Articles de revues : « Low urinary tract disease »

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Scarpa, M. G., M. Iaquinto et J. Schleef. « Urethritis and low urinary tract disease : description of three cases ». European Urology Open Science 32 (octobre 2021) : S63. http://dx.doi.org/10.1016/s2666-1683(21)00821-1.

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Kim, Myung Soo, et Seung Il Jung. « The Urinary Tract Microbiome in Male Genitourinary Diseases : Focusing on Benign Prostate Hyperplasia and Lower Urinary Tract Symptoms ». International Neurourology Journal 25, n^o 1 (31 mars 2021) : 3–11. http://dx.doi.org/10.5213/inj.2040174.087.

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The human body is sterile during gestation; however, but during and after birth, the entire body surface becomes host to an enormous variety of microorganisms. Urine in the urinary tract was once considered sterile based on the lack of cultured microorganisms. Many recent studies have revealed evidence of microorganisms in human urine in the absence of clinical infection. Sequencing methods and analytical techniques are rapidly evolving to improve the ability to detect bacterial DNA and living bacteria and to understand the microbiota of the urinary tract. In women, fascinating evidence associates urinary tract microbiota with lower urinary tract symptoms. However, in men, the relevance of urinary tract microbiota in low urinary tract symptoms and prostate disease has not been established. In this review, we highlight a recent study that increases our ability to understand the urinary tract microbiota in men with lower urinary tract symptoms.

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Werter, Dominique E., Brenda M. Kazemier, Caroline Schneeberger, Ben W. J. Mol, Christianne J. M. de Groot, Suzanne E. Geerlings et Eva Pajkrt. « Risk Indicators for Urinary Tract Infections in Low Risk Pregnancy and the Subsequent Risk of Preterm Birth ». Antibiotics 10, n^o 9 (31 août 2021) : 1055. http://dx.doi.org/10.3390/antibiotics10091055.

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Symptomatic urinary tract infections are associated with preterm birth. However, data on risk indicators for urinary tract infections are limited and outdated. The research is a secondary analysis. The study was a prospective multicenter cohort study of low-risk pregnant women. Logistic regression was used to identify risk indicators for urinary tract infections. The incidence of urinary tract infections was 9.4%. Multivariate logistic regression showed that a history of recurrent urinary tract infections and the presence of asymptomatic bacteriuria in the present pregnancy were associated with urinary tract infections (resp. OR 3.14, 95%CI 1.40–7.02 and OR 1.96 95%CI 1.27–3.03). Women with a urinary tract infection were at increased risk of preterm birth compared to women without a urinary tract infection (12 vs. 5.1%; adjusted HR 2.5 95%CI 1.8–3.5). This increased risk was not found in women with the identified risk indicators (resp. 5.3% vs. 5.1%, adjusted HR 0.35 95%CI 0.00–420 and adjusted HR 1.5 95CI% 0.59–3.9). In conclusion, in low-risk pregnant women, risk indicators for urinary tract infections are: a history of recurrent urinary tract infections and the presence of asymptomatic bacteriuria. The risk of preterm birth is increased in women with a urinary tract infection in this pregnancy. However, women with recurrent urinary tract infections and asymptomatic bacteriuria this pregnancy appear not to be at increased risk of preterm birth.

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Tomaszewski, Jeffrey John, Marc Christopher Smaldone et Michael Cecil Ost. « Endourologic Management of Upper Tract Transitional Cell Carcinoma following Cystectomy and Urinary Diversion ». Advances in Urology 2009 (2009) : 1–6. http://dx.doi.org/10.1155/2009/976401.

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Traditionally, nephroureterectomy is the gold standard therapy for upper tract recurrence of transitional cell carcinoma (TCC) following cystectomy and urinary diversion. With advances in endoscopic equipment and improvements in technique, conservative endourologic management via a retrograde or antegrade approach is technically feasible with acceptable outcomes in patients with bilateral disease, solitary renal units, chronic renal insufficiency, or significant medical comorbidities. Contemporary studies have expanded the utility of these techniques to include low-grade, low-volume disease in patients with a normal contralateral kidney. The aim of this report is to review the current outcomes of conservative management for upper tract disease and discuss its application and relevance in patients following cystectomy with lower urinary tract reconstruction.

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Kodzo-Grey Venyo, Anthony. « Coronavirus Infection of the Urinary Bladder and Lower Urinary Tract : A Review and Update ». Clinical Research and Clinical Trials 4, n^o 2 (24 août 2021) : 01–11. http://dx.doi.org/10.31579/2693-4779/056.

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COVID-19 infection does affect males and females. Even though the commonest manifestations of COVID-19 infection tend to be related to symptoms associated with the respiratory tract, many other organs of the body also tend to be affected and COVID-19 infection of these other organs could manifest contemporaneously with symptoms of the respiratory tract system in addition to symptoms of the affected organs. At times COVID-19 may initially manifest solely related to non-respiratory tract organs and because the symptoms are non-specific without a high index of suspicion, the diagnosis of COVID-19 infection may be missed initially or there may be delay in the diagnosis which would tend to lead to spreading of the disease. Some of the manifestations of COVID-19 infection of the urinary bladder may include: Lower urinary tract symptoms of urinary frequency, and or urinary urgency, and or nocturia, and or urinary incontinence, or on rare occasions non-visible or visible haematuria, or acute retention of urine. The aforementioned symptoms may occur as De novo (new-onset) symptoms alone or they may be associated with or without fever, with or without respiratory tract symptoms. Some individuals who already have lower urinary tract symptoms could experience worsening of their previous lower urinary tract symptoms and if the clinician does not have a high index of suspicion for the possible development of COVID-19 infection, and the clinician does blame the symptoms on benign prostatic hyperplasia then the diagnosis could be missed or delayed. If the COVID-19 cystitis is associated with COVID-19 infection of the male genital tract then some of the patients could experience scrotal discomfort, swelling of the scrotum, erythema of the scrotum, or low-flow priapism or clinical and radiology imaging features of acute orchitis, or acute epididymitis, or acute epididymo-orchitis. However, if the lower urinary tract symptoms are associated with respiratory tract symptoms all clinicians globally are aware of the fact that a high index of suspicion for COVID-19 infection should be exercised. What is important is that every clinician and every individual should be made aware of the fact that the development of De novo lower urinary tract symptoms or sudden onset of worsening lower urinary tract symptoms should be regarded as possibly due to COVID-19 infection and appropriate tests should be undertaken to confirm or negate the diagnosis of COVID-19 infection quickly. Diagnosis of COVID-19 infection of the urinary bladder can be confirmed the undertaking of various COVID-19 infection tests but COVID-19 PCR test has tended to be a common test that most people use globally.

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Hazen, Kevin C., Gordon W. Theisz et Susan A. Howell. « Chronic Urinary Tract Infection Due toCandida utilis ». Journal of Clinical Microbiology 37, n^o 3 (1999) : 824–27. http://dx.doi.org/10.1128/jcm.37.3.824-827.1999.

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An elderly male was seen at an outpatient urology clinic over a period of 3 years with repeat urine specimens containing 104 to 105 CFU of a “Candidaspecies, not C. albicans.” The urine specimens were described as infected due to the presence of pyuria, but no antifungal therapy was administered. On two occasions, the patient presented to the emergency room and urine specimens were sent to the clinical microbiology laboratory. On both occasions, a yeast was isolated at concentrations of >105 CFU/ml. The organism was identified as the anamorphic yeast Candida utilis (teleomorph:Pichia jadinii) by conventional methods. Molecular methods, including karyotyping and restriction enzyme analysis, confirmed that the isolates were identical and were C. utilis. The patient developed benign prostatic hypertrophy and chronic obstructive pulmonary disease during the 3-year course. This report is the first demonstration of the isolation of the industrially important yeastC. utilis from a urinary tract infection. In the present case, the organism was associated with chronic, symptomatic disease. The significance of this unusual, low-virulence isolate from a case of urinary tract infection is discussed.

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Kruger, JM, et CA Osborne. « Recurrent, nonobstructive, idiopathic feline lower urinary tract disease : an illustrative case report ». Journal of the American Animal Hospital Association 31, n^o 4 (1 juillet 1995) : 312–16. http://dx.doi.org/10.5326/15473317-31-4-312.

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A three-year-old, spayed female domestic shorthair was evaluated because of recurrent hematuria, dysuria, and pollakiuria of one year's duration. With the exception of hematuria and proteinuria, results of other physical, clinicopathological, radiographic, and microbiologic evaluations were normal. Low concentrations of bovine herpesvirus-4 (BHV-4) antibodies (titer 1:40) were detected by an indirect fluorescent antibody test (IFAT). A diagnosis of nonobstructive, idiopathic feline lower urinary tract disease was established by exclusion of other known causes of hematuria and dysuria. Clinical signs resolved in approximately seven days without symptomatic therapy. During the next 69 months, the owners observed five episodes of self-limiting, gross hematuria and pollakiuria. Persistent low titers of BHV-4 antibodies were detected by the IFAT. This case typifies the clinicopathological, radiographic, and microbiologic findings and the natural course characteristics of many cases of nonobstructive, idiopathic feline lower urinary tract disease.

