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Balsara, Zarine R., Sherry S. Ross, Paul C. Dolber, John S. Wiener, Yuping Tang, and Patrick C. Seed. "Enhanced Susceptibility to Urinary Tract Infection in the Spinal Cord-Injured Host with Neurogenic Bladder." Infection and Immunity 81, no. 8 (June 10, 2013): 3018–26. http://dx.doi.org/10.1128/iai.00255-13.
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ABSTRACTNeurogenic bladder predisposes to recurrent urinary tract infections (UTI) and renal failure, and susceptibility is commonly ascribed to urinary stasis from elevated residual urine volumes.Escherichia coliUTI was modeled in the spinal cord-injured (SCI) rat with the hypothesis that SCI animals would require fewer bacteria to establish infection, have an exaggerated inflammatory response, and have delayed clearance of infection compared to normal-voiding controls. T10 SCI rats and controls had median infectious doses (ID50) of 102and 105CFU, respectively. Mean residual volumes in the SCI animals did not correlate with susceptibility to initiation of UTI or outcome. In the acute infection, control and SCI rats developed acute cystitis and pyelitis without acute differences in histopathological scores of inflammation. However,in vivoimaging of infected animals revealed persistently higher levels of bacteria in the SCI urine and bladders than were seen for controls over 2 weeks. Likewise, at 2 weeks, acute and chronic inflammatory infiltrates persisted in the bladders and kidneys of SCI rats, whereas inflammation largely resolved within the controls. Together these data demonstrate that SCI rats exhibit delayed clearance of infection and exaggerated inflammatory responses in bladders and kidneys; however, the severity of residual volumes does not predict increased susceptibility to UTI. These studies suggest that host-dependent mechanisms that are discrete from alterations in bladder physiology influence UTI susceptibility with the SCI-neurogenic bladder. This model will allow elucidation of SCI-neurogenic bladder-mediated changes in host response that yield UTI susceptibility and may lead to new preventative and therapeutic options.
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Lobão, Maria João, and Paulo Sousa. "Hospital-Acquired Urinary Tract Infections: Results of a Cohort Study Performed in an Internal Medicine Department." Acta Médica Portuguesa 30, no. 9 (September 29, 2017): 608. http://dx.doi.org/10.20344/amp.8606.
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Introduction: Urinary tract infections are the most frequent healthcare associated infections, being related to both high costs and morbidity. Our intention was to carry out an epidemiological characterization of hospital acquired urinary tract infections that occurred in an internal medicine department of a Portuguese hospital.Material and Methods: Retrospective cohort study (historic cohort). Data were analysed from a systematic random sample of 388 patients, representative of the 3492 admissions occurred in 2014 in that department.Results: One in four patients underwent the placement of a bladder catheter [24.7% (n = 96); 95% CI: 20% - 29%], 36.5% (95% CI: 33% - 48%) of which in the absence of clinical criteria for that procedure. The global cumulative incidence rate for nosocomial urinary tract infections was 4.6% (95% CI: 2.5% - 6.7%). Most hospital acquired urinary tract infections (61.1%) were related to bladder catheter use. We quantified 3.06 infections / 1000 patient-days and 14.5 infections / 1000 catheter-days. Catheter associated urinary tract infection occurred at an early stage of hospitalization. The vast majority of patients (66.7%) that developed a catheter associated urinary tract infection were subjected to bladder catheter placement at emergency department. Seventy one per cent of catheter associated urinary tract infection occurred in patients that were subjected to bladder catheter placement without criteria.Discussion: These results point to an excessive and inadequate use of urinary catheters, highlighting the need for judicious use taking into account the formal clinical indications. The incidence of catheter associated urinary tract infection is similar to what we found in other studies. Nevertheless we found a very high incidence density per catheter-days that may foresee a problem probably related to the absence of early withdrawal of the device, and to both bladder catheter placement and maintenance practices. A significant part of catheter associated urinary tract infection occurred in patients that had the bladder catheter placed in the emergency department, before the admission to the internal medicine ward, which highlights the need to assess the urinary catheterization practices in those departments.Conclusion: The high rate of catheter associated urinary tract infection that occurred in the absence of bladder placement indication reinforces the need to implement prevention strategies that contemplate the reduction of its use. Emergency departments should be part of quality improvement projects in this area. Causes for the early onset of catheter associated urinary tract infection in this cohort should be investigated.
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Reyes, Leticia, Mary Reinhard, L. J. O'Donell, Janet Stevens, and Mary B. Brown. "Rat Strains Differ in Susceptibility to Ureaplasma parvum-Induced Urinary Tract Infection and Struvite Stone Formation." Infection and Immunity 74, no. 12 (September 18, 2006): 6656–64. http://dx.doi.org/10.1128/iai.00984-06.
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ABSTRACT Individuals with struvite uroliths are susceptible to recurrent urinary tract infections (UTI), sepsis, and renal disease. Unfortunately, little is known about the host-specific factors that predispose to this disease. In order to develop a rodent model that can address this problem, we inoculated female Fischer 344 (F344), Lewis (LEW), Sprague-Dawley (SD), and Wistar (WIS) rats with a host-adapted strain of Ureaplasma parvum. Animals were necropsied at 2 weeks postinoculation; 100% of F344, 42% of SD, 10% of LEW, and 10% of WIS rats remained infected. Severe bladder lesions and struvite calculi were seen in 64% of F344 rats; in other rat strains, bladder lesions were mild or absent. F344 rats with struvite uroliths had the highest urinary levels of proinflammatory cytokines, such as GRO/KC, interleukin-1α (IL-1α), and IL-1β. F344 rats without struvite stones at necropsy had milder bladder lesions and significantly lower urinary levels of proinflammatory cytokines but a more prominent inflammatory response than did other rat strains. Based on our results, struvite stone formation is linked to a robust inflammatory response that does not resolve UTI but instead promotes damage to surrounding tissues.
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Ashmawey, Abeer Mostafa, Waleed S. Mohamed, Ibrahim M. Abdel-Salam, Saad M. El-Gendy, Ali I. Ali, and Abdelbaset A. El-Aaser. "Role of Urinary Tract Bacterial Infection in the Process of Bladder Carcinogenesis (Molecular and Biochemical Studies)." Asian Journal of Medical Sciences 2, no. 1 (May 15, 2011): 31–40. http://dx.doi.org/10.3126/ajms.v2i1.3542.
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Objective: This work is designed to study the possible role of chronic inflammation induced by E. coli in the urinary bladder of rats, the protective role of soybean flour, in addition to the role of oxidative and nitrosative stresses during bladder carcinogenesis. Material & Methods: This study was done on one hundred and fifty adult male albino rats (50 - 60 gm) that divided into five groups; a) Normal control group, b) Dibutyl amine and sodium nitrate treated group, c)E.Coli treated group, d) Dibutyl amine and sodium nitrate treated group plus E. coli, and e) Dibutyl amine and sodium nitrate treated group plus soy bean flour. Survival rate and histopatholgical changes during the period of treatment were recorded. Level of malondialdhyde, glutathione, catalase, hydrogen peroxide, Total anti-oxidant capacity and nitric oxide were measured. RNA extracted from bladder tissues was determined in addition to P16 level and caspase-3 expression. Results: Survival analysis showed a significant decrease (p< 0.001) in E.Coli and dibutyl amine plus sodium nitrate treated groups in comparing with the normal and other treated groups. Also, E. coli infection in the bladder tissues increases the carcinogenic ability of nitrosamine precursors, and enhances oxidative and nitrosative stresses via increasing levels of nitric acid, hydrogen peroxide and malondialdhyde. Regarding the molecular changes, extra bands have been found in E. coli and E. coli + carcinogen treated groups approximately at 16-18KD which are not present in the other groups. Conclusion: Bacterial infection of the urinary bladder may play a major additive and synergistic role in bladder carcinogenesis. Our results have also shown that soy bean flour may have a protective action during induction of urinary tumors. Key Words: Bladder carcinogenesis; E. Coli; Soybean; DBA; P16 DOI: 10.3126/ajms.v2i1.3542 Asian Journal of Medical Sciences 2 (2011) 31-40
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Dedeić-Ljubović, Amela, and Mirsada Hukić. "Catheter-Related Urinary Tract Infection in Patients Suffering from Spinal Cord Injuries." Bosnian Journal of Basic Medical Sciences 9, no. 1 (February 20, 2009): 2–9. http://dx.doi.org/10.17305/bjbms.2009.2849.
