The Experts below are selected from a list of 132 Experts worldwide ranked by ideXlab platform
Lowell C Parsons - One of the best experts on this subject based on the ideXlab platform.
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the role of a leaky epithelium and potassium in the generation of bladder symptoms in interstitial cystitis overactive bladder Urethral Syndrome prostatitis and gynaecological chronic pelvic pain
BJUI, 2011Co-Authors: Lowell C ParsonsAbstract:What’s known on the subject? and What does the study add? This article reviews entirely new concepts concerning the etiology, presentation and diagnosis of interstitial cystitis. It pulls the information together in a concise fashion that emphasizes there is a radical change taking place in the concepts of what generates bladder symptoms. Primarily this emphasizes that the paradigm for interstitial cysititis and the generation of bladder symptoms is going to change dramatically. The data reviewed shows that the symptoms are caused by a leaky epithelium and subsequent diffusion of potassium into the tissues causing frequency, urgency, pain and incontinence. This is totally different from current concepts. The traditional diagnosis of interstitial cystitis (IC) only recognizes the severe form of the disease. The far more common early and intermittent phases of the disease are not perceived to be part of IC but rather are misdiagnosed as urinary tract infection, Urethral Syndrome, overactive bladder, chronic prostatitis, urethritis, or a type of gynecologic pelvic pain (such as endometriosis, vulvodynia, or some type of vaginitis). All of these patient groups actually suffer from the same bladder disease. This disease results from a leaky bladder epithelium and subsequent potassium leakage into the bladder interstitium that generates the symptoms of frequency, urgency, pain or incontinence in any combination. Robust scientific data now support this important concept. These data will be reviewed herein. The conclusions derived from these data substantially alter the paradigms for urology and gynecology in the generation of frequency, urgency and pelvic pain. All the above-mentioned Syndromes unite into one primary disease process, lower urinary dysfunction epithelium, or LUDE disease, and not the 10 plus Syndromes traditionally recognized.
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the role of a leaky epithelium and potassium in the generation of bladder symptoms in interstitial cystitis overactive bladder Urethral Syndrome prostatitis and gynaecological chronic pelvic pain
BJUI, 2011Co-Authors: Lowell C ParsonsAbstract:The traditional diagnosis of interstitial cystitis (IC) only recognizes the severe form of the disease. The far more common early and intermittent phases of the disease are not perceived to be part of IC but rather are misdiagnosed as urinary tract infection, Urethral Syndrome, overactive bladder, chronic prostatitis, urethritis, or a type of gynecologic pelvic pain (such as endometriosis, vulvodynia, or some type of vaginitis). All of these patient groups actually suffer from the same bladder disease. This disease results from a leaky bladder epithelium and subsequent potassium leakage into the bladder interstitium that generates the symptoms of frequency, urgency, pain or incontinence in any combination. Robust scientific data now support this important concept. These data will be reviewed herein. The conclusions derived from these data substantially alter the paradigms for urology and gynecology in the generation of frequency, urgency and pelvic pain. All the above-mentioned Syndromes unite into one primary disease process, lower urinary dysfunction epithelium, or LUDE disease, and not the 10 plus Syndromes traditionally recognized.
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prostatitis interstitial cystitis chronic pelvic pain and Urethral Syndrome share a common pathophysiology lower urinary dysfunctional epithelium and potassium recycling
Urology, 2003Co-Authors: Lowell C ParsonsAbstract:S we fail to “see the forest for the trees.” In recent years, medical science has made substantial advances in understanding the pathophysiology of interstitial cystitis (IC). The disease still goes unrecognized in most affected individuals, however. Of the clinical symptoms of IC, urinary frequency/urgency has an obvious source, but pain can be referred to one or more locations throughout the pelvis in any combination.1–3 Unless the pain is perceived in the bladder or urethra, its origin is more difficult to identify. As a result, the patient who has frequency/urgency and/or pelvic pain may receive any of a variety of diagnoses. An abundance of recent data shows that many patients aged 55 years or younger, male or female, who present to a physician with a complaint of urinary urgency and/or pelvic pain in any combination suffer from one primary pathophysiologic disorder: an epithelial dysfunction in the lower urinary tract.2–6 This disorder can be called “lower urinary dysfunctional epithelium” (LUDE). On the basis of extensive evidence of the biochemical events that trigger symptoms and injure tissue in LUDE, a new paradigm can be constructed for IC that will aid in the diagnosis and treatment of this disease process. The goal of this review was to place new research findings into a broad and evidence-based perspective that will help the physician to diagnose IC readily and to direct therapy that relieves the patient’s symptoms and results in a real impact on disease outcome.
