydroxyapatite) in 74% of cases and calcium oxalate in the remaining 26% (Ross et al., Urol Res 36:99-102, 2008). In conclusion, urolithiasis during pregnancy can be serious, causing preterm labor in up to 40% of affected women. The pathogenesis, diagnosis, and management are analyzed.
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