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Smithson, Alex, Maria Rosa Sarrias, Juanjo Barcelo, Belen Suarez, Juan Pablo Horcajada, Sara Maria Soto, Alex Soriano et al. « Expression of Interleukin-8 Receptors (CXCR1 and CXCR2) in Premenopausal Women with Recurrent Urinary Tract Infections ». Clinical Diagnostic Laboratory Immunology 12, n^o 12 (décembre 2005) : 1358–63. http://dx.doi.org/10.1128/cdli.12.12.1358-1363.2005.

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ABSTRACT The migration of neutrophils through infected tissues is mediated by the CXC chemokines and its receptors (CXCR1 and CXCR2). It has been proposed that a CXCR1 deficiency could confer susceptibility to acute pyelonephritis in children. The objective of the study is to assess the surface expression of CXCR1 and CXCR2 and the existence of polymorphisms in the CXCR1 gene in premenopausal women with recurrent urinary tract infections. The study included 20 premenopausal women with recurrent urinary infections, with normal urinary tracts, and without diseases potentially associated with relapsing urinary infections and 30 controls without previous urinary infections. The levels of CXCR1 and CXCR2 expression on neutrophils were measured and analyzed by flow cytometry by measuring the mean fluorescence intensity (MFI) channel. The promoter and coding regions of the CXCR1 gene were analyzed for the presence of polymorphisms by a sequence-based typing method. Patients with recurrent urinary tract infections exhibited median levels of CXCR1 expression, determined from MFI values, similar to those of the controls. The analysis of CXCR2 showed that patients with recurrent urinary infections had lower median levels of expression, determined from the MFI values, than the controls (P = 0.002, Mann-Whitney U test). No polymorphisms were detected at the promoter or at the exon 1 region of the CXCR1 gene either in the patients or in the controls. Polymorphisms were detected at the exon 2 of CXCR1, but their frequencies did not differ between patients and controls. We have found a low level of CXCR2 expression in patients with recurrent urinary tract infections. These results suggest that a low level of CXCR2 expression may increase the susceptibilities of premenopausal women to urinary tract infections.

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GÜNEŞ, Yiğit, Ceren ANLAŞ et Banu DOKUZEYLÜL. « Pharmacological and clinical approach to plant based complementary health products in lower urinary system diseases in cats and dogs ». Journal of Istanbul Veterinary Sciences 6, n^o 3 (31 décembre 2022) : 116–22. http://dx.doi.org/10.30704/http-www-jivs-net.1150072.

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Medicinal plants, which are widely used in the treatment of many diseases in folk medicine, are alternative treatment approaches that allow to overcome the limitations of modern treatments such as high treatment costs and difficulty in accessing health services. In addition to their traditional uses, the World Health Organization (WHO) also recommends the use of medicinal plants as alternative applications, especially in countries where have limited access to modern medical facilities. Limitations on the methods used in the treatment of lower urinary tract diseases such as urinary tract infection and urolithiasis in both human and veterinary practice (high treatment cost, low tolerability, development of antibacterial resistance, etc.) have brought the use of natural products of herbal origin within the scope of supportive/complementary treatment approaches. Although the mechanism of action of medicinal plants in the treatment of lower urinary tract diseases is not clearly known, studies have shown that they increase the glomerular filtration rate; and they can be complementary alternatives to conventional treatment due to their anti-lithogenic, antibacterial, antioxidant and anti-inflammatory activities. Patients that referred to with one or more of the symptoms of urinary system diseases such as polyuria, pollakiuria, dysuria, stranguria, anuria, hematuria, urinary incontinence constitute the case group of one of the first three systemic diseases most frequently brought to the clinic. Failure to intervene in the diseases shaped in the lower urinary system in a timely manner causes negative consequences such as the disease becoming chronic, the progression of the disease to the upper urinary system in progressive cases, and a decrease in the quality of life. Complementary products used in addition to medical treatment are sometimes used for prophylactic purposes. In this context, many supplements have been prescribed for different diseases in small animal practice in recent years. In this review, it is aimed to convey current developments about medicinal plants, which are used effectively within the scope of supportive treatment practices in lower urinary system diseases of cats and dogs, to veterinary clinical practice.

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Kärkkäinen, U. M., R. Ikäheimo, M. L. Katila, A. Sivonen et A. Siitonen. « Low Virulence of Escherichia coli Strains Causing Urinary Tract Infection in Renal Disease Patients ». European Journal of Clinical Microbiology & ; Infectious Diseases 19, n^o 4 (4 mai 2000) : 254–59. http://dx.doi.org/10.1007/s100960050472.

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Bigosiński, Karol, Maciej Dubaj et Aleksandra Dembowska. « Medullary sponge kidney - the mysterious name of a simple disease ». Journal of Education, Health and Sport 12, n^o 8 (19 août 2022) : 548–54. http://dx.doi.org/10.12775/jehs.2022.12.08.058.

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Medullary sponge kidney (renal spongiosis), (MSK) is a rare developmental anomaly of the kidney of unknown cause. It is presumed, that people with a genetic predisposition (<5% family occurrence) are prone to the disease. The peak of diagnosis is between the ages of 20-50, usually by chance (due to lack of symptoms) during an abdominal X-ray, where the so-called nephrocalcinosis (calcifications in the kidney) can be observed. Another radiologic test, that may suggest the condition in question is abdominal ultrasound, where cysts up to 8 mm in diameter in the medullary part of the kidney and calcifications can be seen. Diagnosis may also be based on the diagnosis of pre-existing stones and urinary tract infections, or hematuria. Urography has the highest sensitivity to sponge kidney. Symptoms, if already present, are characterized by low back pain, hematuria, hematuria, recurrent urinary tract infections, proteinuria, sterile purulence. Ultimately, the aforementioned pathologies can lead to kidney failure. To date, no causal treatment has been developed; only symptomatic treatment of lithiasis foci and urinary tract infections is possible. The purpose of the following paper was to describe the definition, epidemiology and etiology of MSK and to highlight the randomness of diagnosis and the problem in the lack of specific therapy for this renal developmental disorder. Current publications and guidelines from scientific societies around the world were reviewed, using MeSH-compliant keywords.

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BAUER, SOFIA, ALON ELIAKIM, AVISHALOM POMERANZ, RIVKA REGEV, ITA LITMANOVITS, SHMUEL ARNON, HAIM HURI et TZIPORA DOLFIN. « Urinary tract infection in very low birth weight preterm infants ». Pediatric Infectious Disease Journal 22, n^o 5 (mai 2003) : 426–29. http://dx.doi.org/10.1097/01.inf.0000065690.64686.c9.

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Gnanaraj, J. « Cystometrogram : the low-cost method for rural areas and its benefits ». Tropical Doctor 48, n^o 1 (21 juin 2017) : 80–84. http://dx.doi.org/10.1177/0049475517712658.

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Cystometrography (CMG) is a means of studying bladder pressure. It is a very useful diagnostic tool in patients with lower urinary tract symptoms for which a simple cystoscopy will not offer sufficient information to form a diagnosis. Of the 8893 patients who underwent screening for urological conditions in rural northeast India during 2010–2014, 280 with lower urinary tract symptoms were investigated with a combination of cystoscopy and CMG. By corresponding CMG diagnosis and treatment, we could examine patients’ overall satisfaction with both the procedure and the treatment. We describe a low-cost method of CMG and our results using this method in rural areas of India.

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Hailay, Abrha, Kidane Zereabruk, Guesh Mebrahtom, Woldu Aberhe et Degena Bahrey. « Magnitude and Its Associated Factors of Urinary Tract Infection among Adult Patients Attending Tigray Region Hospitals, Northern Ethiopia, 2019 ». International Journal of Microbiology 2020 (28 juillet 2020) : 1–8. http://dx.doi.org/10.1155/2020/8896990.

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Background. Urinary tract infection is a major public health problem in terms of morbidity and mortality worldwide. It ranks as the number one infection which leads to an antibiotic prescription after a physician’s visit. However, there are limited studies done on UTI in Ethiopia. Hence, this study was aimed to assess the magnitude of urinary tract infection and its associated factors among adult patients attending hospitals of the Tigray region, Ethiopia. Methods and Material. A hospital-based cross-sectional study was conducted from April to May 2019. Systematic random sampling technique was used to select 472 participants from five randomly selected hospitals in Tigray region. A pretested structured questionnaire through face-to-face interview and patient chart review checklist was used to collect data. Data were analyzed by SPSS version 21. A binary logistic regression model was used to test the association between dependent and independent variables. Result. The magnitude of urinary tract infection was 86 (18.2%) (95% CI: 14.6%–21.6%). After adjustment of the independent variables, the significant factors associated with urinary tract infection were being female (AOR = 3.50; 95% CI: 1.88–6.51), urine passing frequency < five times in a day (AOR = 2.32; 95% CI: 1.08–4.96), having diabetes mellitus (AOR = 4.03; 95% CI: 1.69–9.63), history of urinary tract infection (AOR = 4.40; 95% CI: 2.31–8.39), <7 glasses of water intake per day (AOR = 2.16; 95% CI: 1.02–4.58), and history of urinary obstructive diseases (AOR = 2.67; 95% CI: 1.03–6.90). Conclusion and Recommendation. The magnitude of urinary tract infection was considerably high. The factors associated with urinary tract infection were sex, less urine passing frequency, diabetes mellitus, low water intake, history of urinary tract infection, and urinary obstructive diseases. Therefore, patients having DM, previous history of UTI, and urinary obstructive diseases should be routinely screened for urinary tract infection and provided with education on voiding urine at least five times a day and on increasing daily water intake.