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Urinary tract infection is commoner in patients with spinal cord injuries because of incomplete bladder emptying and the use of catheters that can result in the introduction of bacteria into the bladder. 145 patients suffering from spinal cord injuries, admitted to the Institute for physical medicine and rehabilitation, Centre for paraplegia of the Clinical Centre of the University of Sarajevo, were included. The patients were divided in three groups according to the method of bladder drainage: Group A (n=61) consisted of patients on clean intermittent catheterization; Group B (n=54) consisted of patients with indwelling catheters; Group C (n=30) consisted of patients who had performed self-catheterization. From a total of 4539 urine samples, 3963 (87,3%) were positive and 576 (12,7%) were sterile. More than 90% of the infected patients were asymptomatic.The overall rate of urinary infection amounted to about 2,1 episodes, and bacteriuria to 8,1 episodes per patient. 77% of infections (113/145) were acquired within seven days from catheterization.Infection was usually polymicrobial; the greatest number of urine samples 1770/3943 (44,9%) included more than one bacterium.The vast majority of cases of urinary tract infection and bacteriuria are caused by Gram-negative bacilli and enterococci, commensal organisms of the bowel and perineum, representative of those from the hospital environment. Providencia stuarti (18,9%) being the most common, followed by Proteus mirabilis (16,3%), Escherichia coli (11,8%), Pseudomonas aeruginosa (10,2%), Klebsiella pneumoniae (8,1%), Morganella morgani (5,4%), Acinetobacter baumannii (4,6%), Providencia rettgeri (3,5%). 15,7% of isolates were Gram-positive with Enterococcus faecalis (8,6%) as the most common. 55,3% of isolates were multidrug-resistant, and the highest rates of resistance were found among Acinetobacter baumannii (87,8%), Providencia rettgeri (86,7%), Pseudomonas aeruginosa (85,4%), Providencia stuarti (84,3%) and Morganella morgani (81,0%). Lower rates of resistance were found in Group C, i.e. patients on intermittent self- catheterisation. Eradication of organisms was achieved in only 53 (10,05%) of patients; hence, antibiotic therapy had no or very low effect.Significant correlations were found between the method of catheterization and the frequency of bacteriuria and urinary tract infections. The analysis of Group C showed a rate of lower urinary tract infection and bacteriuria than the other two Groups of patients. The objective of this study is the update of etiology and antimicrobial susceptibility in urinary tract infections in this group of patients. In addition, possible correlations between UTI and the type of bladder management were examined.
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Cornish, J., M. A. Vanderwee, G. Findon, and T. E. Miller. "Reliable diagnosis of Trichosomoides crassicauda in the urinary bladder of the rat." Laboratory Animals 22, no. 2 (April 1, 1988): 162–65. http://dx.doi.org/10.1258/002367788780864385.
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Two reliable methods are described for identifying infection of laboratory rats with the nematode Trichosomoides crassicauda. The first is a rapid method where cryostat sections of the rat urinary bladder are stained with acridine orange and viewed under a fluorescence microscope. The second involves the stabilization of the bladder surface prior to examination using scanning electron microscopy (SEM).
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Garcia-Roig, Michael L., and Andrew J. Kirsch. "Urinary tract infection in the setting of vesicoureteral reflux." F1000Research 5 (June 30, 2016): 1552. http://dx.doi.org/10.12688/f1000research.8390.1.
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Vesicoureteral reflux (VUR) is the most common underlying etiology responsible for febrile urinary tract infections (UTIs) or pyelonephritis in children. Along with the morbidity of pyelonephritis, long-term sequelae of recurrent renal infections include renal scarring, proteinuria, and hypertension. Treatment is directed toward the prevention of recurrent infection through use of continuous antibiotic prophylaxis during a period of observation for spontaneous resolution or by surgical correction. In children, bowel and bladder dysfunction (BBD) plays a significant role in the occurrence of UTI and the rate of VUR resolution. Effective treatment of BBD leads to higher rates of spontaneous resolution and decreased risk of UTI.
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Korac, Milos, Branko Milosevic, Lidija Lavadinovic, Aleksandar Janjic, and Branko Brmbolic. "Disseminated BCG infection in patients with urinary bladder carcinoma." Medical review 62, no. 11-12 (2009): 592–95. http://dx.doi.org/10.2298/mpns0912592k.
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Introduction. Bacillus Calmette-Gu?rin - a live, attenuated strain of Mycobacterium bovis has been used in immunotherapy of patients with superficial urinary bladder carcinoma. Some patients develop complications after intravesical instillation of BCG: high temperature followed by hematuria or granulomatous prostatits, epidydimoorchitis, urethral obstruction, and less than 1% have a systemic disease followed by dissemination of bacteria into other organs. Case report. A 50-year-old man underwent transurethral resection of a bladder tumor. One month after the operation BCG intravesical instillations were administered for three weeks. After the fourth instillation, our patient developed high fever, fatigue, vomiting, dark urine, light stools, and jaundice. On admission he was jaundiced with a high fever, enlarged liver and spleen and laboratory findings which included high erythrocyte sedimentation rate, pancytopenia, elevated liver enzymes, especially alkaline phosphatase and aminotranspherases. The bone-marrow biopsy showed granulomatous inflamation suggesting mycobacterial spread in the bone marrow, liver and spleen and sepsis. The patient was initially treated with antituberculous therapy, but his state did not improve until corticosteroids were added to the antituberuculous treatment regimen. Conclusion. Although dissemination of BCG is a rare complication of intravesical BCG treatment of the bladder carcinoma, it may result in prolonged fever and granulomatous inflamation of the liver, spleen, lungs, bone marrow and BCG sepsis. Antituberculous agents in combination with corticosteroids comprise the treatment of choice for disseminated BCG infection.
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Reyes, Leticia, Sophie Alvarez, Ayman Allam, Mary Reinhard, and Mary B. Brown. "Complicated Urinary Tract Infection Is Associated with Uroepithelial Expression of Proinflammatory Protein S100A8." Infection and Immunity 77, no. 10 (August 10, 2009): 4265–74. http://dx.doi.org/10.1128/iai.00458-09.
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ABSTRACT F344 rats chronically infected with Ureaplasma parvum develop two distinct profiles: asymptomatic urinary tract infection (UTI) and UTI complicated by struvite urolithiasis. To identify factors that affect disease outcome, we characterized the temporal host immune response during infection by histopathologic analysis and in situ localization of U. parvum. We also used differential quantitative proteomics to identify distinguishing host cellular responses associated with complicated UTI. In animals in which microbial colonization was limited to the mucosal surface, inflammation was indistinguishable from that which occurred in sham-inoculated controls, and the inflammation resolved by 72 h postinoculation (p.i.) in both groups. However, inflammation persisted in animals with microbial colonization that extended into the deeper layers of the submucosa. Proteome profiling showed that bladder tissues from animals with complicated UTIs had significant increases (P < 0.01) in proteins involved in apoptosis, oxidative stress, and inflammation. Animals with complicated UTIs (2 weeks p.i.) had the highest concentrations of the proinflammatory protein S100A8 (P ≤ 0.005) in bladder tissues, and the levels of S100A8 positively correlated with those of proinflammatory cytokines GRO/KC (P ≤ 0.003) and interleukin-1α (P ≤ 0.03) in urine. The bladder uroepithelium was a prominent cell source of S100A8-S100A9 in animals with complicated UTIs (2 weeks p.i.), which was not detected in animals with asymptomatic UTIs (2 weeks p.i.) or in any bladder tissues harvested at earlier p.i. time points. Based on these results, we surmise that invasive colonization of the bladder triggers chronic inflammation and immune dysregulation, which may be critical to struvite formation.
