Non-Surgical Management of Vesicourethral Dysfunction

  • Leonard D. Gaum
  • William R. Fair


Vesicourethral dysfunction refers to any alteration in the storage or evacuation capacity of the lower urinary tract due to an imbalance between the bladder and urethral sphincter mechanisms.


Pelvic Floor Musculature Pudendal Nerve Urethral Catheter Spinal Cord Injury Patient Intermittent Catheterization 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.


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  1. 1.
    Dietrick RB, Russi S: Tabulation and review of autopsy findings in fifty-five paraplegics. JAMA 166: 41, 1958.Google Scholar
  2. 2.
    Tribe CR, Silver JR: Renal failure in paraplegia. London, Pitman Medical Publ Co, 1969.Google Scholar
  3. 3.
    Donnelly J, Hackler RH, Bunts RC: Present urologic status of World War II paraplegic: 25 year follow-up. Comparison with status of the 20 year Korean War paraplegic and 5 year Vietnam paraplegic. J Urol 108: 558, 1972.PubMedGoogle Scholar
  4. 4.
    Gibbon NOK: Neurogenic bladder in spinal cord injury: Management of patients in Liverpool. England. Urol Clin North Am 1: 147, 1974.Google Scholar
  5. 5.
    O’Flynn ID: Neurogenic bladder in spinal cord injury: Management of patients in Dublin, Ireland. Urol Clin North Am 1: 135, 1974.Google Scholar
  6. 6.
    Andriole VT: Hospital acquired urinary infection and the indwelling catheter. Urol Clin North Am 2: 451, 1975.PubMedGoogle Scholar
  7. 7.
    Fincke GB, Friedland G: Prevention and management of infection in the catheterized patient. Urol Clin North Am 3: 313, 1976.PubMedGoogle Scholar
  8. 8.
    Garibaldi RA, Burke JP, Dickman ML, et al: Factors predisposing to bacteriuria during indwelling urethral catheterization. N Eng J Med 291: 215 - 219, 1974.CrossRefGoogle Scholar
  9. 9.
    Kunin CM, McCormack RC: Prevention of catheter- induced urinary tract infection by sterile closed drainage. N Eng J Med 274: 1155 - 1161, 1966.CrossRefGoogle Scholar
  10. 10.
    Helmholz HF: Determination of the bacterial content of the urethra. J Urol 64: 158 - 166, 1950.PubMedGoogle Scholar
  11. 11.
    Guze LB, Beeson PB: Observations of the reliability and safety of bladder catheterization for bacteriologic study of the urine. N Eng J Med 255: 474 - 475, 1956.CrossRefGoogle Scholar
  12. 12.
    Finkelberg Z, Kunin CM: Clinical evaluation of closed urinary drainage systems. JAMA 207: 1657 - 1662, 1969.PubMedCrossRefGoogle Scholar
  13. 13.
    Thornton GF, Andriole VT: Bacteriuria during indwelling catheter drainage. JAMA 214: 339 - 342, 1970.PubMedCrossRefGoogle Scholar
  14. 14.
    Keys TF, Marker MD, Segura JW: Bacteriuria during closed urinary drainage: An evaluation of top-vented versus bag-vented systems. J Urol 122: 49 - 51, 1979.PubMedGoogle Scholar
  15. 15.
    Martin CM, Bookrajian EM: Bacteriuria prevention after indwelling urinary catheterization. Arch Intern Med 110: 703 - 711, 1962.Google Scholar
  16. 16.
    Kass EH, Sössen HS: Prevention of UTI in the presence of indwelling catheters. JAMA 169: 1181 - 1183, 1959.Google Scholar
  17. 17.
    Thornton GF, Lytton B, Andriole VT: Bacteriuria during indwelling catheter drainage: Effect of constant bladder rinse. JAMA 195: 179 - 183, 1966.PubMedCrossRefGoogle Scholar
  18. 18.
    Blocklehurst JC, Brocklehurst S: The management of indwelling catheters. Brit J Urol 50: 102 - 105, 1978.CrossRefGoogle Scholar
  19. 19.