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Visca, P., F. Chiarini, A. Mansi, C. Vetriani, L. Serino et N. Orsi. « Virulence determinants inPseudomonas aeruginosastrains from urinary tract infections ». Epidemiology and Infection 108, n^o 2 (avril 1992) : 323–36. http://dx.doi.org/10.1017/s0950268800049797.

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SUMMARYA total of 121 uropathogenicPseudomonas aeruginosastrains were examined for production of several virulence-related factors. These strains were distributed in five predominant O-serotypes, i.e. O 4, O 12, O 11, O 6 and O 5, which accounted respectively for 23·9, 23·1, 12·3, 8·2 and 5·7% of isolates. Pyochelin and pyoverdin siderophores were produced by most of the isolates, defective variants occurring at very low frequency (2·4% for pyochelin and 7·4% for pyoverdin). Adherence to uroepithelial cells and production of cytotoxins was demonstrated in 52·8 and 67·7% of the strains, respectively, with higher frequencies for epidemiologically related strains belonging to serotypes O 4 and O 12. Titration of total proteases, elastase and phospholipase C revealed a high degree of heterogeneity among isolates. However, examination of individual O-serotypes by exoenzyme production showed that elevated levels of total proteases and elastase were characteristics of serotypes of minor numerical importance, i.e. O 1, O 10, O 11 and O 17, whilst low levels of elastase were produced by strains belonging to the predominant serotypes, namely O 4 and O 12. Moreover, epidemiologically related strains belonging to serotypes O 4 and O 12 appeared more homogeneous than the whole serogroup, when compared with other groups on the basis of exoenzyme levels.

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Ebrahimzadeh Attari, Vahideh, Arezoo Maddah, Zahra Shahveghar Asl, Mahsa Jalili, Mohammad Reza Ardalan et Saman Mokari. « The association of serum uromodulin with allograft function and risk of urinary tract infection in kidney transplant recipients ». Journal of Renal Injury Prevention 10, n^o 1 (3 février 2020) : e02-e02. http://dx.doi.org/10.34172/jrip.2021.02.

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Introduction: There is some evidence to suggest that low levels of uromodulin in urine and serum are associated with decreased renal function and increased mortality risk. Objectives: This study is designed to measure circulating uromodulin levels and explore their relationship to urinary tract infection and renal function in kidney transplant recipients. Patients and Methods: In this cross-sectional study, 90 eligible kidney transplant recipients were evaluated 6–12 months of post-transplantation. Fasting blood samples were taken to determine the serum level of uromodulin with urea, creatinine, and other biochemical characteristics. Urine samples were taken for analysis and culture. Kidney function was estimated based on the chronic kidney disease epidemiology collaboration (CKD-EPI) creatinine equation and the modification of diet in renal disease (MDRD) equation. Results: Patients’ serum uromodulin levels were significantly correlated with their serum creatinine (P = 0.024) and estimated glomerular filtration rate by the EPI equation (eGFR-EPI, P = 0.038). There was no significant association between serum uromodulin levels and incidence of urinary tract infection of post-transplantation (P > 0.05). Conclusion: Serum and urine uromodulin levels may be regarded as the predictive indicators of renal function. However, given the lack of studies on the association between serum uromodulin levels and urinary tract infection risks in kidney transplant recipients, further research is needed to clarify uromodulin’s protective effect against urinary tract infection.

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Armstrong, Lawrence E., Colleen X. Muñoz et Elizabeth M. Armstrong. « Distinguishing Low and High Water Consumers—A Paradigm of Disease Risk ». Nutrients 12, n^o 3 (23 mars 2020) : 858. http://dx.doi.org/10.3390/nu12030858.

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A long-standing body of clinical observations associates low 24-h total water intake (TWI = water + beverages + food moisture) with acute renal disorders such as kidney stones and urinary tract infections. These findings prompted observational studies and experimental interventions comparing habitual low volume (LOW) and high volume (HIGH) drinkers. Investigators have learned that the TWI of LOW and HIGH differ by 1–2 L·d−1, their hematological values (e.g., plasma osmolality, plasma sodium) are similar and lie within the laboratory reference ranges of healthy adults and both groups appear to successfully maintain water-electrolyte homeostasis. However, LOW differs from HIGH in urinary biomarkers (e.g., reduced urine volume and increased osmolality or specific gravity), as well as higher plasma concentrations of arginine vasopressin (AVP) and cortisol. Further, evidence suggests that both a low daily TWI and/or elevated plasma AVP influence the development and progression of metabolic syndrome, diabetes, obesity, chronic kidney disease, hypertension and cardiovascular disease. Based on these studies, we propose a theory of increased disease risk in LOW that involves chronic release of fluid-electrolyte (i.e., AVP) and stress (i.e., cortisol) hormones. This narrative review describes small but important differences between LOW and HIGH, advises future investigations and provides practical dietary recommendations for LOW that are intended to decrease their risk of chronic diseases.

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Spivak, L. G., A. V. Zaitsev, I. A. Apolikhina et L. A. Khodyreva. « 21st All-Russian Science Education Forum “Mother & ; Child”. Urinary tract infections in women : what a gynecologist needs to know ? (Post-release) ». Russian Journal of Woman and Child Health 3, n^o 4 (2020) : 282–89. http://dx.doi.org/10.32364/2618-8430-2020-3-4-282-289.

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A round table on the topic “Urinary tract infections in women: what a gynecologist needs to know?” was organized within the framework of the 21st All-Russian Science Education Forum “Mother & Child” that was held on September 28–30, 2020, in Moscow. The speakers reported on an increasing incidence of urinary tract infections (UTIs), in particular, cystitis. This is accounted for by the lack of a common diagnostic and treatment approach to this disease among various medical specialties and self-medicating with randomly chosen or low-dose antibiotics. Current recommendations for the prescribing of medications to reduce the symptoms of acute cystitis are addressed. The increase in the prevalence of antibiotic resistance is highlighted. The development and more active implementation of the approaches avoiding the use of antibiotics to prevent UTI recurrences are required. KEYWORDS: cystitis, urinary tract infections, recommendations, immune prophylaxis, cranberry, D-mannose, vitamin D. FOR CITATION: 21st All-Russian Science Education Forum “Mother & Child”. Urinary tract infections in women: what a gynecologist needs to know? (Post-release). Russian Journal of Woman and Child Health. 2020;3(4):282–288. DOI: 10.32364/2618-8430-2020-3-4-282-289.

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Ferlizza, Enea, Francesco Dondi, Giulia Andreani, Diego Bucci, Joy Archer et Gloria Isani. « Validation of an electrophoretic method to detect albuminuria in cats ». Journal of Feline Medicine and Surgery 19, n^o 8 (23 août 2016) : 860–68. http://dx.doi.org/10.1177/1098612x16664112.

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Objectives The aims of this study were to validate a semi-automated high-resolution electrophoretic technique to quantify urinary albumin in healthy and diseased cats, and to evaluate its diagnostic performance in cases of proteinuria and renal diseases. Methods Urine samples were collected from 88 cats (healthy; chronic kidney disease [CKD]; lower urinary tract disease [LUTD]; non-urinary tract diseases [OTHER]). Urine samples were routinely analysed and high-resolution electrophoresis (HRE) was performed. Within-assay and between-assay variability, linearity, accuracy, recovery and the lowest detectable and quantifiable bands were calculated. Receiver operating curve (ROC) analysis was also performed. Results All coefficients of variation were <10%, percentage recovery was between 97% and 109% with a high linearity (r = 0.99). HRE allowed the visualisation of a faint band of albumin and a diffused band between alpha and beta zones in healthy cats, while profiles from diseased cats were variable. Albumin (mg/dl) and urine albumin:creatinine ratio (UAC) were significantly ( P <0.05) different between healthy and diseased cats. After ROC analysis, UAC values of 0.035 and 0.074 had a high sensitivity and high specificity, respectively, to classify proteinuria and identify borderline proteinuric cats. Moreover, a UAC of 0.017 had a high sensitivity in distinguishing between healthy and diseased cats. However, UAC was not able to distinguish between renal (CKD) and non-renal diseases (LUTD/OTHER), probably owing to the pathophysiology of CKD in cats, which is characterised by low-grade proteinuria and less glomerular involvement than in dogs. Conclusions and relevance HRE is an accurate and precise method that could be used to measure albuminuria in cats. UAC was useful to correctly classify proteinuria and to discriminate between healthy and diseased cats. HRE might also provide additional information on urine proteins with a profile of all proteins (albumin and globulins) to aid clinicians in the diagnosis of diseases characterised by proteinuria.

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Kokorovic, Andrea, et Surena F. Matin. « UGN-101 (mitomycin gel) : a novel treatment for low-grade upper tract urothelial carcinoma ». Therapeutic Advances in Medical Oncology 12 (janvier 2020) : 175883592093795. http://dx.doi.org/10.1177/1758835920937950.