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Ford, Delvina, Bonnie Haupt, Renada Rochon, Debra Bartoshevich, Monalisa Rodriguez, and Jose Cadena Zuluaga. "Beyond Bundles in Prevention of CAUTI and UTI’s." Infection Control & Hospital Epidemiology 41, S1 (October 2020): s139—s140. http://dx.doi.org/10.1017/ice.2020.654.
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Background: Urinary tract infections (UTIs) are common healthcare-associated infections. Evidenced-based practice (EBP) successes of catheter associated urinary tract infection (CAUTI) bundles has resulted in rates decreasing >50% in community-based nursing homes. The South Texas Community Living Center (CLC SA), our 42-bed long-term care and rehabilitation center, conducts routine infection prevention surveillance. During routine surveillance, the infection prevention team noticed an increase in UTI percentages and CAUTI rates. Thus, we sought to increase compliance with standard CAUTI bundles, and we implemented an intervention called the “bladder bundle.” Methods: A multidisciplinary team (ie, infection preventionist, clinical nurse leader, simulation director, educator, leadership and frontline staff champions) identified and evaluated practices through documentation of audits and safety rounds during April and May of 2017 (FY19 QTR 3). The comprehensive bladder bundle was initiated in June 2017, based on EBP interventions and included education for staff with audit and feedback. The team reviewed the literature and expanded the bladder bundle to include a comprehensive urinary note and oral hydration program for the veterans in addition to the standard CAUTI bundles (ie, minimize catheter use, use with appropriate indications, consider alternatives to catheters, proper insertion and securement). In May 2018, a facility-wide, hospital-wide initiative focused on a new urinary catheter insertion kit, insertion competencies and perineal care to improve outcomes. This initiative was added to our bladder bundle for CLC SA. Results: Before the intervention (FY16 Q3 to FY17 Q2), percentages of veterans with a UTI had increased to 4.65%, in FY17 Q3, this rate had increased to 11.76%. After the intervention (FY17 Q4 to FY19 Q3) the percentage dropped significantly to 0%, and this rate has now been sustained for 8 quarters. Our CLC SA has remained at zero harm and has no NHSN CAUTI has occurred since October 2017 (FY18Q1). The catheterization in bladder days has decreased from 162 days in FY14 to 49 in FY18, and for the first 2 quarters of FY19, there were only 25 days. For the last 8 quarters, documentation compliance has increased, as has use of BB interventions. Conclusions: The continuous improvement project targeted within the CLC SA, with education to staff, audit and feedback tools, and a comprehensive urinary note with the oral hydration program in combination with the standard CAUTI bundles, have improved veteran health outcomes and have expanded provider and nursing practices. The interprofessional team approach enhanced the success of this project.Funding: NoneDisclosures: None
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Burke, John P., Robert A. Larsen, and Lane E. Stevens. "Nosocomial Bacteriuria: Estimating the Potential for Prevention by Closed Sterile Urinary Drainage." Infection Control & Hospital Epidemiology 7, S2 (February 1986): 96–99. http://dx.doi.org/10.1017/s0195941700065553.
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Urinary tract infections associated with the temporary use of indwelling bladder catheters remain a vexing problem in acute care hospitals. The appreciable morbidity and mortality from these infections are still under active investigation. Because of the large numbers of patients at risk, increased attention is also being given to the costs for prevention, detection, treatment, and follow-up of catheter-associated infections.Before the advent of commercially available systems for maintaining closed sterile urinary drainage, infection was believed to be inevitable. In the past 25 years, the successful prevention of infection in 70% to 80% of catheterized patients by aseptic methods has undoubtedly prevented thousands of deaths from gram-negative bacteremia and stimulated efforts to further reduce the infection rate.
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Shadle, Benjamin, Casey Barbaro, Kenneth Waxman, Scott Connor, and Kathryn Von Dollen. "Predictors of Postoperative Urinary Retention." American Surgeon 75, no. 10 (October 2009): 922–24. http://dx.doi.org/10.1177/000313480907501012.
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Postoperative urinary retention (PUR) rates vary greatly depending on the population studied. PUR leads to urinary tract instrumentation, which causes increased hospital costs and morbidity. We sought to determine our PUR rate and the risk factors that associated with it. One hundred seventy-six adult surgical inpatients were included in the study. Excluded were those receiving intraoperative catheterization, epidural anesthesia, and urologic procedures. The study population included 42 per cent spinal, 24 per cent laparoscopic abdominal, 20 per cent neck surgeries excluding the spine, and 14 per cent miscellaneous surgeries. Patient bladder volumes were determined using ultrasound scanning at three different intervals: a postvoid residual just before transfer to the operating suite, immediately on arrival in the recovery unit, and then immediately before transfer to the ward. Our overall rate of PUR was 5.7 per cent (10 of 176), defined as the need for catheterization during the postoperative hospitalization. Associated with PUR were advanced age ( P = 0.0292) and postoperative bladder volume ( P = 0.0246). Preoperative bladder volume, intraoperative fluid, and operative time did not reach statistical significance as being predictive of urinary retention. Our data suggest that PUR is associated with increased bladder volumes on arrival to the recovery room. A prospective study to determine whether identification of patients at risk will lead to decreased incidence of urinary tract infection is warranted.
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Medvedev, Vladimir L., Igor V. Mihailov, Sergey N. Lepetunov, Yuriy N. Medoev, and Mikhail I. Kogan. "Bladder neck stenosis surgery in interstitial cystitis / bladder pain syndrome treatment." Urology reports (St. - Petersburg) 10, no. 1 (May 15, 2020): 5–10. http://dx.doi.org/10.17816/uroved1015-10.
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Introduction. Current methods of interstitial cystitis / bladder pain syndrome (IC/BPS) treatment dont allow to achieve long-term clinical remission.
Aim of the study was to investigate the clinical efficacy of bladder neck transurethral incision (TUI) in women with IC/BPS, who had bladder outlet obstruction signs.
Materials and methods. TUI was performed to patients with IC/BPS and proven bladder neck stenosis (n = 29). Assessment of the results of this operation was provided after 1, 3 and 6 months after surgical treatment. Treatment efficacy was evaluated by using Global Response Assessment (GRA) Scale, Pelvic Pain and Urgency / Frequency (PUF) Patient Symptom Scale, urination diaries, analysis of which allowed to determine functional bladder capacity, urinary frequency and nocturia. Pain assessment was made with 10-point Visual Analogue Pain Scale (VAS). Functional efficacy was evaluated with urodynamic examination, which included cystometric bladder capacity, maximal urinary flow rate and residual volume rate. Treatment results were compared with such in 39 patients with IC/BPS without signs of bladder neck stenosis.
Results. GRA score 2 had 96.5% and 72.4% in 1 and 3 months after bladder neck TUI, respectively. VAS, PUF Scale parameters, cystometric bladder capacity, maximal urinary flow rate, residual volume rate, urinary frequency and nocturia values also significantly improved after surgery.
Conclusions. This prospective clinical study is the first, in which IC/BPS course in women with bladder neck stenosis was investigated. It was noticed, that in 1 month after bladder TUI in 96.5% of patients decreased severity of IC/BPS symptoms, there were no urinary tract infection and local complications. In addition, this effect lasted for 3 months after surgery in 72.4% of patients and for 6 months in 68.9% of patients.
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Li, X., T. Guan, W. J. Huang, and C. H. Liang. "Modeling and Simulation of Bladder Power Pump Driven by External Electromagnet." Journal of Mechanics 28, no. 4 (October 16, 2012): 647–55. http://dx.doi.org/10.1017/jmech.2012.106.
