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Related Concept Videos

Local Anesthetics: Clinical Application as Spinal Anesthesia01:11

Local Anesthetics: Clinical Application as Spinal Anesthesia

Spinal anesthetics are given during lower abdomen and limb surgeries to block sensory and motor neurons. They are administered in the mid to low lumbar regions, primarily acting on the cauda equina's nerve roots. The blockade level depends on the local anesthetic (LA) concentration. Usually, low LA concentrations are sufficient to block sensory fibers, while only high LA concentrations block motor fibers. Other factors like injection volume and speed, the patient's posture, and the drug...
Local Anesthetics: Clinical Application as Epidural Anesthesia01:29

Local Anesthetics: Clinical Application as Epidural Anesthesia

Epidural anesthetics are administered in the fat-filled epidural space, the outermost part of the spinal canal. This technique is commonly employed for pain management and anesthesia during lower abdomen and pelvis surgeries or labor and delivery.
Since epidural anesthetics can be infused through an epidural catheter, all types of drugs, including short-acting ones, can be administered. Chloroprocaine and lidocaine are examples of short and long-duration anesthetics, respectively. Bupivacaine...
Anatomy of the Genitourinary System II: Bladder and Urethra01:19

Anatomy of the Genitourinary System II: Bladder and Urethra

The lower urinary system consists of the urinary bladder and urethra, which are essential in storing and expelling urine from the body. Together with the internal and external sphincters, these structures work together to regulate urination effectively.Anatomy of the BladderThe urinary bladder is a muscular, stretchable organ behind the pubic bone and in front of the rectum. In females, the bladder is positioned anterior to the vagina and inferior to the uterus, while in males, it is located...
Local Anesthetics: Adverse Effects01:12

Local Anesthetics: Adverse Effects

While local anesthetics are generally safe and well-tolerated, they can occasionally cause adverse effects that vary in severity. Local anesthetics can induce toxicity at two distinct levels. They can either produce local effects through direct contact with the neural elements or be absorbed into the bloodstream from the injection site, leading to systemic effects.
Once absorbed into the systemic circulation, local anesthetics can affect the organs that depend on the functioning of sodium...
Microbiota of the Urogenital Tract01:28

Microbiota of the Urogenital Tract

The human urogenital system, once thought to be sterile in healthy individuals, is now recognized as a complex microbial habitat. Advancements in molecular sequencing techniques have revealed that even in healthy adults, the kidneys and bladder harbor microbial populations similar to those found in the distal urethra, albeit in much lower abundance. These resident microorganisms, while generally innocuous, can become opportunistic pathogens under conditions that alter the urogenital...
Urodynamic Studies: Uroflowmetry01:19

Urodynamic Studies: Uroflowmetry

Uroflowmetry is a non-invasive urodynamic test designed to measure various aspects of urination, including volume, flow rate, and the time to void. This test is crucial for diagnosing and assessing conditions such as bladder outlet obstruction, bladder dysfunction, incomplete bladder emptying, incontinence, and urinary tract blockages caused by benign prostatic hyperplasia (BPH) and urethral strictures.Pre-Test Instructions:Before a uroflowmetry test, patients are typically advised to drink...

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In Vivo Luminal Measurement of Distension-Evoked Urothelial ATP Release in Rodents
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The effect of spinal anaesthesia on urethral function.

R A Jonathan Duckett1, Panagiotis Grapsas, Maria Eaton

  • 1Department of Obstetrics and Gynaecology, Urogynaecology Unit, Medway Maritime Hospital, Gillingham, Kent ME7 5NY, UK. jraduckett@hotmail.com

International Urogynecology Journal and Pelvic Floor Dysfunction
|June 6, 2007
PubMed
Summary

Spinal anesthesia reduces urethral resistance and increases leakage during TVT surgery. Coughing after spinal anesthesia does not accurately predict incontinence, impacting patient outcomes.

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Cystometric and External Urethral Sphincter Measurements in Awake Rats with Implanted Catheter and Electrodes Allowing for Repeated Measurements
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Published on: January 30, 2018

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Last Updated: Jul 14, 2026

In Vivo Luminal Measurement of Distension-Evoked Urothelial ATP Release in Rodents
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Published on: September 7, 2022

Cystometric and External Urethral Sphincter Measurements in Awake Rats with Implanted Catheter and Electrodes Allowing for Repeated Measurements
10:07

Cystometric and External Urethral Sphincter Measurements in Awake Rats with Implanted Catheter and Electrodes Allowing for Repeated Measurements

Published on: January 30, 2018

Area of Science:

  • Urology
  • Anesthesiology
  • Gynecology

Background:

  • Urinary incontinence is a common condition affecting many women.
  • Tension-free vaginal tape (TVT) operations are frequently performed to treat stress urinary incontinence.
  • Spinal anesthesia is a common anesthetic technique for these procedures.

Purpose of the Study:

  • To evaluate the impact of spinal anesthesia on urethral retro-resistance pressure (URP) and cough-induced leakage.
  • To assess the reliability of the cough test under spinal anesthesia for predicting postoperative incontinence.

Main Methods:

  • 32 women undergoing TVT surgery under spinal anesthesia were studied.
  • Urethral retro-resistance pressure (URP) and cough pressures were measured before and after spinal anesthesia.
  • Leakage was assessed using a five-point scale with a 350 ml bladder volume.

Main Results:

  • Mean URP significantly decreased from 75.0 to 54.0 cm/H2O (p=0.0003) post-spinal anesthesia.
  • Mean cough pressure showed a non-significant decrease from 85.0 to 67.5 cm/H2O (p=0.06).
  • The degree of urinary leakage significantly increased (p=0.005) after spinal anesthesia.

Conclusions:

  • Spinal anesthesia reduces urethral resistance, increasing the likelihood of leakage during TVT surgery.
  • The cough test under spinal anesthesia is not a reliable predictor of incontinence, as it doesn't mimic pre-anesthesia cough response.
  • These findings suggest altered urethral function under spinal anesthesia may contribute to increased postoperative leakage.