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Upper tract urothelial carcinoma (UTUC) is a rare malignancy. The standard treatment for localized high-risk disease is radical nephroureterectomy, which confers significant morbidity and is not appropriate for all patients. Patients harboring low-risk, non-invasive disease may be candidates for organ-sparing treatment, which includes endoscopic resection with or without intracavitary drug therapy. Successful administration of intracavitary chemotherapy to the upper tracts is impeded by rapid washout of the agent and short dwell times. This has limited the clinical utility of mitomycin C for treatment of upper tract tumors, despite the successful outcomes observed in low-grade urothelial carcinoma of the bladder. Currently, there is an unmet need for development of a technically feasible and oncologically sound intracavitary therapy for management of low-grade UTUC. UGN-101 (Jelmyto™) is a novel formulation of mitomycin C that uses a unique hydrogel designed to increase urinary dwell time, and thereby efficacy of treatment. Preclinical data demonstrated promising results regarding the safety and feasibility of this agent. Preliminary results of a phase III trial (OLYMPUS study) [ClinicalTrials.gov identifier: NCT02793128] demonstrated the efficacy of UGN-101 as a successful chemo-ablative agent for low-grade upper tract tumors. UGN-101 may represent a pivotal paradigm shift in the treatment of low-grade UTUC. Indeed, the drug has recently been granted approval by the US Food and Drug Administration as the first treatment for low-grade UTUC, which may lead to significant improvements in patient care and a long-awaited decrease in the burden of disease.

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Reid, Gregor. « Perspective : microbial interventions in the urinary tract ». Microbiome Research Reports 2, n^o 1 (2023) : 3. http://dx.doi.org/10.20517/mrr.2022.17.

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Despite multiple advances in medicine, the management of urinary tract infections (UTIs) in women has remained stalled for decades. To prevent the development of symptomatic recurrences, low-dose antibiotics are the mainstay, while alternative approaches have been attempted with limited success. The use of probiotics was first considered forty years ago, and while some promising studies have been published, additional evidence in larger patient groups is needed to recommend specific strains as a primary preventive regimen. Overall, the role of beneficial microbes in reducing the risk of UTI and other urological diseases, such as urolithiasis, remains a target for researchers. The aim of this perspective is to offer a viewpoint on the status of this approach and recommendations for how to develop novel probiotic therapies.

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Kim, Min Jung, Sook-young Woo, Eun Ran Kim, Sung Noh Hong, Dong Kyung Chang, Poong-Lyul Rhee, Jae J. Kim, Jong Chul Rhee et Young-Ho Kim. « Incidence and Risk Factors for Urolithiasis in Patients with Crohn's Disease ». Urologia Internationalis 95, n^o 3 (2015) : 314–19. http://dx.doi.org/10.1159/000375536.

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Background: The incidence of urinary tract calculi is thought to be higher in patients with inflammatory bowel disease (IBD) than that in the general population. However, few data are available about urolithiasis in patients with Crohn's disease (CD). We investigated the incidence of urolithiasis and the risk factors for urolithiasis in patients with CD. Methods: We examined the records of 387 patients with CD followed at Samsung Medical Center from July 2011 to June 2013. Evidence for the presence of calculi was obtained from radiologic findings (plain films, ultrasonography, or computed tomography), urinary colic symptoms, or a treatment history of urolithiasis after diagnosis of CD. Demographic variables, phenotype, concurrent medications, and previous CD-related surgery were analyzed. Results: Urinary tract calculi were found in 18 (4.7%) patients, which developed after the CD diagnosis. The incidence of urolithiasis in CD was 706 per 100,000 patient-years. Cox models with a time-dependent covariate showed that azathioprine (AZA)/6-mercaptopurine (6-MP) treatment (hazard ratio = 0.963; 95% CI: 0.931, 0.996; p = 0.030) was negatively associated with urolithiasis. Conclusions: The annual incidence rate of urolithiasis in patients with CD was 0.7%. AZA/6-MP therapy was associated with a low risk of urolithiasis in these patients.

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Martín-Gutiérrez, Guillermo, Jerónimo Rodríguez-Beltrán, José Manuel Rodríguez-Martínez, Coloma Costas, Javier Aznar, Álvaro Pascual et Jesús Blázquez. « Urinary Tract Physiological Conditions Promote Ciprofloxacin Resistance in Low-Level-Quinolone-Resistant Escherichia coli ». Antimicrobial Agents and Chemotherapy 60, n^o 7 (2 mai 2016) : 4252–58. http://dx.doi.org/10.1128/aac.00602-16.

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ABSTRACTEscherichia coliisolates carrying chromosomally encoded low-level-quinolone-resistant (LLQR) determinants are frequently found in urinary tract infections (UTIs). LLQR mutations are considered the first step in the evolutionary pathway producing high-level fluoroquinolone resistance. Therefore, their evolution and dissemination might influence the outcome of fluoroquinolone treatments of UTI. Previous studies support the notion that low urine pH decreases susceptibility to ciprofloxacin (CIP) inE. coli. However, the effect of the urinary tract physiological parameters on the activity of ciprofloxacin against LLQRE. colistrains has received little attention. We have studied the activity of ciprofloxacin under physiological urinary tract conditions against a set of well-characterized isogenicE. coliderivatives carrying the most prevalent chromosomal mutations (ΔmarR,gyrA-S83L,gyrA-D87N, andparC-S80R and some combinations). The results presented here demonstrate that all the LLQR strains studied became resistant to ciprofloxacin (according to CLSI guidelines) under physiological conditions whereas the control strain lacking LLQR mutations did not. Moreover, the survival of some LLQRE. colivariants increased up to 100-fold after challenge with a high concentration of ciprofloxacin under UTI conditions compared to the results seen with Mueller-Hinton broth. These selective conditions could explain the high prevalence of LLQR mutations inE. coli. Furthermore, our data strongly suggest that recommended methods for MIC determination produce poor estimations of CIP activity against LLQRE. coliin UTIs.

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Jaekel, Anke K., Franziska I. Winterhagen, Federico L. Zeller, Anna-Lena Butscher, Franziska K. Knappe, Franziska Schmitz, Christopher Hauk, Johannes Stein, Ruth K. M. Kirschner-Hermanns et Stephanie C. Knüpfer. « Neurogenic Lower Urinary Tract Dysfunction in Asymptomatic Patients with Multiple Sclerosis ». Biomedicines 10, n^o 12 (15 décembre 2022) : 3260. http://dx.doi.org/10.3390/biomedicines10123260.

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Neurogenic lower urinary tract dysfunction (NLUTD) in asymptomatic patients with MS has been described in preliminary studies, but specific investigations of this topic are rare. Many authors advise early diagnosis and treatment of NLUTD in patients with MS. In contrast, clinical practice and different guidelines recommend neuro-urological diagnostics only in the presence of symptoms. Our aim was to investigate the characteristics of NLUTD and the correlations of clinical parameters with NLUTD in asymptomatic patients with MS. We evaluated bladder diaries, urodynamic findings, and therapy proposals. Correlations of the voided volume, voiding frequency, urinary tract infections, and uroflowmetry including post-void residual with the urodynamic findings were determined. In our study, 26% of the patients were asymptomatic. Of these, 73.7% had urodynamic findings indicative of NLUTD, 21.1% had detrusor overactivity, 13.2% had detrusor underactivity, 13.2% detrusor overactivity and detrusor sphincter dyssynergia, and 57.9% had radiologically abnormal findings of the bladder. No patients presented low bladder compliance or renal reflux. Clinical parameters from the bladder diary and urinary tract infections were found to be correlated with NLUTD, and the absence of symptoms did not exclude NLUTD in patients with MS. We observed that urinary tract damage is already present in a relevant proportion. Based on our results, we recommend that patients with MS be screened for NLUTD regardless of the subjective presence of urinary symptoms or the disease stage.

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Shapiro, T. « The Prevalence of Urinary Tract Infections and Sexually Transmitted Disease in Women with Symptoms of a Simple Urinary Tract Infection Stratified by Low Colony Count Criteria ». Academic Emergency Medicine 12, n^o 1 (1 janvier 2005) : 38–44. http://dx.doi.org/10.1197/j.aem.2004.08.051.

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Berger, Richard E. « The Prevalence of Urinary Tract Infections and Sexually Transmitted Disease in Women With Symptoms of a Simple Urinary Tract Infection Stratified by Low Colony Count Criteria ». Journal of Urology 174, n^o 5 (novembre 2005) : 1842. http://dx.doi.org/10.1016/s0022-5347(01)68800-1.

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Martinez-Ramirez, Daniel, Edna Sophia Velazquez-Avila, Alejandro Almaraz-Espinoza, Arnulfo Gonzalez-Cantú, Genaro Vazquez-Elizondo, Daniel Overa-Posada, Amin Cervantes-Arriaga, Mayela Rodriguez-Violante et Mirna Gonzalez-Gonzalez. « Lower Urinary Tract and Gastrointestinal Dysfunction Are Common in Early Parkinson’s Disease ». Parkinson's Disease 2020 (17 octobre 2020) : 1–8. http://dx.doi.org/10.1155/2020/1694547.

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Purpose. Autonomic dysfunction is a common nonmotor feature and early manifestation of Parkinsons disease (PD). Autonomic dysfunction in PD is associated with a worse prognosis. We sought to characterize autonomic dysfunction and identify associated factors in patients with early PD. Methods. An observational, cross-sectional, descriptive, and analytical study was conducted to evaluate patients with early PD from the Parkinsons Progression Markers Initiative. We utilized the Scales for Outcomes in Parkinsons Disease-Autonomic dysfunction questionnaire to determine the prevalence and frequencies of autonomic symptomatology. The cohort was grouped into high and low dysautonomic scores. A regression model identified variables that independently explained dysautonomic scores in our early PD cohort. Results. 414 PD patients had a mean age of 61.1 (SD 9.7) years at diagnosis and mean disease duration of 6.7 (SD 6.6) months. Among all patients, 43.7% (181/414) had high dysautonomic scores. Urinary and gastrointestinal symptoms were the most prevalent and frequently reported dysautonomic symptoms. Patients with fatigue (beta = 4.28, p < 0.001 ), probable rapid eye movement sleep behavior disorder (beta = 2.71, p < 0.001 ), excessive daytime sleepiness (beta = 1.88, p = 0.039 ), impulsivity and compulsivity (beta = 2.42, p < 0.001 ), and increasing age (beta = 1.05, p < 0.001 ) were more likely to have high dysautonomic scores. Conclusion. Lower urinary tract and gastrointestinal symptoms are prevalent and frequent in early PD patients. Fatigue, sleep disorders, impulsivity and compulsivity, and age are predictors of autonomic dysfunction. Autonomic symptoms predominated in this group of early PD patients in the disease course and were associated with more severe disease.