    Kirk D, Dunn M, Bullock DW, Mitchell JP, Hobbs SJF: Hibitane bladder irrigation in the prevention of catheter associated urinary infection. Brit J Urol 51: 528 - 531, 1979.PubMedCrossRefGoogle Scholar
  20. 20.
    Gelman ML: Letter to the editor: Antibiotic irrigation and catheter associated urinary tract infection. Nephron 25: 259, 1980.PubMedCrossRefGoogle Scholar
  21. 21.
    Warren JW, Piatt R, Thomas RJ, Rosner B, Kass EH: Antibiotic irrigation and catheter associated urinary tract infection. N Eng J Med 299: 570 - 573, 1978.CrossRefGoogle Scholar
  22. 22.
    Harper WES, Matz LR: Further studies on effects of irrigation solutions on rat bladders. Brit J Urol 48: 463-467, 46. 1976.Google Scholar
  23. 23.
    Gibson CJ, Moon AH: Urinary output and incidence of acute UTI in patients with indwelling bladder catheters. Arch Phy Med Rehab 59: 17 - 20, 1978.Google Scholar
  24. 24.
    Bruce AW, Clark AF: The problem of catheter encrustation. Can Med J 3: 238 - 241, 1974.Google Scholar
  25. 25.
    Keristeci AG, Leers WD: Indwelling catheter infection. Can Med J 109: 711 - 713, 1973.Google Scholar
  26. 26.
    Norberg B, Norberg A, Parkhede U, Geppert H: Affect of short-term high-dose treatment with methenamine hippurate on urinary infection in geriatric patients with an indwelling catheter. Eur J Clin Pharmacol 15: 357 - 361, 1979.PubMedCrossRefGoogle Scholar
  27. 27.
    Turck M, Petersdorf RG: The role of antibiotics in the prevention of urinary tract infection. J Chronic Dis 15: 683 - 689, 1962.PubMedCrossRefGoogle Scholar
  28. 28.
    Vainrub B, Musher DM: Lack of effect of methenamine in suppression of, or prophylaxis against, chronic urinary infection. Antimicrob Agents Chemother 12: 625, 1977.PubMedGoogle Scholar
  29. 29.
    Maizels M, Schaeffer AJ: Decreased incidence of bacteriuria associated with periodic instillations of hydrogen peroxide into the urethral catheter drainage bag. J Urol 123: 841 - 845, 1980.PubMedGoogle Scholar
  30. 30.
    Kass EH, Schneiderman LJ: Entry of bacteria into the urinary tracts of patients with inlying catheters. N Eng J Med 256: 556, 1957.CrossRefGoogle Scholar
  31. 31.
    Ansell J: Some observations on catheter care. J Chron Dis 55. 15: 675, 1962.CrossRefGoogle Scholar
  32. 32.
    Gillespie WA, Lennon GG, Linton KB, Phippen GA: Prevention of urinary infections by means of closed drainage with a sterile plastic bag. Brit Med J 3: 90, 1967.PubMedCrossRefGoogle Scholar
  33. 33.
    Lawrence CA, Block SS (eds): Disinfection, sterilization and preservation. Philadelphia, Lea and Febiger, 1968. 57.Google Scholar
  34. 34.
    Desautels RE: The causes of catheter-induced urinary infections and their prevention. J Urol 101: 757 - 760, 1969.PubMedGoogle Scholar
  35. 35.
    Sanford JP: Disinfectants that don’t. Ann Int Med 72: 282 - 283, 1970.PubMedGoogle Scholar
  36. 36.
    Lindan R: The prevention of ascending, catheter-induced infections of the urinary tract. J Chronic Dis 22: 321 - 332, 1969.PubMedCrossRefGoogle Scholar
  37. 37.
    Harrison LH: Comparison of a microbicidal povidoneiodine gel and a placebo gel as catheter lubricants. J Urol 124: 347 - 349, 1980.PubMedGoogle Scholar
  38. 38.