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ABSTRACTThe clinical urination assist measures are usually taken to overcome the neurogenic bladder difficult to cure, but easily cause patients bladder stones, urinary system infection and other complications. To solve the problem of the urination assist of neurogenic bladder, a bladder power pump (BPP) driven by external electromagnet was proposed in this study according to the structure and micturition mechanism of human urinary bladder. The mathematic models of the BPP were established based on the theories of electromagnetics and fluid dynamics. A simulated experiment system with a bladder physical model for simulating human urinary system was designed according to the similarity criterion of fluid dynamincs. The micturition performance of the BPP was investigated by simulation and experiment. The results showed that the intravesical pressure and urine flow rate of the bladder physical model can be controlled by adjusting electromagnet exciting current. The micturition performance of the BPP is basically accordant with that of human urinary bladder detrusor. The established mathematic models are simple and practicable, which can provide the theoretical guidance for the performance analysis and structural optimization design of the BPP.
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De Baets, Karen, Joost Baert, Luc Coene, Marc Claessens, Robert Hente, and Geert Tailly. "Emphysematous Cystitis: Report of an Atypical Case." Case Reports in Urology 2011 (2011): 1–5. http://dx.doi.org/10.1155/2011/280426.
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We report the atypical case of a nondiabetic 66-year old male with severe abdominal pain and vomiting who was found to have emphysematous cystitis. Of all gas-forming infections of the urinary tract emphysematous cystitis is the most common and the least severe. The major risk factors are diabetes mellitus and urinary tract obstruction. Most frequent causative pathogens areEscherichia coliandKlebsiella pneumoniae. The clinical presentation is nonspecific and ranges from asymptomatic urinary tract infection to urosepsis and septic shock. The diagnosis is made by abdominal imaging. Treatment consists of broad-spectrum antibiotics, bladder drainage, and management of the risk factors. Surgery is reserved for severe cases. Overall mortality rate of emphysematous cystitis is 7%. Immediate diagnosis and treatment is necessary because of the rapid progression to bladder necrosis, emphysematous pyelonephritis, urosepsis, and possibly fatal evolution.
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Madeo, M., B. Barr, and E. Owen. "A study to determine whether the use of a preconnect urinary catheter system reduces the incidence of nosocomial urinary tract infections." Journal of Infection Prevention 10, no. 2 (March 2009): 76–80. http://dx.doi.org/10.1177/1757177408093500.
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Nosocomial urinary tract infection (NUTI) is a common problem in the UK and is often related to the use of urinary catheters. In the UK urinary catheters account for approximately 25% of all healthcare associated infections and can have a considerable financial burden on the health service. Bacteria may gain entry into the bladder of a catheterised patient via the intra-luminal route especially if accidental disconnection arises. A prospective study was undertaken to determine the NUTI rates in patients using a preconnected catheter system compared to a traditional bag and catheter system on three medical wards. A total of 205 patients were included in the study. The catheter-associated urinary tract infection rate (CAUTI) in the baseline was 37.8 per 1,000 catheter days and 22.4 per 1,000 catheter days in the intervention group. The rates of CAUTI were 41% lower in the intervention group. The data in this sample group suggests the use of the preconnected catheter offers some protection against infection. The use of the preconnected system is a new concept in the UK and further studies are required to evaluate its effectiveness. The results from this study suggest their use may help to reduce the risk of CAUTI in certain clinical areas.
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Yi, Wei-min, Qing Chen, Chang-hao Liu, Jia-yun Hou, Liu-dan Chen, and Wei-kang Wu. "Acupuncture for Preventing Complications after Radical Hysterectomy: A Randomized Controlled Clinical Trial." Evidence-Based Complementary and Alternative Medicine 2014 (2014): 1–6. http://dx.doi.org/10.1155/2014/802134.
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We aimed to investigate the preventive effects of acupuncture for complications after radical hysterectomy. A single-center randomized controlled single-blinded trial was performed in a western-style hospital in China. One hundred and twenty patients after radical hysterectomy were randomly allocated to two groups and started acupuncture from sixth postoperative day for five consecutive days. Sanyinjiao (SP6), Shuidao (ST28), and Epangxian III (MS4) were selected with electrical stimulation and Zusanli (ST36) without electrical stimulation for thirty minutes in treatment group. Binao (LI14) was selected as sham acupuncture point without any stimulation in control group. The main outcome measures were bladder function and prevalence of postoperative complications. Compared with control group, treatment group reported significantly improved bladder function in terms of maximal cystometric capacity, first voiding desire, maximal flow rate, residual urine, and bladder compliance, and decreased bladder sensory loss, incontinence, and urinary retention on fifteenth and thirtieth postoperative days. Treatment group showed significant advantage in reduction of urinary tract infection on thirtieth postoperative day. But no significant difference between groups was observed for lymphocyst formation. By improving postoperative bladder function, early intervention of acupuncture may provide a valuable alternative method to prevent bladder dysfunctional disorders and urinary tract infection after radical hysterectomy.
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Esteghamati, Maryam, Seyedeh Elaheh Mousavi, and Shervin Haj Alizadeh. "Risk factors of pediatric urinary tract infections: an epidemiologic study." International Journal of Contemporary Pediatrics 6, no. 1 (December 24, 2018): 204. http://dx.doi.org/10.18203/2349-3291.ijcp20185210.
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Background: Urinary tract infection (UTI) is the second most prevalent pediatric infection, and if it is not recognized and treated properly, it can cause severe irreversible complications such as renal failure and hypertension. In this research, some of the risk factors of UTIs were compared in children with urinary tract infections.Methods: This is a cross-sectional study, with the urinary tract infection as the dependent variable and gender, circumcision status, history of urinary catheterization, family history, history of renal stone, hypercalciuria, constipation history, reflux, neurogenic bladder, phimosis, posterior urethral valves (PUV), ureteropelvic junction obstruction (UPJO), and ureterovesical junction obstruction (UVJO) as the independent variables. A total of 405 children were studied in this research. The data was collected using questionnaires, checklists, and examinations. Data analysis was also carried out using descriptive and analytical statistics method in SPSS.Results: This research revealed the prevalence of urinary tract infection among children with several risk factors, and the common factors were positive family history, history of urinary catheterization, constipation, and other non-anatomical disorders (history of renal stone and hypercalciuria. The most common risk factors regardless of gender and age were non-anatomic disorders that were observed in 147 cases (43.7%) (p-value<0.001). Among the non-anatomical factors, constipation was the most common factor observed in 66 cases (16.3%). A higher rate of urinary infection was observed in the uncircumcised male patients than the circumcised patients, and there was a significant relationship between circumcision and UTI.Conclusions: In this study, urinary tract infection staged a significant relationship with gender, circumcision status, urinary catheterization history, family history, renal stone history, hypercalciuria, history of constipation, reflux, neurogenic bladder, phimosis, PUV, UPJO, and UVJO.
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Matulevičius, Augustinas, and Edmundas Štarolis. "INVASIVE UPPER URINARY TRACT UROTHELIAL CARCINOMA WITH ATYPICAL CLINIC: CASE REPORT." Medicinos teorija ir praktika 22, no. 4 (January 10, 2017): 378–81. http://dx.doi.org/10.15591/mtp.2016.061.
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Key words: invasive upper tract urothelial carcinoma, radical nephroureterectomy, chemotherapy treatment. Based on literature sources Urothelial carcinomas (UCs) are the fourth most common tumors. They can be located in the lower (bladder and urethra) or upper (pyelocaliceal cavities and ureter) urinary tract. Herein, we report a rare case of upper tract high malignancy urothelial carcinoma with atypical clinic which looks like an apostematous pyelonephritis. Upper tract urothelial carcinomas that invade the muscle wall usually have poor prognosis. Retrospectively assessing our patient has the most common symptoms of urinary tract infection and malignancy. It was non-visible hematuria, flank pain, chronic urinary tract infection, and also systemic symptoms (including anorexia, weight loss, malaise, fatigue, fever, and night sweats). The right diagnose we have determined by biopsy and CTU. Open RNU with bladder cuff excision is the standard for high-risk UTUC, regardless of tumor location and bladder cuff removal is imperative. AC adjuvant chemotherapy is the most widely used treatment in patients with cancer after undergoing surgery. Unfortunately the overall survival rate of urothelial metastatic tumor for this day is poor.