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Tsuzuki, Shunsuke, Shoji Kimura, Wataru Fukuokaya, Takafumi Yanagisawa, Kenichi Hata, Jun Miki, Takahiro Kimura, Hirokazu Abe et Shin Egawa. « Modified Glasgow prognostic score is a pre-surgical prognostic marker of disease mortality in upper urinary tract urothelial carcinoma ». Japanese Journal of Clinical Oncology 51, n^o 1 (30 juillet 2020) : 138–44. http://dx.doi.org/10.1093/jjco/hyaa133.

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Abstract Background To investigate the prognostic value of pre-surgical modified Glasgow prognostic score in upper urinary tract urothelial carcinoma patients treated with radical nephroureterectomy. Methods We retrospectively reviewed the clinical records of 273 urinary tract urothelial carcinoma patients treated with radical nephroureterectomy. The modified Glasgow prognostic score was evaluated based on pre-surgical serum C-reactive protein and albumin. Association of modified Glasgow prognostic score with recurrence-free survival, cancer-specific survival and overall survival rates was estimated using Kaplan−Meier method and log-rank test was used to compare survival outcome. Cox regression analyses were performed for the assessment of the modified Glasgow prognostic score with recurrence-free survival, cancer-specific survival and overall survival. Results Of total 273 patients, the modified Glasgow prognostic score 0, 1 and 2 were assigned in 216 (79%), 45 (17%) and 12 (4%), respectively. The recurrence-free survival, cancer-specific survival and overall survival of urinary tract urothelial carcinoma patients with modified Glasgow prognostic score 2 were significantly worse than those with modified Glasgow prognostic score 0. On univariate analysis, modified Glasgow prognostic score 2 was associated with worse recurrence-free survival, cancer-specific survival and overall survival (all P value <0.01). On multivariate analyses, modified Glasgow prognostic score 2 was independently associated with worse cancer-specific survival and overall survival (hazard ratio: 4.73, 95% confidence interval: 1.31–17.2 and hazard ratio: 3.66, 95% confidence interval: 1.08–12.4, respectively). In the subgroup analyses of advanced urinary tract urothelial carcinoma patients, modified Glasgow prognostic score 2 was independently associated with worse recurrence-free survival (hazard ratio 4.31, 95% confidence interval: 1.69–11.1). Conclusions Pre-surgical modified Glasgow prognostic score independently predicts cancer-specific survival and overall survival of urinary tract urothelial carcinoma patients. Assessment of pre-surgical modified Glasgow prognostic score status could help identifying the worse survivor of urinary tract urothelial carcinoma patients.

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Ezekwudo, Daniel E., Foluso Ogunleye, Bolanle Gbadamosi, LeAnn M. Blankenship, Michael Kinoyan, Daniel Krauss, Mitchell Hollander, Kristle Haberichter et Ishmael Jaiyesimi. « Primary Extranodal Diffuse Large B-Cell Lymphoma of the Prostate : A Case Report ». Case Reports in Oncology 10, n^o 1 (15 février 2017) : 199–204. http://dx.doi.org/10.1159/000457117.

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We report a case of primary diffuse large B-cell lymphoma of the prostate in a 54-year-old Caucasian male who presented with urinary retention and benign prostatic hyperplasia. We discuss the rare presentation of this disease and its clinicopathologic features and review the literature for up-to-date information on the diagnosis and clinical management. Despite the low incidence of lymphoma involving the prostate gland, it should always be considered as part of the differential diagnosis in cases of prostate gland enlargement with urinary tract obstructive symptoms resistant to medical therapy. Treatment modalities for this rare disease are also discussed.

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Gîrleanu, I., A. Trifan, A. M. Singeap, C. Cojocariu, S. Chiriac et C. Stanciu. « P221 Incidence and risk factors for low urinary tract infections in patients with inflammatory bowel disease ». Journal of Crohn's and Colitis 7 (février 2013) : S98. http://dx.doi.org/10.1016/s1873-9946(13)60243-3.

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Malloy, Katherine M., Kristen R. Nichols et Anna E. Thomas. « Candida nivariensis Urinary Tract Infection in an Extremely Low-Birth-Weight Neonate ». Journal of Pediatric Infectious Diseases 15, n^o 01 (16 janvier 2018) : 057–60. http://dx.doi.org/10.1055/s-0037-1621719.

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AbstractWe report on the diagnosis and treatment of a Candida nivariensis urinary tract infection in an extremely low-birth-weight neonate. The isolate was identified by MALDI-TOF technology and is the first known report of C. nivariensis in the neonatal or pediatric population. Treatment was initiated with amphotericin B deoxycholate and later completed with intravenous fluconazole following susceptibility results.

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Pirvut, Mircea Valentin, Ionela Mihai, Alexandra Ioana Micu, Alexandru Tiberiu Priporeanu, Vasile Baisanu, Ionel Dudas, Adrian Hasegan et Nicolae Grigore. « Renal colic secondary to ureteral metastasis : Rare presenting manifestation of prostate cancer ». Medical Science and Discovery 7, n^o 7 (24 juillet 2020) : 575–77. http://dx.doi.org/10.36472/msd.v7i7.395.

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Objective: Ureteral metastasis of prostate cancer is a very rare pathology, that can be confused with an upper urinary tract urothelial carcinoma, with great implications in the surgical management and therapy of the disease. Case: A 56-years old male patient admitted to the emergency room with 2 weeks history of left flank pain without low urinary tract symptoms or hematuria. PSA level was 43,4 ng/ml. The patient underwent prostate needle biopsy and ureteral biopsy using flexible ureteroscopy, after the Lich-Gregoire ureterovesical reimplantation. In this case, renal colic as the first symptom of a ureteral metastasis secondary to prostate cancer is extremely rare which diagnosed in the patient. Conclusion: Neoureterocystostomy is a safe and effective treatment for ureteral obstruction due to prostate cancer metastasis, with low morbidity and significant benefits in terms of quality of life for patients with life expectancy more than 10 years.

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Moore, K., J. Khastgir et M. Ghei. « Endoscopic Management of Upper Tract Urothelial Carcinoma ». Advances in Urology 2009 (2009) : 1–6. http://dx.doi.org/10.1155/2009/620604.

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Nephroureterectomy is currently the gold standard for management of upper urinary tract urothelial carcinoma despite it results. This review article in the loss of a renal unit. The ultimate aim of endoscopic management of this condition is cancer control whilst preserving renal function and the integrity of the urinary tract. Endoscopic treatments of upper tract TCC include the antegrade percutaneous and retrograde ureteroscopic approaches. This review article summarizes the endoscopic management of upper tract urothelial carcinoma, surveillance of the disease after endoscopic management and adjuvant therapy. The main message regarding endoscopic management of upper tract urothelial cancer is that patients must be carefully selected. Patient selection is based on tumour size, grade, and multifocality. Single low-grade tumours, less than 1.5 cm in size, generally have a good outcome with endoscopic treatment provided that they have regular ureteroscopic surveillance. Ureteroscopic treatment of high-grade tumours is essentially palliative. It is essential that patients are motivated and compliant as lifetime follow-up is necessary. However, until large randomized trials with long-term follow-up are performed, endoscopic management cannot be considered a standard treatment and should be limited to poor performance status patients.

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Roitberg, G. E., V. V. Astashov, K. G. Mkrtchyan et A. A. Lomshakov. « Treatment of beneficial prostate hyperplasia of large sizes : traditional surgical, low-invasive and laser technologies (literature review) ». Laser Medicine 24, n^o 4 (28 avril 2021) : 62–68. http://dx.doi.org/10.37895/2071-8004-2020-24-4-62-68.

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Benign prostatic hyperplasia – one of the most common diseases in older men. The treatment strategy for benign prostatic hyperplasia consists in its drug therapy, or active surgical tactics. The indication for planned surgical treatment of benign prostatic hyperplasia is the progression of symptoms of the lower urinary tract, which are not amenable to drug correction. Men with a large prostate volume of more than 80 m3, with severe symptoms of the lower urinary tract, with a history of acute urinary retention episodes, represent a difficult group of patients in terms of choosing the tactics of surgical treatment. This article discusses the most common operations that are used in the treatment of benign prostatic hyperplasia (especially of large sizes): open adenectomy, transurethral resection of the prostate gland, enucleation of benign prostatic hyperplasia using a holmium laser, embolization of an artery of the prostate gland. Surgical treatment of benign prostatic hyperplasia requires an individual approach to the patient, taking into account his age, concomitant pathology and clinical symptoms.

