B G Wise

King's College London, Londinium, England, United Kingdom

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Publications (11)25.17 Total impact

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    ABSTRACT: A prospective randomised double-blind placebo-controlled trial of 17-beta oestradiol 25-mg vaginal tablets or placebo daily for 12 weeks was undertaken in 110 postmenopausal women with urinary frequency, urgency and/or urge incontinence recruited from a tertiary referral urogynaecology clinic. After 3 months the only statistically significant difference was a greater reduction in urinary urgency in those women with sensory urgency treated with 17-beta oestradiol compared to placebo. This may be due to the effective treatment of local vaginal atrophy by low-dose oestrogen rather than any effect on the lower urinary tract.
    Journal of Obstetrics and Gynaecology 08/2001; 21(4):383-5. · 0.55 Impact Factor
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    ABSTRACT: The phenomenon of urethral instability has been poorly defined and its significance is disputed. The aim of this study was to investigate the prevalence and significance of urethral instability in a group of women with idiopathic detrusor instability. Urethral instability was defined as a spontaneous fall in maximum urethral pressure of one-third or more, in the absence of detrusor activity, over a 2-min period. Urethral instability occurred in 42% of patients with detrusor instability and was strongly associated with the sequence of relaxation of the urethra prior to unprovoked detrusor contraction. Women with detrusor instability and a stable urethra exhibited primary contraction of the detrusor. The symptom of stress incontinence was more common in women with urethral instability. Women with detrusor instability may be subdivided into 2 groups on the basis of urethral instability, the presence of which suggests a primary dysfunction of the urethra. Such patients may derive more benefit from treatment with an alpha adrenoceptor agonist in addition to (or instead of) standard anticholinergic therapy.
    British Journal of Urology 08/1993; 72(1):26-9.
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    ABSTRACT: Nine women with primary ovarian failure, who were having their artificial menstrual cycles manipulated with physiological levels of estrogen and high doses of progesterone, were entered into the study. They filled in urinary symptom questionnaires and had urodynamic investigations in the two phases of treatment: estrogen and progesterone, and estrogen alone. The number of voids per 24 hours was significantly greater in the progesterone phase, as was the end filling pressure on cystometry. This is the first report in the literature of the effects of high-dose progesterone on the lower urinary tract.
    International Urogynecology Journal 01/1993; 4(5):259-261. · 2.17 Impact Factor
  • B. G. Wise, L. D. Cardozo
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    ABSTRACT: Detrusor instability is a common cause of urinary symptoms, including incontinence. It severely affects the quality of life of thousands of women and at present many of the available treatments lack efficacy, specificity, or are associated with unacceptable side effects. The treatment methods currently in use will be reviewed.
    International Urogynecology Journal 08/1992; 3(3):229-237. · 2.17 Impact Factor
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    ABSTRACT: Vaginal ultrasonography has been advocated as an alternative to videocystourethrography. Ultrasound avoids the potential risks of X-rays and reduces the cost of equipment. We have investigated the effect of the vaginal probe on the physiology of the bladder and urethra. A series of 24 women underwent urethral pressure profilometry, with and without a vaginal probe in situ. There was a significant increase in maximum urethral pressure, functional urethral length and area under the profile curve both at rest and during stress in the presence of the device. This was due to stretching and compression of the urethra by the probe. Transmission pressure ratios were significantly increased for the first 3 quartiles of the urethra. Twenty women underwent lateral bead chain urethrocystography with and without a vaginal probe. At rest, the probe resulted in elevation of the bladder neck and apposition to the symphysis pubis, and during a Valsalva manoeuvre the descent of the bladder neck was restricted by the presence of the probe. These results indicate that a vaginal probe alters the position and function of the lower urinary tract. We postulate that incontinence is reduced as a result of the probe. The use of vaginal ultrasonography in the assessment of women with urinary incontinence is therefore not recommended.
    British Journal of Urology 08/1992; 70(1):12-6.
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    ABSTRACT: Twenty-three postpartum women underwent perineal ultrasonography to determine bladder neck position at rest, on Valsalva and during pelvic floor contraction. On Valsalva, significant descent of the bladder neck and apposition to the symphysis pubis occurred. During pelvic floor contraction, there was significant elevation of the bladder neck; however, in approximately one-third of cases no movement was demonstrated. The bladder neck was shown to move through the arc of a circle whose center is the inferior border of the symphysis pubis. Perineal ultrasound provides a simple, objective way of measuring bladder neck elevation during pelvic floor contraction. This may be a more appropriate means of determining treatment outcome, in women undergoing conservative treatment for genuine stress incontinence, than measures of vaginal squeeze pressure.
    Ultrasound in Obstetrics and Gynecology 04/1992; 2(2):116-20. · 3.56 Impact Factor
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    BMJ Clinical Research 02/1992; 304(6819):119-20. · 14.09 Impact Factor
  • B. G. Wise, L. D. Cardozo
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    ABSTRACT: The term ‘urge syndrome’ is used to describe a clinical condition which presents with a characteristic combination of urinary symptoms, comprising; urgency, urge incontinence, frequency, nocturia, and sometimes dysuria. Such symptoms are referred to as irritative and hence the label of an ‘irritable bladder’ is sometimes ascribed to these women. Whilst implying a particular clinical picture, the term ‘urge syndrome’ is not a diagnosis. Each urinary symptom may occur alone, or in combination, and so the range of possible presentations and underlying diagnoses is wide. The condition may arise as a result of gynaecological, urological, medical, or even psychological pathology, so each patient must be assessed carefully in order to ensure appropriate management.
    Current Obstetrics and Gynaecology 01/1992; 2(2):105-110.
  • A Cutner, L D Cardozo, B G Wise
    British Journal of Obstetrics and Gynaecology 12/1991; 98(11):1181-3.
  • B Wise, L Cardozo
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    ABSTRACT: Urinary incontinence remains a common problem that adversely affects the quality of life of millions of women. In detrusor instability, treatment measures often lack efficacy or are accompanied by unacceptable side effects. In this review, standard treatments are discussed, together with recent pharmacologic advances and the introduction of newer techniques including maximal electrical stimulation. The nonsurgical treatment options currently available for genuine stress incontinence are considered in the light of recent advances.
    Current Opinion in Obstetrics and Gynecology 09/1991; 3(4):520-7. · 2.64 Impact Factor
  • B G Wise, L D Cardozo
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    ABSTRACT: Urinary urgency is a common unpleasant symptom which may result from a variety of different pathologies. Careful patient assessment and appropriate investigation allow the cause to be elucidated and treated effectively in most cases. However, further research is necessary to increase our understanding of these disorders and to improve the quality of life of the women affected by them.
    British journal of hospital medicine 50(5):243-50.