L Jørgensen’s research while affiliated with University of Copenhagen and other places

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Publications (24)


Acute Effect of Norfenefrine on the Urethral Pressure Profile in Females with Genuine Stress Incontinence
  • Article

February 1991

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8 Reads

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4 Citations

Urologia Internationalis

Lisbeth Jørgensen

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Niels Alexander

To study the acute effect of norfenefrine, given orally in aqueous solution, on the urethral closure function, profilometry was performed before and after administration of placebo and increasing doses of norfenefrine in 6 females with genuine stress incontinence. A weak increase in urethral pressure was observed after administration of 90 mg of norfenefrine. No changes in heart rate and blood pressure occurred. The results indicate that the direct sympathomimetic effect of norfenefrine is weak. It is suggested that norfenefrine mainly acts via indirect mechanisms.


Variations in Urethral and Bladder Pressure during Stress Episodes in Healthy Women

November 1990

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7 Reads

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36 Citations

British Journal of Urology

Pressure variations in the urethra and bladder during stress episodes and their time separations were investigated in 30 healthy female volunteers. The pressure was measured by means of a double microtip transducer catheter with the distal sensor in the bladder and the proximal sensor at the bladder neck, the mid-urethra and the distal urethra. In advance of the pressure spike during cough a pressure rise was demonstrated in the bladder and at all 3 sites of measurement in the urethra. The urethral pressure increments preceding and following the pressure spike were statistically significantly higher in the mid-urethra than the corresponding bladder pressures. This active urethral pressure generation in the mid-urethra and distal urethra was initiated 200 ms before the bladder pressure began to rise. The pressure in the urethral high pressure zone was higher than the bladder pressure in all cases. Passive pressure transmission to the urethral high pressure zone can take place only insignificantly due to a continuous higher pressure inside the urethra than in the bladder and due to the location of the high pressure zone in the demarcation of the abdominal cavity. It was concluded that the urethral pressure rise in the high pressure zone during stress episodes is mainly generated actively by intra- and/or peri-urethral structures.


Doxepin in the Treatment of Female Detrusor Overactivity: A Randomized Double-Blind Crossover Study

November 1989

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5 Reads

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53 Citations

The Journal of Urology

A total of 19 women with detrusor overactivity and associated symptoms completed a double-blind placebo-controlled crossover study of doxepin. All patients had previously failed to respond to conventional pharmacotherapy. Doxepin was given at bedtime in a single 50 mg. dose for the first 2 weeks and, if needed, the dose was increased with 25 mg. in the morning for the last week of the 3-week treatment period, which was followed by 2 weeks of washout before crossover. The preference for doxepin to placebo was statistically significant (p less than 0.01). Doxepin caused a significant decrease in the nighttime micturition frequency and the nighttime incontinence episodes (p less than 0.05). Urine loss at the standardized 1-hour pad weighing test decreased significantly during treatment with doxepin although statistical significance (p equals 0.07) was not obtained. Cystometric parameters (first sensation and maximum cystometric capacity) improved significantly during treatment with doxepin (p less than 0.06 and less than 0.04, respectively). Side effects were frequent but mild. Suggestions for use of this tricyclic antidepressant in women with detrusor overactivity and possible mechanisms of action are discussed.


24-Hour home pad weighing test versus 1-hour ward test in the assessment of mild stress incontinence

February 1989

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75 Reads

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76 Citations

Acta Obstetricia et Gynecologica Scandinavica

Twenty-three normal volunteers and 31 women admitted for stress or mixed incontinence underwent two 24-hour home pad weighing tests. In the patients the test result was compared with the result obtained with the 1-hour ward pad weighing test. Median pad weight gain was 4 g/24-h, with an upper 99% limit of 8 g/24 h in normal women. The median urine loss was 17 g/24-h in the patients. Eighteen (58%) patients were classified as incontinent according to the result of the 1-h ward test, versus 28 (90%) according to the result of the 24-h home test. There was no significant correlation between the result of the 1-h test and the 24-h test. In the patients, test-retest analysis showed a significant variation in the result of the 24-h test. It is concluded that the better of two 24-h home tests is more sensitive for confirmation incontinence than is one 1-h ward test. Consequently, the 24-h home test is of practical use as a screening test for incontinence. The reproducibility of the test, however, seems insufficiently satisfactory to allow of its use in comparative scientific studies.


Effect of urethral catheterization on urethral sphincter EMG and pressure profile

January 1989

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29 Reads

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6 Citations

Neurourology and Urodynamics

The impact on urethral sphincter EMG and pressure profile of the introduction of a catheter per urethram was assessed in 48 women with various voiding dysfunctions. Urethral EMG activity was recorded with vaginal surface electrodes placed behind the midurethra. A 5F urethral profile catheter was used in 13 patients (group I), an 8F in 23 patients (group II), and a 10F in 12 patients (group III). In all three groups a statistically significantly increased EMG activity was observed following the introduction of the catheter. This increased activity ceased after a median time of 3–5 minutes. The increased EMG activity did not affect the maximum urethral closure pressure and functional profile length. No correlation could be established between changes in EMG activity and changes in urethral closure pressure. It is concluded that the increased sphincter EMG activity provoked by catheterisation does not affect the urethral pressure profile significantly.