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Letkiewicz, Sławomir, Marzanna Łusiak-Szelachowska, Ryszard Międzybrodzki, Maciej Żaczek, Beata Weber-Dąbrowska et Andrzej Górski. « Low Immunogenicity of Intravesical Phage Therapy for Urogenitary Tract Infections ». Antibiotics 10, n^o 6 (25 mai 2021) : 627. http://dx.doi.org/10.3390/antibiotics10060627.

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Patients with chronic urinary and urogenital multidrug resistant bacterial infections received phage therapy (PT) using intravesical or intravesical and intravaginal phage administration. A single course of PT did not induce significant serum antibody responses against administered phage. Whilst the second cycle of PT caused a significant increase in antibody levels, they nevertheless remained quite low. These data combined with good therapy results achieved in some patients suggest that this mode of PT may be an efficient means of therapy for urogenital infections and a reliable model for a clinical trial of PT.

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Julinawati, Syarifah, Oke Rina, Rosmayanti Rosmayanti, Rafita Ramayati et Rusdidjas Rusdidjas. « Urine dipstick test for diagnosing urinary tract infection ». Paediatrica Indonesiana 53, n^o 6 (30 décembre 2013) : 315. http://dx.doi.org/10.14238/pi53.6.2013.315-9.

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Background Urinary tract infection (UTI) is a common diseasein children. Approximately 3-5% of girls and 1 % of boys developa UTI. In children, prompt treatment is essential because UTImay be a risk factor for developing renal insufficiency or end stagerenal disease. Howevet; prompt treatment depends on having arapid diagnosis. Urine dipstick testis a useful and commonly usedbecause it is low cost and gives rapid results, compared to urinecultures for diagnosing UTis. However, the diagnostic accuracyof the urine dipstick test is debatable.Objective To compare urine dipstick test (leukocyte esterase,nitrite, and combined leukocyte es terase and nitrite) to urineculture for diagnosing UTis.Methods A diagnostic study was held in H. Adam Malik Hospitalfrom May to June 2010. There were 70 children aged 2 to 14years and recruited by consecutive sampling. Two midstreamurine specimens were collected from subjects after cleaning theexternal urethral orifice. The first specimen was used for urinedipstick testing for leukocyte esterase and nitrite. The secondurine specimen was cultured in the laboratory. Urinalysis forleukocyte esterase and nitrite studies were performed with freshand uncentrifuged urine. Leukocyte esteras e and nitrite causeda change in dipstick color apparent within 2 minutes. Urinalyseswere considered to be positive for UTI if either leukocyte esteraseor nitrite were positive. The results of urine culture were used asthe golden standard.Results The sensitivities of leukocyte esterase and nitratetests were 90 .5% and 73.8%, respectively. However, thesensitivity for combined leukocyte esterase and nitrite testwas 96.4%. Nitrite test was more specific (60.7%) than theleukocyte esterase test (39.3%). The specificity of both teststaken together was 64.3% . For leukocyte esterase alone, nitratealone, and the two combined the positive predictive values(PPV) were 69.1 %, 73.8%, and 64.3.%, respectively, and thenegative predictive values (NPV) were 73.3%, 60.7%, and96.4%, respectively.Conclusion Urine dipstick test for leukocyte esterase and nitritecombined may be a good alternative diagnostic test for UTis inchildren than leukocyte esterase or nitrite by themselves in areaswith limited resources.

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Bieri, Uwe, Benedikt Kranzbühler, Burkhardt Seifert, Birgit Maria Helmchen, Alexander Gu, Basil Kaufmann, Dejan Lavrek et al. « Is Regular Radiographic Upper Urinary Tract Imaging for Surveillance of Non-Muscle Invasive Bladder Cancer Justified ? » Cancers 14, n^o 22 (14 novembre 2022) : 5586. http://dx.doi.org/10.3390/cancers14225586.

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Patients with non-muscle invasive (NMI) urothelial bladder cancer (BC) are at increased risk for the development of a secondary upper-urinary-tract urothelial carcinoma (UTUC). We aimed to assess the usefulness of routine upper-tract imaging surveillance during NMIBC follow-up in a patient cohort of a tertiary academic center. All routine upper-tract-imaging scans using computerized tomography urography (CTU) between 2003 and 2016 were assessed for UTUC detection. A total of 315 patients were analyzed. Initial tumor stage was Ta in 207 patients (65.7%), T1 in 98 patients (31.1%) and pure CIS in 10 patients (3.2%). A total of 149 (47.3%) presented with low-grade (LG), and 166 (52.7%) with high-grade (HG) disease. Median follow-up was 48 months (IQR: 55). Four patients (1.2%) were diagnosed with UTUC during follow-up. All four patients presented with initial Ta HG BC. Two of the patients (50%) were diagnosed by routine upper tract imaging. The other two patients were diagnosed after development of symptoms. The 5- and 10-year UTUC-free survival was 98.5% (standard error (SE) 0.9) and 97.6% (SE 1.3), respectively. UTUCs were detected exclusively in patients with initial HG disease, indicating that upper-tract surveillance might only be necessary in these patients.

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Putra Gofur, Nanda Rachmad, Aisyah Rachmadani Putri Gofur, Soesilaningtyas Soesilaningtyas, Rizki Nur Rachman Putra Gofur, Mega Kahdina et Hernalia Martadila Putri. « Risk Factor and Pathophysiology of Nephrolithiasis : A Review Article ». Journal of Clinical Surgery and Research 2, n^o 1 (10 avril 2021) : 01–04. http://dx.doi.org/10.31579/2768-2757/007.

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Introduction: Nephrolithiasis is a urinary tract stone disease that can be found in the kidneys, ureters, bladder, and urethra. This disease is the three most common diseases in the field of urology besides urinary tract infections and benign prostate enlargement. Kidney stones are the most common, with an estimated lifetime prevalence as high as 15%. Bladder stones have significant morbidity but occur much less frequently than kidney stones. Many factors cause reduced urine flow and cause obstruction, one of which is urine static and decreased urine volume due to dehydration and inadequate fluid intake, this can increase the risk of nephrolithiasis. Low urine flow is a common abnormal symptom. In addition, various conditions that trigger nephrolithiasis such as the composition of various stones are the main factors in identifying the cause of nephrolithiasis. Aims of this article is to review risk factors and pathophysiology of nephrolithiasis. Discussion: Symptoms associated with urinary tract stones depend on the location of the stone, the size of the stone, and any complications that have occurred. Usually, stones in the kidney calyx are asymptomatic. When the stone falls off and descends into the narrow ureter, it becomes symptomatic. Stones generally get stuck in the narrowest part of the ureter, such as the uretero-pelvic junction, when the ureter crosses the iliac vasa, and the uretero-vesical junction. The main symptom of ureteric stones is often an acute onset of pain in the back. This pain can be colicky or not. Colic pain occurs because the peristaltic activity of the smooth muscle of the calical system or ureter increases in an attempt to remove stones from the urinary tract. The increase in peristalsis causes the intraluminal pressure to increase so that there is stretching of the nerve terminals that provide a sensation of pain. The pain can radiate from the pelvis and to the ipsilateral groin. Other symptoms include nausea, vomiting and hematuria. Hematuria can occur macros or microscopy from urinalysis. Hematuria occurs as a result of trauma to the urinary tract mucosa caused by stones. Conclusion: Nephrolithiasis is rock-forming salt reaches a urine concentration that exceeds the equilibrium point between the dissolved component and crystallization occurs. There are several risk factors that nephrolithiasis occurs due to various causes. Therapy and lifestyle changes are interventions that can change risk factors, but there are also risk factors that cannot be changed.

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Uchiyama, T., T. Yamamoto, Y. Watanabe, T. Kadowaki, K. Hashimoto, T. Shingo, K. Kaga et al. « Photo-stimulating effect of low reactive level laser on lower urinary tract dysfunction in Parkinson disease model ». Journal of the Neurological Sciences 357 (octobre 2015) : e212-e213. http://dx.doi.org/10.1016/j.jns.2015.08.730.

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Zdziarski, Jaroslaw, Catharina Svanborg, Björn Wullt, Jörg Hacker et Ulrich Dobrindt. « Molecular Basis of Commensalism in the Urinary Tract : Low Virulence or Virulence Attenuation ? » Infection and Immunity 76, n^o 2 (26 novembre 2007) : 695–703. http://dx.doi.org/10.1128/iai.01215-07.

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ABSTRACT In some patients, Escherichia coli strains establish significant bacteriuria without causing symptoms of urinary tract infection (UTI). These asymptomatic-bacteriuria (ABU) strains have been shown to express fewer virulence factors than the uropathogenic E. coli (UPEC) strains that cause severe, symptomatic UTI. Paradoxically, ABU strains carry many typical UPEC virulence genes, and the molecular basis of their low virulence therefore remains unclear. This study examined whether ABU strains might evolve from UPEC by genome loss and virulence gene attenuation. The presence of conserved E. coli K-12 genes was examined using an E. coli K-12 strain MG1655-specific DNA array and the distribution of UPEC virulence-related genes was examined with the E. coli pathoarray. Two groups of strains could be distinguished. Several ABU strains were shown by multilocus sequence typing and by comparative genomic analyses to be related to UPEC but to have smaller genome sizes. There were significant alterations in essential virulence genes, including reductive evolution by point mutations, DNA rearrangements, and deletions. Other strains were unrelated to UPEC and lacked most of the virulence-associated genes. The results suggest that some ABU strains arise from virulent strains by attenuation of virulence genes while others are nonvirulent and resemble commensal strains. We propose that virulence attenuation might constitute a general mechanism for mucosal pathogens to evolve toward commensalism.