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Stamatiou, Konstantinos, Aggeliki Papadatou, Hippocrates Moschouris, Ioannis Kornezos, Anargiros Pavlis, and Georgios Christopoulos. "A Simple Technique to Facilitate Treatment of Urethral Strictures with Optical Internal Urethrotomy." Case Reports in Urology 2014 (2014): 1–3. http://dx.doi.org/10.1155/2014/137605.
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Urethral stricture is a common condition that can lead to serious complications such as urinary infections and renal insufficiency secondary to urinary retention. Treatment options include catheterization, urethroplasty, endoscopic internal urethrotomy, and dilation. Optical internal urethrotomy offers faster recovery, minimal scarring, and less risk of infection, although recurrence is possible. However, technical difficulties associated with poor visualization of the stenosis or of the urethral lumen may increase procedural time and substantially increase the failure rates of internal urethrotomy. In this report we describe a technique for urethral catheterization via a suprapubic, percutaneous approach through the urinary bladder in order to facilitate endoscopic internal urethrotomy.
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Hoffman, Daniel, and Kimberly L. Ferrante. "Urinary Tract Infection Rates and Mechanisms After OnabotulinumtoxinA Bladder Injection: a Review." Current Bladder Dysfunction Reports 12, no. 1 (January 24, 2017): 54–57. http://dx.doi.org/10.1007/s11884-017-0404-9.
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Ebrahimzadeh, Tahmineh, Amy Kuprasertkul, Michael L. Neugent, Kevin C. Lutz, Jorge L. Fuentes, Jashkaran Gadhvi, Fatima Khan, et al. "Urinary prostaglandin E2 as a biomarker for recurrent UTI in postmenopausal women." Life Science Alliance 4, no. 7 (May 6, 2021): e202000948. http://dx.doi.org/10.26508/lsa.202000948.
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Urinary tract infection (UTI) is one of the most common adult bacterial infections and exhibits high recurrence rates, especially in postmenopausal women. Studies in mouse models suggest that cyclooxygenase-2 (COX-2)–mediated inflammation sensitizes the bladder to recurrent UTI (rUTI). However, COX-2–mediated inflammation has not been robustly studied in human rUTI. We used human cohorts to assess urothelial COX-2 production and evaluate its product, PGE2, as a biomarker for rUTI in postmenopausal women. We found that the percentage of COX-2–positive cells was elevated in inflamed versus uninflamed bladder regions. We analyzed the performance of urinary PGE2 as a biomarker for rUTI in a controlled cohort of 92 postmenopausal women and PGE2 consistently outperformed all other tested clinical variables as a predictor of rUTI status. Furthermore, time-to-relapse analysis indicated that the risk of rUTI relapse was 3.6 times higher in women with above median urinary PGE2 levels than with below median levels. Taken together, these data suggest that urinary PGE2 may be a clinically useful diagnostic and prognostic biomarker for rUTI in postmenopausal women.
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Mutlu, Hatice, and Zelal Ekinci. "Urinary Tract Infection Prophylaxis in Children with Neurogenic Bladder with Cranberry Capsules: Randomized Controlled Trial." ISRN Pediatrics 2012 (July 1, 2012): 1–4. http://dx.doi.org/10.5402/2012/317280.
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Objectives. The aim of this randomized controlled prospective study is to evaluate the efficacy of cranberry capsules for prevention of UTI in children with neurogenic bladder caused by myelomeningocele. Patients and Methods. To be eligible for this study, patients had to be diagnosed as neurogenic bladder caused by myelomeningocele, evaluated urodynamically, followed up with clean intermittent catheterization and anticholinergic drugs. Intervention. Six months of treatment with placebo; after a week of wash-out period treatment of cranberry extract tablets (1 capsule/day) for an additional 6 months. Randomization was performed sequentially. Patients and care givers were blinded to drug assignment. Main outcome measure was infection rate. Group comparisons were performed with Wilcoxon test. Results. The study population included 20 (F/M: 13/7) patients with neurogenic bladder with the mean age of 7.25±3.49 (4, 18) years. The median UTI rate was 0.5/year during placebo usage whereas 0/year during cranberry capsule usage. Decrease in infection rate was significant with cranberry capsule usage (P=0.012). Decrease in the percentage of the pyuria was also recorded as significant (P=0.000). Any adverse events or side effects were not recorded. Conclusion. We concluded that cranberry capsules could be an encouraging option for the prevention of recurrent UTI in children with neurogenic bladder caused by myelomeningocele.
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Johnson, David E., C. Virginia Lockatell, Robert G. Russell, J. Richard Hebel, Michael D. Island, Ann Stapleton, Walter E. Stamm, and John W. Warren. "Comparison of Escherichia coli Strains Recovered from Human Cystitis and Pyelonephritis Infections in Transurethrally Challenged Mice." Infection and Immunity 66, no. 7 (July 1, 1998): 3059–65. http://dx.doi.org/10.1128/iai.66.7.3059-3065.1998.
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ABSTRACT Urinary tract infection, most frequently caused byEscherichia coli, is one of the most common bacterial infections in humans. A vast amount of literature regarding the mechanisms through which E. coli induces pyelonephritis has accumulated. Although cystitis accounts for 95% of visits to physicians for symptoms of urinary tract infections, few in vivo studies have investigated possible differences between E. coli recovered from patients with clinical symptoms of cystitis and that from patients with symptoms of pyelonephritis. Epidemiological studies indicate that cystitis-associated strains appear to differ from pyelonephritis-associated strains in elaboration of some putative virulence factors. With transurethrally challenged mice we studied possible differences using three each of the most virulent pyelonephritis and cystitis E. coli strains in our collection. The results indicate that cystitis strains colonize the bladder more rapidly than do pyelonephritis strains, while the rates of kidney colonization are similar. Cystitis strains colonize the bladder in higher numbers, induce more pronounced histologic changes in the bladder, and are more rapidly eliminated from the mouse urinary tract than pyelonephritis strains. These results provide evidence that cystitis strains differ from pyelonephritis strains in this model, that this model is useful for the study of the uropathogenicity of cystitis strains, and that it would be unwise to use pyelonephritis strains to study putative virulence factors important in the development of cystitis.
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Saber, Sadia, Naz Yasmin, Mohammed Tarek Alam, Mohammad Monower Hossain, and Rafa Faaria Alam. "Study on Urinary Tract Infection Among Females of Reproductive Age Group in Tertiary Care Teaching Hospital, Dhaka, Bangladesh." European Journal of Medical and Health Sciences 3, no. 1 (January 26, 2021): 85–89. http://dx.doi.org/10.24018/ejmed.2021.3.1.680.
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Introduction: Among all the bacterial infections encounter in primary care, urinary tract infection (UTI) has considered as one of the most frequent bacterial infection. UTI can be defined as the presence of an infection in any part of our urinary system-kidneys, ureters, urinary bladder and urethra. Majority of the infections involve the lower urinary tract – the urinary bladder and the urethra. Women of reproductive age group (15-44 years) are the most vulnerable of developing UTI than men. The objective of this study is to determine the prevalence rate of UTI among females of reproductive age group and to ascertain the association between socio demographic factors among study population.
Material and Methods: This is a cross sectional observational study executed in a tertiary care teaching hospital, Dhanmondi, Dhaka. 250 women of reproductive age group were encountered as the study group here. Data collection was done by using a structured interview schedule followed by collection of urine sample for microscopic examination and culture. Analysis of data was done by using SPSS 15 software. Prevalence of UTI among study population was calculated by using percentage and the strength of association between socio demographic factors were evaluated in our study.