Spontaneus versus intubated flow in male patients

January 1989

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7 Reads

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11 Citations

Urology

The spontaneous flow rate was compared with the flow rate obtained during a pressure-flow study with two 5F catheters in the urethra, in 57 male patients with various lower urinary tract disorders. Intubation caused a median decrease in maximum flow rate of 1 mL/sec (95% confidence limits 0-2 mL/sec). In patients with infravesical obstruction a significant decrease in maximum and mean flow rates was found whereas the flow rate was unchanged in the group of patients without obstruction. It seems that changes in flow rate due to intubation of the urethra is of minor importance compared with other factors and intubation may actually provide diagnostic information in diagnosing mechanical obstruction. It is concluded that the transurethral technique for pressure-flow studies offers a simple and reliable method for obtaining simultaneous pressure-flow values. It can be performed without further invasion in conjunction with cystometry. Therefore this technique is recommended in the urodynamic testing of male patients with lower urinary tract disorders.


24Hour Home Par Weighing Test Versus 1Hour Ward Test in the Assessment of Mild Stress Incontinence

January 1989

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18 Reads

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68 Citations

Twenty-three normal volunteers and 31 women admitted for stress or mixed incontinence underwent two 24-hour home pad weighing tests. In the patients the test result was compared with the result obtained with the 1-hour ward pad weighing test. Median pad weight gain was 4 g/24-h, with an upper 99% limit of 8 9/24 h in normal women. The median urine loss was 17 g/24-h in the patients. Eighteen (58%) patients were classified as incontinent according to the result of the 1-h ward test, versus 28 (90%) according to the result of the 24-h home test. There was no significant correlation between the result of the 1-h test and the 24-h test. In the patients, test-retest analysis showed a significant variation in the result of the 24-h test. It is concluded that the better of two 24-h home tests is more sensitive for confirmation incontinence than is one 1-h ward test. Consequently, the 24-h home test is of practical use as a screening test for incontinence. The reproducibility of the test, however, seems insufficiently satisfactory to allow of its use in comparative scientific studies.




Pressure variations in the female urethra measured by the infusion technique: Is it an artifact?

January 1988

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12 Reads

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12 Citations

Neurourology and Urodynamics

The aim of this study was to investigate the possibility that pressure variation in the female urethra, as registered by the Brown-Wickham technique, is an artifact due to infusion of fluid into the urethra. Sixteen women with various lower urinary tract disorders underwent pressure registration in the urethral high pressure zone for 5 minutes using the infusion method, followed by pressure registration using a water column pressure head. In nine patients, well-defined pressure variations were observed during infusion; similar stepwise pressure decreases were found in these patients using the water column method. Because the stepwise decreases with the latter method can be due only to genuine relaxations of the urethral wall, obtaining similar patterns with these two techniques indicates that the infusion method is reliable in detecting urethral pressure variations.


Citations (14)


... Nineteen (30.2%) women had preoperative DO, and after surgery it disappeared in 74% of them. These results are supported by data from other studies after vaginal or abdominal POP repair [17][18][19][20]. In contrast, Kummeling [2] and Abdullah [6] showed no statistically significant decrease in DO after LSC. ...

Reference:

Urodynamic findings and functional outcomes after laparoscopic sacrocolpopexy for symptomatic pelvic organ prolapse
Vaginal Repair in Female Motor Urge Incontinence
  • Citing Article
  • January 1987

European Urology

... The difference in weight corresponds to the volume of urine lost. Both short-(1 h) and longterm pad tests (24-48 h) have been described, although reliability has been shown to be greater for the longer-term tests [20]. ...

Diagnosis of mild stress incontinence in females: 24-hour pad weighing test versus the one-hour test
  • Citing Article
  • January 1987

Neurourology and Urodynamics

... Those studies relying on the shorter tests (1, 2 and 8 hours) have the benefit of better standardization [3], at the cost of poor reliability [8,9]. While the longer test (24 h) is validated with respect to both reliability and validity [3,8,10]. the 24-h pad test is neither invasive nor requires a clinic appointment. However, participants in a recent study [11] reported the 24-h pad test to be the least favored, second only to urodynamic testing. ...

24Hour Home Par Weighing Test Versus 1Hour Ward Test in the Assessment of Mild Stress Incontinence
  • Citing Article
  • January 1989

... Contrary to the present CFD analyses and previous works, a comparative study of spontaneous and 5 Fr catheterized urinary flow in 60 female patients noted even, in presence of a catheter, an improved voiding with an increase in the maximum flow rate [12] . It should be noted that in these works the direct comparison of the flow rates with or without the catheter under the assumptions of the same pressure conditions is a quite strong hypothesis, as suggested by other studies [ 9 , 29 , 30 ], due to the potential increase in the bladder pressure for the presence of the catheter. ...