    Desautels RE, Walter CW, Graves RC, Harrison JH: Technical advances in the prevention of urinary tract infection. J Urol 87: 487 - 490, 1962.PubMedGoogle Scholar
  39. 39.
    Butler HK, Kunin CM: The case for closed urinary catheter drainage I: Evaluation of polymyxin catheter lubricant and impregnated catheters. J Urol 100: 560-566, 63. 1968.Google Scholar
  40. 40.
    Center for Disease Control: National nosocomial infections study quarterly report, third quarter 1971, May 1973, pp 5 - 8.Google Scholar
  41. 41.
    Desautels RE: Aseptic management of catheter drainage. 65. N Eng J Med 263: 189 - 191, 1960.CrossRefGoogle Scholar
  42. 42.
    Gillespie WA, Lennon GG, Linton KB, Slade N: Prevention of urinary infection in gynecology. Brit Med J 2: 423 - 425, 1964.PubMedCrossRefGoogle Scholar
  43. 43.
    Kunin CM: Detection, prevention and treatment of urinary tract infection. Philadelphia, Lea and Febiger, Third ed, 1979, section IV, p 153.Google Scholar
  44. 44.
    Raz S, Bradley WE: Neuromuscular dysfunction of the lower urinary tract. Campbell’s urology. Philadelphia, W.B. Saunders Co, 4th ed, 1979, Vol 2, p 1257.Google Scholar
  45. 45.
    Gibbon NOK, Ross JC, Silver JR: Changes in the upper urinary tracts following various types of initial treatment. Paraplegia 7: 63 - 71, 1969.PubMedCrossRefGoogle Scholar
  46. 46.
    Khanna OP: Non-surgical therapeutic modalities. In: Krane RJ, Siroky MB (eds), Clinical neuro-Urology, 1st ed, pp 159-196.Google Scholar
  47. 47.
    Melzak J: The incidence of bladder cancer in paraplegic. Paraplegia 4: 85, 1966.PubMedCrossRefGoogle Scholar
  48. 48.
    Stamm WE: Guidelines for prevention of catheter associated urinary tract infections. Ann Int Med 82: 386 - 390, 1975.PubMedGoogle Scholar
  49. 49.
    Guttmann L, Frankel H: Value of intermittent catheterization in early management of traumatic paraplegia and tetraplegia. Paraplegia 4: 63 - 84, 1966.PubMedCrossRefGoogle Scholar
  50. 50.
    Vivian JM, Bors E: Experience with intermittent catheterization in southwest regional system for treatment of spinal injury. Paraplegia 12: 158 - 166, 1974.PubMedCrossRefGoogle Scholar
  51. 51.
    Ott R, Rossier AB: Importance of intermittent catheterization in bladder reeducation of acute traumatic spinal cord lesions. Proc Veterans Adm Spinal Cord Inj Conf 18: 139 - 148, 1971.PubMedGoogle Scholar
  52. 52.
    Perkash I: Intermittent catheterization and bladder rehabilitation in spinal cord injury patients. J Urol 114:230- 233, 1975.Google Scholar
  53. 53.
    Pearman JW: Urological follow-up of 99 spinal cord injured patients initially managed by intermittent catheterization. Brit J Urol 48: 297, 1976.PubMedCrossRefGoogle Scholar
  54. 54.
    Lapides J, Diokno AC, Silber SJ, Lowe BS: Clean intermittent self-catheterization in the treatment of urinary tract disease. J Urol 107: 458 - 461, 1972.PubMedGoogle Scholar
  55. 55.
    Anderson RU: Prophylaxis of bacteriuria during intermittent catheterization of the acute neurogenic bladder. J Urol 123: 364 - 366, 1980.PubMedGoogle Scholar
  56. 56.
    Orikasa S, Koyanagi T, Motomura M, Kudo T, Tozashi M, Tsuju I: Experience with non-sterile, intermittent self catheterization. J Urol 115: 141, 1976.PubMedGoogle Scholar
  57. 57.