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Langman, Craig B., Danica Grujic, Rita M. Pease, Linda Easter, Jennifer Nezzer, Alexey Margolin et Lee Brettman. « A Double-Blind, Placebo Controlled, Randomized Phase 1 Cross-Over Study with ALLN-177, an Orally Administered Oxalate Degrading Enzyme ». American Journal of Nephrology 44, n^o 2 (2016) : 150–58. http://dx.doi.org/10.1159/000448766.

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Background: Hyperoxaluria may result from increased endogenous production or overabsorption of dietary oxalate in the gastrointestinal tract leading to nephrolithiasis and, in some, to oxalate nephropathy and chronic kidney disease. ALLN-177 is an oral formulation of a recombinant, oxalate specific, microbial enzyme oxalate decarboxylase intended to treat secondary hyperoxaluria by degrading dietary oxalate in the gastrointestinal tract, thereby reducing its absorption and subsequent excretion in the urine. Methods: This double-blind, placebo controlled, randomized, cross-over, phase 1 study of ALLN-177 evaluated the tolerability of ALLN-177 and its effect on urinary oxalate excretion in 30 healthy volunteers with hyperoxaluria induced by ingestion of a high oxalate, low calcium (HOLC) diet. The primary end point was the difference in the mean 24-hour urinary oxalate excretion during the ALLN-177 treatment period compared with the placebo treatment period. Results: The daily urinary oxalate excretion increased in the study population from 27.2 ± 9.5 mg/day during screening to 80.8 ± 24.1 mg/day (mean ± SD) on the HOLC diet before introducing ALLN-177 or placebo therapy for 7 days. Compared to placebo, ALLN-177 treatment reduced urinary oxalate by 11.6 ± 2.7 mg/day, p = 0.0002 (least squares mean ± SD). Conclusions: In healthy volunteers, with diet-induced hyperoxaluria treatment with ALLN-177, when compared to placebo, significantly reduced urinary oxalate excretion by degrading dietary oxalate in the gastrointestinal tract and thereby reducing its absorption. ALLN-177 may represent a new approach for managing secondary hyperoxaluria and its complications.

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Liu, Meng, Jiasheng Chen, Nailong Cao, Weixin Zhao, Guo Gao, Ying Wang et Qiang Fu. « Therapies Based on Adipose-Derived Stem Cells for Lower Urinary Tract Dysfunction : A Narrative Review ». Pharmaceutics 14, n^o 10 (19 octobre 2022) : 2229. http://dx.doi.org/10.3390/pharmaceutics14102229.

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Lower urinary tract dysfunction often requires tissue repair or replacement to restore physiological functions. Current clinical treatments involving autologous tissues or synthetic materials inevitably bring in situ complications and immune rejection. Advances in therapies using stem cells offer new insights into treating lower urinary tract dysfunction. One of the most frequently used stem cell sources is adipose tissue because of its easy access, abundant source, low risk of severe complications, and lack of ethical issues. The regenerative capabilities of adipose-derived stem cells (ASCs) in vivo are primarily orchestrated by their paracrine activities, strong regenerative potential, multi-differentiation potential, and cell–matrix interactions. Moreover, biomaterial scaffolds conjugated with ASCs result in an extremely effective tissue engineering modality for replacing or repairing diseased or damaged tissues. Thus, ASC-based therapy holds promise as having a tremendous impact on reconstructive urology of the lower urinary tract.

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Peker, Deniz, Timothy Edward Kubal, Eduardo M. Sotomayor, Lubomir Sokol, Jennifer L. Cultrera, Celeste M. Bello, Paul A. Chervenick et al. « Unusual primary presentations of mantle cell lymphoma in the urinary tract and testes. » Journal of Clinical Oncology 30, n^o 15_suppl (20 mai 2012) : e18503-e18503. http://dx.doi.org/10.1200/jco.2012.30.15_suppl.e18503.

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e18503 Background: The initial clinical presentation of Mantle Cell Lymphoma is protean, ranging from single sites of indolent disease followed for years without therapy to aggressive disseminated disease that requires treatment within weeks of diagnosis. While many cases of Mantle Cell Lymphoma present with disseminated disease, other patients may present with symptoms related to a primary extranodal site of disease. The majority of these primary extranodal cases are diagnosed in the gastrointestinal tract, other cases have been noted in the skin, conjunctiva, testes and male genitourinary tract. Methods: Database review of 204 patients diagnosed with Mantle Cell Lymphoma at Moffitt Cancer Center between May 1992 and December 2010. Results: Three cases of Mantle Cell Lymphoma presented with symptoms related to primary extranodal sites in the urinary tract and male genital organs. Two cases of testicular involvement presented with gradual enlargement of the testes. In patient 1, the orchiectomy specimen harbored both seminoma and mantle cell lymphoma. Low level bone marrow involvement by mantle cell lymphoma was present and in the presence of indolent features he was treated for his primary seminoma and followed expectantly for mantle cell lymphoma. In patient 2, orchiectomy revealed a pleomorphic variant of mantle cell lymphoma with no other sites of disease on staging workup. He was treated with 6 cycles of R-CHOP and prophylactic IT methotrexate with a complete remission. A third patient presented with obstructive urinary symptoms and was found to have mantle cell lymphoma of the prostate. Additional staging revealed diffuse lymphadenopathy, colon and bone marrow involvement. A complete remission was obtained with 6 cycles of R-CHOP. None of these three patients was found to have evidence of CNS involvement at diagnosis or in followup with only the second patient receiving intrathecal prophylaxis. Conclusions: Mantle Cell Lymphoma may present with unusual extranodal involvement at diagnosis including sites and symptoms related to the genitourinary tract and testes. Diagnostic lumbar puncture and intrathecal prophylaxis should be considered in these patients.

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Vasilakopoulou, Alexandra, Sophia Vourli, Nikolaos Siafakas, Dimitra Kavatha, Nikolaos Tziolos et Spyros Pournaras. « Enterococcus casseliflavus Bacteraemia in a Patient with Chronic Renal Disease ». Infectious Disease Reports 12, n^o 3 (4 novembre 2020) : 70–73. http://dx.doi.org/10.3390/idr12030015.

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Enterococcus casseliflavus is a rare pathogen that usually causes urinary tract and abdominal infections. Its main characteristics are positive motility, yellow colonies and constitutive low-level resistance to vancomycin. We present a case of E. casseliflavus bacteraemia due to thrombophlebitis at the site of the central venous catheter used for hemodialysis in a renal patient. The biochemical identification of the microorganism was further corroborated by molecular detection of the vanC gene. The patient received antibiotic therapy initially with daptomycin and gentamicin, and then with ampicillin and ceftriaxone. The outcome was cure, and he was released from the hospital after seven weeks afebrile with negative blood cultures.

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Kampouras, Asterios, Georgios Tzikos, Eustathios Partsanakis, Konstantinos Roukas, Stefanos Tsiamitros, Dimitrios Deligeorgakis, Elisavet Chorafa, Maria Schoina et Elias Iosifidis. « Child Morbidity and Disease Burden in Refugee Camps in Mainland Greece ». Children 6, n^o 3 (17 mars 2019) : 46. http://dx.doi.org/10.3390/children6030046.

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The crisis conflicts in Syria have forced a lot of people to relocate and live in mainland Greece, where they are hosted in refugee camps. In the present study, our aim was to assess child morbidity and overall disease burden in two camps in northern Greece during a six-month winter period. A primary health care office was founded in each camp. Refugees of all ages with health problems were examined daily by specialty doctors. Cases were classified into two categories: Infectious or non-infectious. In total, 2631 patients were examined during this period (out of the 3760 refugees hosted). Of these patients, 9.8% were infants, 12.7% were toddlers, and 13.4% were children. Most of the visits for children aged less than 12 years old were due to infectious diseases (80.8%). The most common sites of communicable diseases among children were the respiratory tract (66.8%), the skin (23.2%), and the urinary (3.2%) and gastrointestinal tracts (6.2%). Non-communicable diseases were mostly due to gastrointestinal (20.2%), respiratory (18.2%), surgical (13.1%), and allergic (10.3%) disorders. Infants, toddlers, and children suffered more frequently from respiratory infections, while in adolescents and adults, non-infectious diseases were more common. Toddlers and children were more likely to fall ill in comparison to infants. Conclusions: During the winter period, infectious diseases, especially of the respiratory tract, are the main reason for care seeking among refugees in Greek camps, with toddlers suffering more than other age groups. The overall mortality and referral percentage were low, indicating that adequate primary care is provided in this newly established refugee hosting model.

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Velasco-Zúñiga, Roberto, Juan Enrique Trujillo-Wurttele, Jose Luis Fernández-Arribas, Beatriz Serrano-Carro, Nathalie Campo-Fernández et Sara Puente-Montes. « Predictive Factors of Low Risk for Bacteremia in Infants With Urinary Tract Infection ». Pediatric Infectious Disease Journal 31, n^o 6 (juin 2012) : 642–45. http://dx.doi.org/10.1097/inf.0b013e31824bf145.

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Járomi, Péter, Tamás Banyó, Mihály Boros, Ferenc Papp et Andrea Szabó. « A neurogén húgyhólyag klinikuma és terápiás lehetőségei ». Orvosi Hetilap 162, n^o 4 (24 janvier 2021) : 135–43. http://dx.doi.org/10.1556/650.2021.31974.