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intravesical potassium sensitivity in patients with interstitial cystitis and Urethral Syndrome
Urology, 2001Co-Authors: Lowell C Parsons, Paul Zupkas, Kellogg J ParsonsAbstract:Abstract Objectives. To examine populations with diagnosed clinical interstitial cystitis (IC) and Urethral Syndrome and normal controls using the potassium sensitivity test (PST), to determine the incidence of PST-provoked pain and/or urgency, and to document the type and location of IC and Urethral Syndrome pain, association of pain with sexual intercourse, and family history of female urgency/frequency problems. Methods. The PST and a questionnaire were administered to 466 patients with clinical IC, 116 patients with Urethral Syndrome, and 42 controls. Results. The PST was positive in 78% of patients with clinical IC, in 55% of patients with Urethral Syndrome, and in 0% of the controls. Of the patients with clinical IC, 9% responded to the PST with pain only and 8% with urgency only. Patients with clinical IC reported the pain as dysuria (58%), Urethral/vaginal (76%), above the pubic bone (53%), lower abdomen (47%), lower back (35%), vaginal (51%), and inguinal (28%). The results were similar for patients with Urethral Syndrome. Of the sexually active men and women, 71% with clinical IC and 59% with Urethral Syndrome reported pain associated with intercourse. Urgency/frequency problems in female relatives were reported by 35% of patients with IC and 33% of those with Urethral Syndrome. Conclusions. The significant potassium sensitivity in both patients with clinical IC and those with Urethral Syndrome and the absence of potassium sensitivity in normal controls indicates that a positive PST suggests the presence of an abnormal bladder epithelium. The lower rate of positive PSTs in patients with Urethral Syndrome reflects the less severe, more intermittent, nature of the symptoms in Urethral Syndrome (early IC). Pelvic pain of bladder origin may occur anywhere in the pelvis. Finally, IC appears to have a genetic component.
A S Arunkalaivanan - One of the best experts on this subject based on the ideXlab platform.
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Urethral Syndrome response to alpha adrenergic blocking agents
International Urogynecology Journal, 2006Co-Authors: Deepali Sinha, A S ArunkalaivananAbstract:Urethral Syndrome patients have irritative bladder symptoms in the absence of any objective urological findings. While not life threatening, it can have a severe disruptive effect on the quality of life. Attempts at symptom control are not always effective because of lack of clarity about the underlying aetiology. We describe a case of a 27-year-old patient whose irritative bladder symptoms showed response to alpha-adrenergic blocking agents on two separate occasions during the course of her treatment.
Louis-jacques Van Bogaert - One of the best experts on this subject based on the ideXlab platform.
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Surgical Repair of Hypospadias in Women with Symptoms of Urethral Syndrome
The Journal of Urology, 1992Co-Authors: Louis-jacques Van BogaertAbstract:AbstractA total of 6 cases of female hypospadias is reported. All patients complained of the Urethral Syndrome, which as a rule started when regular sexual intercourse was begun. All patients had previously been unsuccessfully treated medically during at least 2 years before the correct diagnosis was made and surgical treatment was performed. Urethral meatus transposition was successful in all cases by permanently alleviating the urinary and vaginal discomfort.
Visnja Skerk - One of the best experts on this subject based on the ideXlab platform.