    Anderson RU: Non-sterile intermittent catheterization with antibiotic prophylaxis in the acute spinal cord injured male patient. J Urol 124: 392 - 393, 1980.PubMedGoogle Scholar
  58. 58.
    Hirsh DD Fainstein V, Musher DM: Do condom catheter collecting systems cause urinary tract infection? JAMA 242: 340 - 341, 1979.PubMedCrossRefGoogle Scholar
  59. 59.
    Nanninga JB, Rosen J: Problems associated with the use of external urinary collectors in the male papaplegic. Paraplegia 13: 56 - 58, 1975.PubMedCrossRefGoogle Scholar
  60. 60.
    Manfredi RA, Leol FJ: Selective sacral rhizotomy for the spastic bladder syndrome in patients with spinal cord injuries. J Urol 100: 17, 1968.PubMedGoogle Scholar
  61. 61.
    Torrens MJ: The effect of selective sacral nerve blocks on vesical and urethral function. J Urol 112: 204, 1974.PubMedGoogle Scholar
  62. 62.
    Rockswold GL, Bradley WE: The use of sacral nerve blocks in the evaluation of neurologic bladder disorders. J Urol 118: 415, 1978.Google Scholar
  63. 63.
    Opitz JL: Bladder retraining. An organized program. Mayo Clin Proc 51: 367, 1976.PubMedGoogle Scholar
  64. 64.
    Kiviat MD, Zimmerman TA, Donovan WH: Sphincter stretch. A new technique resulting in continence and complete voiding in paraplegics. J Urol 114: 895, 1975.PubMedGoogle Scholar
  65. 65.
    Kegel AH: Stress incontinence and genital relaxation. Ciba Found Symp 4: 35, 1952.Google Scholar
  66. 66.
    Krauss DJ, Schoenrock GJ, Lilien OM: Reeducation of urethral sphincter mechanism in post-prostatectomy incontinence. Urology 5: 533, 1975.PubMedCrossRefGoogle Scholar
  67. 67.
    McKendry JBJ, Stewart DA, Jeffs RD, Mozes A: Enuresis treated by an improved waking apparatus. Can Med Assoc J 106: 27 - 29, 1972.PubMedGoogle Scholar
  68. 68.
    Borrie P, Fenton JCB: Buzzer ulcers. Brit Med J 2:151- 152, 1966.Google Scholar
  69. 69.
    Neal BW, Coote MA: Hazards of enuresis alarms. Letter to the editor. Arch Dis Child 44: 651, 1969.CrossRefGoogle Scholar
  70. 70.
    DeLuca FG, Sevenson O, Fisher JH, Loudfi AH: The dysfunctional ‘lazy’ bladder syndrome in children. Arch Dis Child 37: 117, 1962.PubMedCrossRefGoogle Scholar
  71. 71.
    Hinman F Jr, Baumann FW: Vesical and ureteral damage from voiding dysfunction in boys without neurologic or obstructive disease. J Urol 109: 727, 1973.PubMedGoogle Scholar
  72. 72.
    Allen TA: The non-neurogenic neurogenic bladder. J Urol 117: 232, 1977.PubMedGoogle Scholar
  73. 73.
    Birk L: Biofeedback. Furor therapeutics. Semin Psychiatry 5: 361 - 364, 1973.PubMedGoogle Scholar
  74. 74.
    El Badawi A, Schenk EA: Dual innervation of the mammalian urinary bladder. A histochemical study of distribution of cholinergic and adrenergic nerves. Am J Anat 119: 405, 1966.PubMedCrossRefGoogle Scholar
  75. 75.
    El Badawi A, Schenk EA: A new theory of the innervation of bladder musculature. I: Morphology of the intrinsic vesical innervation apparatus. J Urol 99: 585, 1968.PubMedGoogle Scholar
  76. 76.
    El Badawi A, Schenk EA: A new theory of the innervation of bladder musculature. II: The innervation apparatus of the ureterovesical junction. J Urol 105: 368, 1971.Google Scholar
  77. 77.