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Összefoglaló. Az alsó húgyutak fő funkciója a vizelet tárolása és ürítése, amely működések zavara az úgynevezett alsó húgyúti tünetegyüttes kialakulásához vezet, ami a kiváltó októl függően vizeletürítési zavarral és vizeletretencióval is járhat. Kezeletlen esetekben a felső húgyutak károsodása következik be a magas hólyagnyomás által kiváltott vesicoureteralis reflux következtében, amely ureter- és veseüregrendszeri tágulat kialakulására, illetve fertőzésekre és kőképződésre hajlamosít. A vizelettárolási/vizeletürítési zavarokat három fő csoportba sorolhatjuk, úgymint stressz- (terheléses) inkontinencia , hiperaktív hólyag (nedves/száraz) és neurogén hólyag. A jelen összefoglaló közlemény tárgyát képező neurogén hólyag egy gyűjtőfogalom, mely magában foglal minden, releváns neurológiai kórkép talaján kialakult vizelettárolási és vizeletürítési zavart. Mivel a húgyhólyag mellett a záróizomzat és a hátsó húgycső is érintett, ezt a kórképet napjainkban „neurogén alsó húgyúti diszfunkció” elnevezéssel is szokás illetni. A kórállapotot a neurológiai diszfunkciók széles spektruma okozhatja, kezdve a helyi funkcionális zavartól a helyi idegi sérülésen át a felső és alsó motoneuron-sérülésig vagy a centrális degeneratív folyamatokig. Az eltérő etiológia ellenére a klinikai tünetek rendszerint két alapvető klinikai típusban manifesztálódhatnak: túlműködő (fokozott detrusorkontraktilitást okozó automata) hólyag vagy alulműködő hólyag formájában. Tekintettel a neurogén alsó húgyúti diszfunkció következtében létrejövő felső húgyúti komplikációkra, a közlemény egyik célja a betegség diagnózisát segítő algoritmus bemutatása a legújabb nemzetközi szakirodalmi ismeretek alapján. A neurogén hólyag kezelése jobbára nem terjedhet ki a kiváltó ok kezelésére, ezért a jelen összefoglaló másik célja azon gyógyszeres és invazív terápiás beavatkozások összefoglalása, melyek a felső húgyutak védelmét szolgálják az alacsony hólyagnyomás fenntartása révén. Orv Hetil. 2021; 162(4): 135–143. Summary. Storage and urination are the main functions of the lower urinary tract and its lesions lead to the so-called lower urinary tract syndrome causing either urinary incontinence or retention. In untreated cases, the upper urinary tract becomes injured via a vesicoureteral reflux resulting from increased bladder pressure and resultant dilations of the ureter and the renal pelvis which predispose to infection and stone formation. Lower urinary tract storage/urination disorders can be classified as stress incontinence, hyperactive bladder (wet/dry) and neurogenic bladder. Neurogenic bladder which is the subject of this review, is a collective term that encompasses all urinary storage and emptying disorders which develop on the basis of neurological diseases. Being not only the bladder, but also the sphincter and posterior urethra (generally termed as the “bladder outlet”) affected, nowadays this condition is referred to as “neurogenic lower urinary tract dysfunction”. A wide range of neurological dysfunctions could contribute to the development of this condition, ranging from local dysfunction (autonomic dysreflexia) or local nerve injury to upper/lower motoneuron injury or central degenerative processes. Regardless of the diverse etiology, the clinical symptoms eventually manifest in two major forms, i.e., overacting (automatic bladder with increased detrusor contractility) and underactive bladder. Considering the severity of complication occurring in the upper urinary tract in response to the pathophysiological changes in the lower urinary tract, one of the aims of this paper was to present an algorithm aiming to build up a state of the art diagnosis of the disease based on current international literature data. Since treatment of the neurogenic bladder usually can not target elimination of the underlying cause, the other goal of the present paper is to summarize the pharmacological treatment regimen and invasive therapeutic interventions that protect the upper urinary tract by maintaining low pressure values in the bladder. Orv Hetil. 2021; 162(4): 135–143.

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Khan, Md Rokonuzzaman, Fazal Naser, Moazzam Hossain et Mostafizur Rahman. « Flexible Cystoscopy a Valuable Diagnostic Lool for Lower Urinary Tract Pathology ». Bangladesh Journal of Urology 23, n^o 2 (15 novembre 2020) : 151–53. http://dx.doi.org/10.3329/bju.v23i2.50306.

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Objective: To assess the role of flexible cystoscopy in the diagnosis of lower urinary tract pathology and its suitability as a routine diagnostic protocol in outdoor patients. Methods: The cross sectional study was conducted at the advanced centre of kidney diseases and urology, Dhaka central international medical college, Dhaka from Jan 2016 to jan2019. All adult patients presenting with lower urinary symptoms to outdoor department were included. Flexible Cystoscopy was performed as a outdoor based procedure without sedation. Results: Of the 249 patients in the study,198(79%) were male and 51(21%) were female. Lower urinary tract pathologies were found in 192(72%) patients. The most common pathology among males was enlarged prostate 56(31%) patients. Urethral stricture, bladder neck high were found 23(11%),21(10%) respectively. Among females, urethral stenosis was the most common pathology in 23(32%)patients. Transitional cell carcinoma was seen in 11(4.4%) patients having hematuria with inconclusive ultrasound and intravenous urography. .All patients tolerated the procedure well with no procedure related complaints. Conclusion: Flexible cystoscopy is an effective, well tolerated and easy way of detecting lower urinary tract pathologies. It can alter the management as well as support the diagnosis and management. It is also helpful in routine surveillance of bladder tumours of low grade and low stage. Flexible cystoscopy should therefore be used as routine diagnostic protocol in outdoor practice. Bangladesh Journal of Urology, Vol. 23, No. 2, July 2020 p.151-153

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Agato, Albert, Victor Yullius et Heru Heru. « Studi kasus : Cystitis pada kucing tom di k and p clinic Surabaya ». VITEK : Bidang Kedokteran Hewan 12, n^o 2 (19 octobre 2022) : 9–12. http://dx.doi.org/10.30742/jv.v12i2.115.

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Cystitis is an inflammation of the urinary bladder which is common in domestic animals as part of a urinary tract infection. Clinical symptoms of cystitis are lower abdominal pain on palpation, dysuria (animals show signs of pain on every attempt to urinate) and hematuria. The diagnosis of cystitis can be obtained through anamnesis, abdominal palpation, physical examination, clinical symptoms, urinalysis with sediment examination, blood chemistry examinations such as urea and creatinine levels, urine culture, uroendoscopy and ultrasound examination and radiography. stated that a biopsy can also be performed to differentiate cystitis from other diseases such as neoplasia. Blood test results show low platelets or platelets / anemia, thrombocytopenia. The results of the ultrasound examination showed a thickening of the walls of the VU

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Crawford, E. David, Neal Shore, Kurt Miller, Bertrand Tombal, Cathrina Kathrup, Egbert van der Meulen et Bo-Eric Persson. « Degarelix versus LHRH agonists : Differential skeletal and urinary tract outcomes from an analysis of six comparative randomized clinical trials. » Journal of Clinical Oncology 31, n^o 6_suppl (20 février 2013) : 68. http://dx.doi.org/10.1200/jco.2013.31.6_suppl.68.

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68 Background: The use of ADT in men with prostate cancer is well established. GnRH antagonists have a mode of action distinct to that of LHRH agonists and comparative trials have shown differences in efficacy and safety between these agents. Adverse events (AE) from the musculoskeletal and renal and urinary systems have now been analysed. Methods: Results were pooled from 6 prospective, comparative randomised trials (n=2328). Most patients (pts) received 1 year of degarelix or LHRH agonist treatment (n=1686); the remaining men had 3–7 months’ treatment (n=642). AEs were analysed using Kaplan Meier plots and a log-rank test for homogeneity on relevant groups of MedDRA terms. Results: Treatment groups (degarelix, n=1491; LHRH agonist, n=837) were balanced for baseline characteristics such as age, testosterone, PSA and disease stage. In men with metastatic disease alkaline phosphatase (ALP) was reduced to a greater extent with degarelix (p=0.0373) throughout the year. Overall probability of fracture (<1% vs. 2%, p=0.0411) and incidence of joint related AEs (4% vs. 6%, p=0.0116) were significantly lower for degarelix-treated men. Incidence of muscle or bone pain was lower for degarelix (9% vs. 12%, p=0.0822). Incidence of urinary infections (UI) was reduced (5% vs. 8% with agonists) and time to first UI was significantly increased (p=0.0010) with degarelix. Overall probability of any renal or urinary tract AEs, including lower urinary tract symptoms (LUTS), was significantly lower in pts receiving degarelix (p<0.0001). Consistent with fewer skeletal and urinary tract AEs indicating better disease control, men with baseline PSA >50 ng/mL had significantly higher PSA PFS compared to agonist treated pts. OS during 1 year of treatment was significantly higher for degarelix pts (98.3% vs. 96.7%, p=0.0329). Conclusions: This analysis of 2,328 men shows degarelix-treated men had lower ALP, significantly fewer fractures, a lower incidence of urinary tract symptoms and higher overall survival than pts receiving an LHRH agonist over one year. Control of such disease symptoms is consistent with previous data on a significantly lower risk of PSA PFS during the first year of treatment.

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