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duration of clinical symptoms in female patients with acute Urethral Syndrome caused by chlamydia trachomatis treated with azithromycin or doxycycline
Journal of Chemotherapy, 2001Co-Authors: Visnja Skerk, Slavko Schonwald, Z Strapac, Antun Beus, Igor Francetic, Ivan Krhen, Vesna Lesko, Jagoda VukovicAbstract:AbstractOne hundred fifty-one female patients with acute Urethral Syndrome caused by Chlamydia trachomatis were examined. First, patients were divided into two groups, those with clinical symptoms present 3 weeks prior to the beginning of therapy. Then patients were further divided into groups and randomized to receive azithromycin once daily in a single dose of 1.0 g or 500 mg once daily for 6 days, or to receive doxycycline 100 mg b.i.d. for 14 days or 100 mg b.i.d. for 7 days (8 study groups in all). Clinical and bacteriological efficacy was evaluated 3 weeks after the end of therapy. In the group of patients with disease symptoms lasting for 3 weeks or longer, the eradication and clinical cure rates were significantly higher after administration of azithromycin in a dose of 1x500 mg/6 days than after a single dose of 1.0 g (p<0.01), and after administration of doxycycline 2x100 mg/14 days than by using doxycycline 2x100 mg/7 day...
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azithromycin and doxycycline in the treatment of female patients with acute Urethral Syndrome caused by ureaplasma urealyticum significance of duration of clinical symptoms
Drugs Under Experimental and Clinical Research, 2001Co-Authors: Visnja Skerk, Slavko Schonwald, Z Strapac, Ivan Krhen, M Rusinovic, Jacinta VukovicAbstract:One hundred ninety-two female patients with acute Urethral Syndrome caused by Ureaplasma urealyticum were examined. First, patients were divided into two groups: those with clinical symptoms present for less than 3 weeks before the start of treatment and those with clinical symptoms 3 weeks or longer before the beginning of therapy. The patients were then further divided into groups and randomized to receive azithromycin once daily in a single dose of 1 g or 500 mg once daily for 6 days, or to receive doxycycline 100 mg b.i.d. for 14 days or 100 mg b.i.d. for 7 days (eight study groups in all). Clinical and bacteriological efficacy were evaluated 3 weeks after the end of therapy. In the group of patients with disease symptoms lasting for 3 weeks or longer, eradication and clinical cure rates were significantly higher after the administration of azithromycin at a dose of 1 x 500 mg/6 days than after a single dose of 1 g (p < 0.001).
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comparative analysis of azithromycin and doxycycline efficacy in the treatment of female patients with acute Urethral Syndrome caused by ureaplasma urealyticum
Journal of Chemotherapy, 2000Co-Authors: Visnja Skerk, Bruno Barsic, Vladimir Car, Slavko Schonwald, Ivana KlinarAbstract:(2000). Comparative Analysis of Azithromycin and Doxycycline Efficacy in the Treatment of Female Patients with Acute Urethral Syndrome Caused by Ureaplasma urealyticum. Journal of Chemotherapy: Vol. 12, No. 2, pp. 186-188.
Michael King - One of the best experts on this subject based on the ideXlab platform.
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the Urethral Syndrome a controlled evaluation
Journal of Psychosomatic Research, 1993Co-Authors: Irwin Nazareth, Michael KingAbstract:It has long been considered that psychological factors play an important role in women with urinary tract symptoms. Where no significant infection can be demonstrated, psychological factors have been claimed as paramount to the extent that the 'irritable Urethral Syndrome' has been postulated as a parallel to the irritable bowel. This paper reports on a controlled study of psychological and menstrual problems in women presenting in family practice with urinary symptoms. Women were assessed by structured interview. Two groups of women took part: (A) 54 women with urinary symptoms, 15 of whom later proved to have significant bacterial infection on culture. (B) 21 women attending for contraceptive advice also agreed to participate in a comparison group. Women presenting with urinary tract symptoms had higher mean scores on psychological and menstrual measures than comparison women, regardless of the presence of demonstrable infection. Thus, psychological and menstrual symptoms appear to determine whether a woman who experiences urinary tract symptoms attends her doctor, regardless of whether significant infection is present. No evidence was found, for the existence of an irritable Urethral Syndrome, in which psychological factors are postulated as the predominant cause.