    El Badawi A, Schenk EA: A new theory of the innervation of bladder musculature. IV: Innervation of vesicourethral junction and external urethral sphincter. J Urol 111: 613, 1974.Google Scholar
  78. 78.
    DeGroat WC, Saum, WR: Adrenergic inhibition in mammalian parasympathetic ganglia. Nature New Biol 231: 188, 1971.CrossRefGoogle Scholar
  79. 79.
    Nergardh A, Boreus LO: The interaction between cholinergic and adrenergic receptor function in the outlet region of the urinary bladder. An in vitro study in the cat. Scand J Urol Nephrol 8: 108, 1974.PubMedCrossRefGoogle Scholar
  80. 80.
    Raezer DM, Wein AJ, Jacobowitz D, Corriere Jr JN: Autonomic innervation of canine urinary bladder. Cholinergic and adrenergic contributions and interaction of sympathetic and parasympathetic nervous systems in bladder function. Urology 2: 211, 1973.CrossRefGoogle Scholar
  81. 81.
    Awad SA, Bruce AW, Carro-Ciampi G, Downie JW, Lin M: Distribution of alpha and beta adrenoreceptors in human urinary bladder. Brit J Pharmacol 50: 525, 1974.Google Scholar
  82. 82.
    Raz S, Caine M: Adrenergic receptors in the female ca- We urethra. Invest Urol 9: 319, 1972.PubMedGoogle Scholar
  83. 83.
    Caine M, Raz S: Clinical implications of adrenergic receptors in the urinary tract. Arch Surg 110: 247, 1975.PubMedGoogle Scholar
  84. 84.
    Lapides J: Urecholine regimen for rehabilitating the atonic bladder. J Urol 91: 658, 1964.PubMedGoogle Scholar
  85. 85.
    Lapides J, Friend CR, Ajemian ER, Sonda LP. Comparison of oral and parenteral bethanechol chloride upon the urinary bladder. Invest Urol 1: 94, 1963.PubMedGoogle Scholar
  86. 86.
    Krane RJ, Olsson CA: Phenoxybenzamine in neurogenic bladder dysfunction. I: A theory of micturition. J Urol 110: 650, 1973.PubMedGoogle Scholar
  87. 87.
    Krane PJ, Olsson CA: Phenoxybenzamine in neurogenic bladder dysfunction. II: Clinical considerations. J Urol 110: 653, 1973.PubMedGoogle Scholar
  88. 88.
    Kleeman FJ: The physiology of the internal urinary sphincter. J Urol 104: 549, 1970.PubMedGoogle Scholar
  89. 89.
    Kleeman FJ: Phenoxybenzamine. Letter to the editor. J Urol 117: 814, 1977.PubMedGoogle Scholar
  90. 90.
    Mobley DF: Phenoxybenzamine in the management of neurogenic vesical dysfunction. J Urol 116: 737, 1976.PubMedGoogle Scholar
  91. 91.
    Kanna OP, Gonick P: Effects of phenoxybenzamine hydrochloride on canine lower urinary tract. Urology 6: 323, 1975.CrossRefGoogle Scholar
  92. 92.
    Khanna OP: Disorders of micturition. Neuropharmacologic basis and resuhs of drug therapy. Urology 8: 316, 1976.PubMedCrossRefGoogle Scholar
  93. 93.
    McGuire EJ, Wagner FM, Weiss RM: Treatment of autonomic dysreflexia with phenoxybenzamine. J Urol 115: 53, 1976.PubMedGoogle Scholar
  94. 94.
    Texter JH Jr, Reece RW, Hranowsky N: Pentolinium in the management of autonomic hyperreflexia. J Urol 116: 350 - 351, 1976.PubMedGoogle Scholar
  95. 95.
    Caine M, Pfau A, Perlberg S: The use of alpha-adrenergic blockers in benign prostatic obstruction. Brit J Urol 48: 255 - 263, 1976.PubMedGoogle Scholar
  96. 96.
    Pedersen E, Harving H, Klemar B: Effect of Dantrolene Sodium on the spastic external urethral sphincter recorded by sphincterometry. J Urol 119: 403, 1979.Google Scholar
  97. 97.