Results: Prevalence of UTI among study population was found to be 41.20%. A strong association of statistical significance was observed among marital status (p values <0.05), the level of education of the study population (p value <0.05) and the urine culture reports among UTI patients (p value 0.001)
Conclusion: Now a days UTI can be considered as one the most serious public health problem if it is remaining untreated. To prevent the possibilities of evolving further complexity of UTI early detection and prompt treatment is very much crucial. We should promote more educational programming about UTI prevention not only to reduce the sufferings of the patients and their hospital stay but also to compensate for the economical loss.
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Liu, Yu Liang, Hao-Lun Luo, Po-Huang Chiang, Yen-Chen Chang, and Po-Hui Chiang. "Long-term urinary tract effect of ileal conduit after radical cystectomy compared with bladder preservation: a nationwide, population-based cohort study with propensity score-matching analysis." BMJ Open 8, no. 12 (December 2018): e023136. http://dx.doi.org/10.1136/bmjopen-2018-023136.
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ObjectiveIleal conduit urinary diversion (ICUD) is the most common procedure after radical cystectomy. Although complications have been reported, few patients with ICUD and bladder preservation controls have been available for long-term follow-up. This study compared the long-term effect of structural changes after cystectomy with ICUD to that in bladder preservation controls.DesignA retrospective nationwide cohort study.SettingData retrieved from the Taiwan National Health Insurance Research Database.ParticipantsThe National Health Insurance database was explored for patients diagnosed with bladder cancer between 1997 and 2006. Only cancer-free patients without chemotherapy and other types of urinary diversion who lived for >5 years were included in the analysis.Outcome measuresPatient characteristics, comorbidity and postoperative urinary tract disease were statistically analysed and compared. Cox proportional hazards model was used to evaluate the incidence rates of outcomes after adjustment for covariates. Propensity scores analysis was used to balance the clinical parameters between groups. The primary outcomes were postoperative new-onset urinary tract disease such as urinary tract infection (UTI), UTI with septicaemia and chronic kidney disease (CKD), or calculus of kidney and ureter.ResultsThere were 11 185 patients included in our cohort, among which 703 (6.3%) and 10 482 (93.7%) patients received ICUD and bladder preservation procedure, respectively. Compared with patients who only underwent a bladder preservation procedure, those who had undergone ICUD after cystectomy were independently associated with postoperative de novo urinary tract disease. Propensity score analysis (1:4) was also performed. ICUD contributed to significantly higher new-onset UTI, UTI with sepsis and CKD (HR=1.30, 3.16, 1.35, respectively) compared with bladder preservation procedure after adjustment for age, gender and comorbidities.ConclusionICUD after radical cystectomy was associated with a higher incidence of UTI, UTI with septicaemia and CKD during long-term follow-up than the incidences following a bladder preservation procedure.
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Herthelius, Maria, Rimma Axelsson, and Karl-Johan Lidefelt. "Antenatally detected urinary tract dilatation: a 12–15-year follow-up." Pediatric Nephrology 35, no. 11 (June 23, 2020): 2129–35. http://dx.doi.org/10.1007/s00467-020-04659-4.
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Abstract Background Antenatally diagnosed urinary tract dilatation (UTD) still burdens healthcare providers and parents. This study was conducted to establish long-term outcome in an unselected group of children with antenatally detected UTD. Methods Seventy-one out of 103 children born in 2003–2005 and diagnosed with antenatal UTD agreed to participate in a 12–15-year follow-up including blood and urine samples, a kidney ultrasound exam, and kidney scintigraphy. The records were searched for previous urinary tract infections. Results Among children with an anteroposterior diameter (APD) ≤ 7 mm and no calyceal, kidney, ureteral, or bladder pathology in the early postnatal period, no one tested had reduced estimated glomerular filtration rate (eGFR), albuminuria, or UTD at the follow-up at a mean age of 13.6 years. One child had kidney damage not affecting kidney function. Among children with postnatal APD > 7 mm and/or kidney, calyceal, ureteral, or bladder pathology, 15% had persistent UTD and 32–39% (depending on the method used) had kidney damage. Major postnatal urinary tract ultrasound abnormalities and a congenital anomalies of the kidney and urinary tract (CAKUT) diagnosis were factors associated with an increased risk for permanent kidney damage (odds ratios 8.9, p = 0.016; and 14.0, p = 0.002, respectively). No one had reduced eGFR. One child (1/71, 1%) had a febrile urinary tract infection after the age of 2. Conclusions We conclude that in children with postnatal APD ≤ 7 mm, no calyceal dilatation, normal bladder, ureters, and kidney parenchyma, the outcome is excellent. There is no need for long-term follow-up in these patients.
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Batista, Odinéa Maria Amorim, Glicia Cardoso Nascimento, and Marcos André Siqueira de Sousa. "Avaliação da sensibilidade dos microrganismos a antimicrobianos: um estudo em Unidades de Terapia Intensiva." Revista Prevenção de Infecção e Saúde 1, no. 4 (July 10, 2017): 26. http://dx.doi.org/10.26694/repis.v2i1-2.6049.
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Objective: to investigate the epidemiological profile of hospital infections acquired in the Intensive Care Unit of a reference hospital in the Northeast. Methods: This is a descriptive, prospective data collection study carried out in two adult intensive care units of a general hospital and teaching hospital. Data were collected through a structured questionnaire. Results: Among the participants, there was a predominance of females and of the age group comprising young adults and married. All patients underwent at least one type of invasive procedure, with nasogastric probe and bladder catheterization being the most prevalent. Respiratory tract infection was the most prevalent (66.7%) among the total number of infections. Attention is also drawn to the high rates of urinary tract infection (45.8%) and bloodstream infection (15.8%). Conclusion: Respiratory tract infection is the main infectious topography in the hospital environment.
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Hadzi-Djokic, Jovan, J. Stoiljkovic, Dragoslav Basic, B. Basic, G. Petrovic, V. Colovic, and V. Stamenkovic. "Clinical and urodynamic outcomes of tension: Free vaginal tape procedure." Acta chirurgica Iugoslavica 51, no. 3 (2004): 57–60. http://dx.doi.org/10.2298/aci0403057h.
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The tension - free vaginal tape procedure (TVT) has been regarded as a safe, minimally invasive method for the treatment of female stress urinary incontinence. In a prospective multicenter study we evaluated safety and efficacy of TVT procedure for the treatment of female stress incontinence. From 1998. to 2003, a total of 42 patients, mean age 60 years (range 34-76) with urodynamically verified stress urinary incontinence underwent the TVT procedure. The mean follow-up period was 28 months (range 14 to 32). Intra- and postoperative complications were few, including bladder perforations (4.7%), vaginal hematoma (2.4%), complete urinary retention (2.4%), transient urinary retention (19%) and urinary tract infection (7.1%). Postoperatively, voiding time and functional urethral length significant increased. The subjective and objective cure rates were 85.7% and 90.5%, respectively. We conclude that the TVT procedure is associated with high cure rate and low morbidity.
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Cox, Lindsey, Chang He, Jack Bevins, J. Quentin Clemens, John T. Stoffel, and Anne P. Cameron. "Gentamicin bladder instillations decrease symptomatic urinary tract infections in neurogenic bladder patients on intermittent catheterization." Canadian Urological Association Journal 11, no. 9 (September 14, 2017): E350–4. http://dx.doi.org/10.5489/cuaj.4434.