Comparison of spontaneous and intubated urinary flow in female patients
  • Citing Article
  • January 1986

Neurourology and Urodynamics

... However, whether these urethral pressure variations are linked to OAB/DO has been a matter of debate. The existence of urethral pressure variations during filling cystometry is well documented in symptomatic patients 40 and asymptomatic controls. 41 DO could be a "physiological answer" to urethral relaxation. ...

Pressure variations in the female urethra measured by the infusion technique: Is it an artifact?
  • Citing Article
  • January 1988

Neurourology and Urodynamics

... [7][8][9] On the basis of that knowledge, α 1 -adrenergic receptor agonists (most commonly phenylpropanolamine and ephedrine) have been used for treatment of stress incontinence in women and for treatment of USMI in dogs. 10-20 Results of experimental and clinical studies 12,15,16,19,[21][22][23][24] in humans and dogs indicate that an increase in MUCP (ie, the difference between MUP and bladder pressure) develops in association with administration of α-adrenoceptor agonists. However, adverse effects such as increased blood pressure, tachycardia, headaches, and dizziness have been reported 16,25-27 in humans taking phenylpropanolamine or ephedrine, which were available in many over-the-counter dietetic preparations. ...

Acute Effect of Norfenefrine on the Urethral Pressure Profile in Females with Genuine Stress Incontinence
  • Citing Article
  • February 1991

Urologia Internationalis

... The rapid decline in distal pressure would suggest rapid fatigue of the male SUS, which concurs with observations of the anal sphincter [8]. The greatest increases in urethral pressure in the female urethra consistently occurred adjacent to the SUS, which concurs with earlier findings of maximum pressure at this location in females [3,[25][26][27]. ...

Variations in Urethral and Bladder Pressure during Stress Episodes in Healthy Women
  • Citing Article
  • November 1990

British Journal of Urology

... 17 Nonetheless, conflicting results exist in the literature regarding the reproducibility of both 1-hour 18,19 and 24-hour pad tests. 20,21 Considering the wide variation of repeated 1-hour pad tests (mean, 10 g [range, −44 to 66 g), 18 the reproducibility of the 1-hour pad test may not be as good as the 24-hour test, which has a repeatability of 0.72 (Lin concordance correlation coefficient). 20 Secondary outcomes included the change from baseline in the amount of urine leakage at week 2; the mean 72-hour urinary incontinence episodes measured by a 72-hour bladder diary (72-hour incontinence episodes) during weeks 1 to 6, 15 to 18, and 27 to 30; the proportion of participants with at least 50% decrease from baseline in the amount of urine leakage measured by pad at week 6 and in the mean 72-hour incontinence episodes during weeks 1 to 6, 15 to 18, and 27 to 30; the participant-reported severity of SUI (mild, leaking several drops; moderate, soaking the underwear; severe, soaking the outerwear 22 ) during weeks 1 to 6, 15 to 18, and 27 to 30; the change from baseline in the validated Chinese version International Consultation on Incontinence Questionnaire-Short Form 23 scores (range, 0 [best]-21 [worst] outcomes, and 2.52 as minimal clinically important differences 24 ); and the participants' self-evaluation of therapeutic effects (no help, little help, medium help, great help) at weeks 6, 18, and 30; the number of urine pads used; and use of other treatments for SUI during weeks 1 to 6, 7 to 18, and 19 to 30. ...

24-Hour home pad weighing test versus 1-hour ward test in the assessment of mild stress incontinence
  • Citing Article
  • February 1989

Acta Obstetricia et Gynecologica Scandinavica

... The drug and its product(s) are available in the market for about 55 years. The drug is used for multitude indications viz anti-depression 7 , insomnia management 7 , anti-viral activity 8 , oral Mucositis control and its pain management 9, anti-inflammatory 10 , antipruritic 11 , tinnitus reduction 12 , analgesic acitivity 13 , antihistaminic 14 , anxiolytic 15 , visual hallucination reduction 16 , for systemic allergic dermatitis 17 , prostate cancer 18 , depressive neurosis 19 , for generalized anxiety disorder 20 , as local anaesthetic 21 , treatment of detrusor overactivity in females 22 , for atopic eczema 23 , anti seizure 24 , anti mania 25 , management of advanced cancer pain 26 , management of fibromyalgia 27 , for opiate withdrawal syndrome 28 , for smoking cessation 29 , for cluster headache 30 ...

Doxepin in the Treatment of Female Detrusor Overactivity: A Randomized Double-Blind Crossover Study
  • Citing Article
  • November 1989

The Journal of Urology

... questions about the potential obstructive nature of the transurethral catheterization during the PFS. A recent study [7] has confirmed its obstructive nature in women while others [8][9][10][11][12] have also found similar results in men. However, both in men and women, other authors have failed to show such results. ...

Spontaneus versus intubated flow in male patients
  • Citing Article
  • January 1989

Urology