    Murdoch MM, Sax D, Krane RJ: Use of Dantrolene Sodium in external sphincter spasm. Urology 8: 133, 1976.CrossRefGoogle Scholar
  98. 98.
    Innes IR, Nickerson M: Atropine, scopolamine and related antimuscarinic dmp. In: Goodman LS, Gilman A (eds). The pharmacological basis of therapeutics. New York, Macmillan Co, 1975, 5th ed, pp 514-532.Google Scholar
  99. 99.
    Finkbeiner AE, Bissada NK, Welch LT: Uropharmacology. Part VI: Parasympathetic depressants. Urology 10: 503, 1977.PubMedCrossRefGoogle Scholar
  100. 100.
    Benson GS, Sarshik SA, Raezer DM, Wein AJ: Bladder muscle contractility. Comparative effects and mechanisms of action of atropine, propantheline, flavoxate and imi- pramine. Urology 9: 31, 1977.PubMedCrossRefGoogle Scholar
  101. 101.
    Lish PM, Labudde JA, Peters EL, Robbins SI: Oxybutynin. A musculotropic antispasmodic drug with moderate anticholinergic action. Arch Int Pharmacodyn 156: 467, 1965.PubMedGoogle Scholar
  102. 102.
    Diokno AC, Lapides J: Oxybutynin: A new drug with analgesic and anticholinergic properties. J Urol 108: 307, 1972.PubMedGoogle Scholar
  103. 103.
    Fredericks CM Green RL, Anderson GF: Comparative in vitro effects of Imipramine, Oxybutynin and Flavoxate on rabbit detrusor. Urology 12: 487, 1978.PubMedCrossRefGoogle Scholar
  104. 104.
    Wein AJ Hanno PM, Raezer DM, Benson GS: Effect of Oxybutynin Chloride on bladder spasm following transurethral surgery. Urology 12: 184, 1978.PubMedCrossRefGoogle Scholar
  105. 105.
    Bradley DV, Cazort RJ: Relief of bladder spasm by Flavoxate. A comparative study. J Clin Pharmacol 10: 65, 1970.Google Scholar
  106. 106.
    Gould S: Urinary tract disorders. Clinical comparison of Flavoxate and Phenazopyridine. Urology 5: 612, 1975.PubMedCrossRefGoogle Scholar
  107. 107.
    Kohler FP, Morales P: Cystometric evaluation of Flavoxate hydrochloride in normal and neurogenic bladders. J Urol 100: 729, 1968.PubMedGoogle Scholar
  108. 108.
    Diokno AC, Taub M: Ephedrine in treatment of urinary incontinence. Urology 5: 624, 1975.PubMedCrossRefGoogle Scholar
  109. 109.
    Finkbeiner AE, Bissada NK, Welch L: Uropharmacology. VIII: Sympathomimetic agents. Urology 11: 536, 1978.PubMedCrossRefGoogle Scholar
  110. 110.
    Stewart BH, Banowsky LHW, Montague DK: Stress incontinence: Conservative therapy with sympathomimetic drugs. J Urol 115: 558, 1976.PubMedGoogle Scholar
  111. 111.
    Montague DK, Stewart BH: Urethral pressure profiles before and after Omade administration in patient with stress urinary incontinence. J Urol 122: 198, 1979.PubMedGoogle Scholar
  112. 112.
    Byck R: Drugs and the treatment of pyschiatric disorders. In: Goodman LS, Gilman A (eds). The pharmacological basis of therapeutics. New York, Macmillan Co, 1975, 5th ed, pp 152-200.Google Scholar
  113. 113.
    Rohner TJ, Sanford EJ: Imipramine toxicity. J Urol 114: 402, 1975.PubMedGoogle Scholar

Copyright information

© Martinus Nijhoff Publishing, Boston / The Hague / Dordrecht / Lancaster 1984

Authors and Affiliations

  • Leonard D. Gaum
  • William R. Fair

There are no affiliations available

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