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Introduction: This study aimed to determine if gentamicin bladder instillations reduce the rate of symptomatic urinary tract infection (UTI) in neurogenic bladder (NGB) patients on intermittent self-catheterization (ISC) who have recurrent UTIs. Secondary aims were to examine the effects of intravesical gentamicin on the organism resistance patterns.Methods: We retrospectively reviewed our prospective NGB database. Inclusion criteria were NGB patients performing ISC exclusively for bladder drainage with clinical data available for six months before and six months after initiating prophylactic intravesical gentamicin instillations. Symptomatic UTIs were defined as symptoms consistent with UTI plus the need for antibiotic treatment.Results: Twenty-two patients met inclusion criteria; etiology of NGB was 63.6% spinal cord injury, 13.6% multiple sclerosis. Median time since injury/diagnosis was 14 years and 6/22 (27.3%) hadundergone urological reconstruction. Patients had fewer symptomatic UTI’s (median 4 vs. 1 episodes; p<0.004) and underwent fewer courses of oral antibiotics after initiating gentamicin (median 3.5 vs. 1; p<0.01). Days of oral antibiotic therapy decreased from 15 before to five after gentamicin, but this did not reach significance. There were fewer telephone encounters for UTI concerns per patient (median 3 vs. 0; p=0.03). The proportion of multidrug-resistant organisms in urine cultures decreased from 58.3%to 47.1% (p=0.04) and the rate of gentamicin resistance did not increase. Adverse events were mild and rare.Conclusions: Gentamicin bladder instillations decrease symptomatic UTI episodes and reduce oral antibiotics in patients with NGB on ISC who were suffering from recurrent UTIs. Antibiotic resistancedecreased while on gentamicin instillations.
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Topal, Jeffrey, Sandra Conklin, Karen Camp, Victor Morris, Thomas Balcezak, and Peter Herbert. "Republished: Prevention of Nosocomial Catheter-Associated Urinary Tract Infections Through Computerized Feedback to Physicians and a Nurse-Directed Protocol." American Journal of Medical Quality 34, no. 5 (September 2019): 430–35. http://dx.doi.org/10.1177/1062860619873170.
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Catheter-associated urinary tract infections (CAUTIs) represent the most common nosocomial infection. The authors’ baseline rate of CAUTI for general medical service was elevated at 36 per 1000 catheter-days. The medical literature has consistently linked inappropriate catheter use with the development of CAUTI. The baseline data also revealed a high rate of inappropriate use of indwelling urinary catheters. Using the dual modalities of technology through prompts in the computerized order/entry system and handheld bladder scanners, as well as in combination with staff education and nurse empowerment, the authors were successful in reducing the use and duration of urinary catheters as well as the incidence of CAUTI. In subsequent data collection cycles over the following 2 years, 81% reduction in device use and a 73% reduction in the clinical end point of nosocomial CAUTI (36/1000 catheter-days to 11/1000 catheter-days; P < .001) was demonstrated.
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Paunovic, Milan, Zoran Krstic, Miroslav Djordjevic, Vojkan Vukadinovic, and Svetlana Paunovic. "Long-term outcomes of catheterizable continent urinary diversion in children." Srpski arhiv za celokupno lekarstvo 148, no. 3-4 (2020): 180–84. http://dx.doi.org/10.2298/sarh180731104p.
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Introduction/Objective. The use of bladder augmentation and/or continent urinary diversion has gained wide acceptance, particularly in children with small, abnormally developed bladder or high-pressure bladder that poses great risk for renal deterioration and incontinence. We discuss indications, results, and complications with various types of continent vesicostomy (CV) in children. Methods. Sixty-eight patients with CV are retrospectively reviewed (51 boys and 17 girls) 1987?2008. The median follow-up time was 17.8 years (3?22 years). CV included appendicovesicostomy in 31 (41.3%), vesicostomy with distal ureter in 27 (36.0%), and preputial CV in 10 (13.3%) patients. CV in patients with augmented bladder was in 18 (26.47%) children. The indications for performing CV were various types of neurogenic and myogenic dysfunctions of urine bladder with incontinence due to the following pathoanatomical substrates: anomalies of the brain?spine segment development (27), bladder exstrophy (10), posterior urethral valve (15), expansive processes (4), and other anatomical defects in 12 patients. Results. Continence was achieved in 94.64% of the cases, without statistically significant difference between particular types of the stoma (p = 0.065). Early complications included stoma necrosis, stoma bleeding, peristomal infection in 5/68 (7.35%) patients, and late complications included calculosis, in 20/68 (29.4%), stomal stenosis, in 8/68 (11.5%), and difficulties of catheterization, in 3/68 patients (4.08%). Calculosis was predominant in appendicovesicostomy (p = 0.012). Conclusion. CV is a safe procedure applied with the main purposes of achieving continence, preservation of renal function, and improvement of the quality of life, along with an acceptably low rate of complications.
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Hassan, Rosline, Shaiful Bahari Ismail, Kamaruddin Jaalam, and Muzaimi Mustapha. "BACTERIAL UTI INVESTIGATION IN MALAYSIA." International Medical Science Research Journal 1, no. 3 (June 23, 2020): 61–66. http://dx.doi.org/10.51594/imsrj.v1i3.65.
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Urinary tract infection (UTI) is an infection of the parts of urinary tract of the body which include the lower and upper tract. The upper tract of the system include ureters and kidneys; while, lower tract include prostate in males, bladder, and urethra. If the infection is in the upper segment in the tract, it is known as kidney infection. Whereas, lower urinary tract is known as cystitis or bladder infection. Two common type of infection are based on bacteria or fungus. In this study, the objective was to test the bacterial UTIs etiology in the area of Kuala Lumpur, Malaysia. The focus was to identify the proper antibiotics, epidemiology especially high-risk groups as well as positivity rate in terms of gender and age. The methodology of the study was collection and analysis of Urine specimen samples using the sterile container for later sensitivity and culture purpose. Isolated organisms were removed using different biochemical tests and proper antibiograms were found by using the AST or dish diffusion method. Our results based on sampling of 1402 specimens collected and tested showed positivity rate of UTI among 23.25 % (326 out of 1402 patients). The most common caused bacteria causing UTI was Escherichia Coli (E.Coli). the other commonly found bacteria included Enterococcoi, proteus, Klebsiella, Staphylococci, and Enterobacter. Our results confirmed that there was more presence of UTI among female compare to male sample. In terms of age, the common age group was between 22 to 28 years. The Tetracyclin was found to be most resistant antibiogram where as Chloramphenicol was found to be the most sensitive.
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Ahmed Sabah Al-Jasimee, Abbas Mayar Hezam, Wurood Jasim Mohammed, Mohammed M Alkhuzaie, and Zinah Abdulkadhim Oudah. "A General Overview on Pseudomonas aeruginosa bacteria and its pathogenicity." International Journal of Research in Pharmaceutical Sciences 11, no. 1 (January 7, 2020): 702–7. http://dx.doi.org/10.26452/ijrps.v11i1.1880.
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The first case of bacterial infection was recorded in 1862, while it was first isolated in 1882 from the scientist Gessard, who was called Bacillus pyocyaneus. The most common infections caused by bacteria are the first bacteremia in patients with serious burns, chronic lung injuries in patients with cystic fibrosis, and acute ulcerative keratitis in people who use contact lenses. The gastrointestinal tract is an important gateway for entry into the blood infection caused by bacteria, and the bacteria cause endocarditis, where the bacteria infects the heart valves from the direct invasion of the bloodstream, as it causes meningitis and brain abscesses, and it can invade the central organ The inner and nasal sinuses can also be accessed from a site far from the injury, such as the urinary tract. Other pathogenic infections caused by bacteria are pulmonary injuries, as bacteria are the most common disease associated with lung injuries. They are caused by bacteria Hospitalized lung with a mortality rate greater than 70%. Bacteria are a common cause and acquired by hospitals for urinary tract infections due to their ability to adhere to urinary epithelial cells in the bladder, as they cause cystitis and urinary tract infections. The percentage of deaths caused by bacteria can reach 50% due to many factors, including weak body defenses and bacteria resistance to anti-life as well as the production of bacteria, enzymes and external toxins.
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Nguyen, Jessica, Ellen M. Harvey, Daniel I. Lollar, Eric H. Bradburn, Mark E. Hamill, Bryan R. Collier, and Katie M. Love. "Alternatives to Indwelling Catheters Cause Unintended Complications." American Surgeon 82, no. 8 (August 2016): 679–84. http://dx.doi.org/10.1177/000313481608200824.
