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Voluntary Versus Reflex micturition Control
Naoki Yoshimura, Michael B. Chancellor, Takeya Kitta, Teruyuki Osawa, and William C. de Groat
Publication Date: 2023
The functions of the lower urinary tract to store and periodically eliminate urine are regulated by a complex neural control system in the brain, spinal cord, and peripheral autonomic ganglia that coordinate the activity of smooth and striated muscles of the bladder and urethral outlet. Although the neural units that can induce contraction and relaxation of the bladder and urethra are located in the lumbosacral spinal cord and peripheral nervous pathways, the coordination between different components of the lower urinary tract necessary for efficient micturition requires a hierarchical neural system, in which spinal storage mechanisms are in turn regulated by circuitry in the rostral brainstem that initiates reflex voiding. Then, voluntary micturition depends on suprapontine inputs from the forebrain that modulate the brainstem circuitry. Many neural circuits controlling the lower urinary tract exhibit switch-like patterns of activity that turn on and off in an all-or-none manner. The major component of the reflex micturition is a spinobulbospinal pathway that has essential connections between the lumbosacral spinal cord and brainstem structures such as the periaqueductal gray matter and Pontine micturition center, which can induce bladder contractions and reciprocal urethral relaxation during voiding. However, these suprapontine and spinobulbospinal pathways, which are responsible for voluntary and reflex voiding, respectively, are still immature in infants and young children, resulting in involuntary voiding, and are often impaired in adults due to diseases or injuries of the nervous system, leading to reemergence of involuntary micturition and urinary incontinence. This chapter summarizes anatomical, neurophysiological, pharmacological, and brain imaging studies in humans and animals that have provided insights into the neural circuitry and neurotransmitter mechanisms controlling voluntary and reflex micturition.
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Anatomic Neurourology
Annah Vollstedt, Larry Sirls, and Kenneth Peters
Publication Date: 10-12-2022
Up to date with current diagnosis and treatment of all female pelvic floor dysfunctions, including urinary incontinence and other lower urinary tract conditions, disorders of the anus and rectum, and disorders of pelvic support. Thorough updates include revised and rewritten content throughout, new full-color illustrations, new surgical videos, new chapters on current clinical topics, and much more.
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Surgical reconstruction of buried penis
Paul J. Rusilko, Thomas W. Fuller, and Frank Burks
Publication Date: 2020
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Botulinum toxin treatment in urological disorders
Christopher P. Smith and Michael B. Chancellor
Publication Date: 2020
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Diagnosis and management of localized prostate cancer
Brett Watson, Pamela Jones, and Jason Hafron
Publication Date: 2020
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Pathophysiology of Detrusor Underactivity/Acontractile Detrusor
Michael B. Chancellor
Publication Date: 8-3-2015
According to the standardization of terminology from the International Continence Society, 1 detrusor under-activity (DU) is urodynamically defined as a contraction of reduced strength and/or duration, resulting in prolonged bladder emptying and/or a failure to achieve complete bladder emptying within a normal time span. Acontractile detrusor (AD) is one that cannot be demonstrated to contract during urodynamic studies. DU or AD (DU/AD) can be developed from various kinds of conditions, when afferent and/or efferent pathways innervating the bladder are mainly damaged. Various myogenic factors in detrusor muscles also cause AD as well as DU.
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The Underactive Bladder
Michael B. Chancellor and Ananias C. Diokno
Publication Date: 11-24-2015
This book provides up-to-date guidance on optimal care of the patient with an underactive bladder. It covers all aspects of management, including clinical evaluation, urodynamic diagnosis, standard care, drug therapy, and emerging treatment options. Nursing issues are extensively discussed, and advice offered on the use of catheters and avoidance of catheter-related complications. Further chapters address epidemiology, pathophysiology, animal modeling, and health care costs.
While most practitioners are familiar with overactive bladder, the converse condition of underactive bladder has generally remained far below the radar. As a consequence, there is still a lack of empirically validated treatments and effective treatment strategies. This is a matter of concern, especially as the burden of the condition is expected to rise in line with the aging of global populations. The Underactive Bladder is a major step forward in raising awareness, exploring best practices in patient care, and searching for future therapies. It will be invaluable for urologists, geriatricians, other specialists, researchers, and nurses.
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Underactive Bladder in Older Adults
Laura E. Lamb and Michael B. Chancellor
Publication Date: 12-11-2015
Overactive bladder is one of the most common bladder problems, but an estimated 20 million Americans have underactive bladder (UAB), which makes going to the bathroom difficult, increases the risk of urinary tract infections, and even leads to institutionalization. This article provides an overview of UAB in older adults, and discusses the prevalence, predisposing factors, cause, clinical investigations, and treatments. At present, there is no effective therapy for UAB. A great deal of work still needs to be done on understanding the pathogenesis and the development of effective therapies.
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Botulinum Toxin in Urology
Michael B. Chancellor
Publication Date: 6-24-2011
The minimally invasive use of botulinum toxin (BoNT) in the lower urinary tract has revolutionized the treatment of debilitating bladder, urethra, and prostate conditions refractory to conventional therapy. This is the first book focusing on the practical application of BoNT to the genitourinary tract. An introductory section discusses the biology, pharmacology, and safety of BoNT in the lower urinary tract. Applications of BoNT in the bladder and the prostate and pelvic floor are then covered in detail, with reviews of the latest clinical series and techniques of BoNT injection in both adults and children. The book closes by considering non-genitourinary uses of BoNT and addressing issues of health economics as well as providing insights from experts from across the world. This is a practical, hands-on book that also includes appendices containing easy to read instructions for patients undergoing bladder and prostate BoNT injections and specific nursing procedural issues.
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Atlas of Urodynamics
Michael B. Chancellor
Publication Date: 8-14-2007
By pairing the highest quality images with succinct text, this fully revised atlas explains methods of diagnosis, evaluation and treatment. Detailing how to set up a urodynamic laboratory and discusses equipment and individual urodynamic techniques Illustrating neurologic conditions, looking at the special problems of pediatric and geriatric patients With unique, carefully reproduced urodynamic tracings and scans show you what to expect in the lab The highly regarded author team is led by Dr. Jerry Blaivas, a recognized expert in the field who received the Lifetime Achievement Award from the Society for Urodynamics and Female Urology.
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