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To reduce the risk of catheter-associated urinary tract infection (CAUTI), limiting use of indwelling catheters is encouraged with alternative collection methods and early removal. Adverse effects associated with such practices have not been described. We also determined if CAUTI preventative measures increase the risk of catheter-related complications. We hypothesized that there are complications associated with early removal of indwelling catheters. We described complications associated with indwelling catheterization and intermittent catheterization, and compared complication rates before and after policy updates changed catheterization practices. We performed retrospective cohort analysis of trauma patients admitted between August 1, 2009, and December 31, 2013 who required indwelling catheter. Associations between catheter days and adverse outcomes such as infection, bladder overdistention injury, recatheterization, urinary retention, and patients discharged with indwelling catheter were evaluated. The incidence of CAUTI and the total number of catheter days pre and post policy change were similar. The incidence rate of urinary retention and associated complications has increased since the policy changed. Practices intended to reduce the CAUTI rate are associated with unintended complications, such as urinary retention. Patient safety and quality improvement programs should monitor all complications associated with urinary catheterization practices, not just those that represent financial penalties.
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Jamulitrat, Silom, Montha Na Narong, and Somchit Thongpiyapoom. "Trauma Severity Scoring Systems as Predictors of Nosocomial Infection." Infection Control & Hospital Epidemiology 23, no. 5 (May 2002): 268–73. http://dx.doi.org/10.1086/502047.
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Objectives:To describe the patterns of nosocomial infections in patients with traumatic injuries and to compare the associations between injury severity, derived from various severity scoring systems, and subsequent nosocomial infections.Design:Prospective observational study.Setting:A 750-bed university hospital serving as a medical school and referral center for the southern part of Thailand.Participants:All trauma patients admitted to the hospital for more than 3 days during 1996 to 1999 were eligible for this study.Methods:The severity of injuries was measured in terms of injury severity score (ISS), revised trauma score (RTS), new injury severity score (NISS), and trauma injury severity score (TRISS). Infections acquired during hospitalization were categorized using Centers for Disease Control and Prevention criteria. The association between severity of injury and nosocomial infection was examined with Poisson regression models.Results:There were 222 nosocomial infections identified among 146 patients, yielding an infection rate of 0.8 infections per 100 patient-days. Surgical-site infection was the most common site-specific infection, accounting for 31.1% of all infections. The incidence of intravenous catheter–related bloodstream infection was 1.6 infections per 100 catheter-days. The bladder catheter–related urinary tract infection rate was 2.8 infections per 100 catheter-days. The rate of ventilator-associated pneumonia was 3.2 infections per 100 ventilator-days. The incidence of infection correlated well with injury severity. The infection incidence rate ratios for one severity category increment of ISS, NISS, RTS, and TRISS were 1.65 (95% confidence interval [CI95, 1.42 to 1.92), 1.79 (CI95, 1.55 to 2.05), 1.64 (CI95, 1.43 to 1.88), and 1.32 (CI95, 1.14 to 1.52), respectively.Conclusions:Surgical-site infection was the most common site-specific nosocomial infection. The NISS might be the most appropriate severity scoring system for adjustment of infection rates in trauma patients.
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Polita, Naiara Barros, Mitiko Morooka, Júlia Trevisan Martins, and Maria Clara Giorio Kreling. "Neurogenic bladder and intermittent catheterization." Revista de Enfermagem UFPE on line 4, no. 2 (March 31, 2010): 889. http://dx.doi.org/10.5205/reuol.900-7318-1-le.0402201055.
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ABSTRACTObjective: to report the benefits of intermittent catheterization and clean technique. Method: it was performed a literature review on internet in Lilacs, Medline, Pubmed, Science Direct and CAPES theses database. The key-words used were: urinary catheters and urinary catheters/history, and the selected period from 1945 to 2009. Results: the intermittent catheterization is indicated for the conditions that lead to difficulties in voiding, especially for patients with bladder-sphincter dysfunction. It has been used since the First World War, but most used after the Second World War. Intermittent bladder catheterization is similar to normal bladder function, as it allows the cyclic emptying of the bladder, avoiding excessive distension and loss of reservoir characteristics, In addition to lower tract infection rates and prevent upper and lower urinary tract deterioration. The clean technique allows to the patient perform it, offering the return to its professional, cultural and leisure activities. Conclusion: it fits for health professionals, especially the nurse, the guidance and training of patients. Descriptors: urinary catheterization; self care; nurse; nursing; nursing care; deseases; tract urinary.RESUMOObjetivo: relatar os benefícios do cateterismo vesical intermitente e da técnica limpa. Método: foi realizado um levantamento bibliográfico via internet nas bases de dados Lilacs, Medline, Pubmed, Science Direct e banco de teses da CAPES. As palavras-chave utilizadas foram: cateterismo urinário e cateterismo urinário/história, sendo o período selecionado de 1945 a 2009. Resultados: o cateterismo vesical intermitente é indicado para as patologias que levam a dificuldades no esvaziamento vesical, principalmente para pacientes portadores de disfunção vesico-esfincteriana. Tem sido utilizado desde a primeira Guerra Mundial, porém mais empregado após a segunda Guerra Mundial. O cateterismo vesical intermitente se assemelha a função vesical normal, já que permite o esvaziamento cíclico da bexiga, evitando a superdistensão e a perda de suas características de reservatório, além de diminuir as taxas de infecção urinária e prevenir a deteriorização do trato urinário superior e inferior. Além disso, a técnica limpa permite que o próprio paciente a execute, proporcionando o retorno às suas atividades profissionais, culturais e de lazer. Conclusão: cabe aos profissionais de saúde, em especial ao enfermeiro, as orientações e o treinamento dos pacientes. Descritores: cateterismo urinário; autocuidado; enfermeiro; enfermagem; assistência de enfermagem; doenças; sistema urinário.RESUMENObjetivo: comunicar los beneficios de la cateterización intermitente y la técnica de limpieza. Método: se realizó una literatura a través de la Internet en la Lilacs, Medline, PubMed, Science Direct y tesis de base de datos de la CAPES. Las palabras clave utilizadas fueron: el uso de sondas y catéteres urinarios / historia, y el período seleccionado desde 1945 hasta 2009. Resultados: la cateterización intermitente es indicado para las condiciones que llevan a dificultades en la micción, especialmente para los pacientes con disfunción del esfínter de la vejiga. Se ha utilizado desde la Primera Guerra Mundial, pero la mayoría de utilizarse después de la Segunda Guerra Mundial. Sondaje vesical intermitente es similar a la función normal de la vejiga, ya que permite la superdistensão cíclica vaciado de la vejiga, y evitar la pérdida de las características del yacimiento, y puede reducir las tasas de infección urinaria y evitar el deterioro del tracto urinario superior e inferior. Por otra parte, la técnica de limpieza permite que el paciente siga, proporcionando un retorno a sus actividades profesionales, culturales y de ocio. Conclusión: es para los profesionales de la salud, especialmente la enfermera, la orientación y la formación de los pacientes. Descriptores: cateterismo urinário; autocuidado; enfermero; enfermería; atención de enfermería; enfermedades; sistema urinário.
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Hachem, Ray, Ruth Reitzel, Agatha Borne, Ying Jiang, Peggy Tinkey, Rajesh Uthamanthil, Jyotsna Chandra, Mahmoud Ghannoum, and Issam Raad. "Novel Antiseptic Urinary Catheters for Prevention of Urinary Tract Infections: Correlation of In Vivo and In Vitro Test Results." Antimicrobial Agents and Chemotherapy 53, no. 12 (October 5, 2009): 5145–49. http://dx.doi.org/10.1128/aac.00718-09.
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ABSTRACT Urinary catheters are widely used for hospitalized patients and are often associated with high rates of urinary tract infection. We evaluated in vitro the antiadherence activity of a novel antiseptic Gendine-coated urinary catheter against several multidrug-resistant bacteria. Gendine-coated urinary catheters were compared to silver hydrogel-coated Foley catheters and uncoated catheters. Bacterial biofilm formation was assessed by quantitative culture and scanning electron microscopy. These data were further correlated to an in vivo rabbit model. We challenged 31 rabbits daily for 4 days by inoculating the urethral meatus with 1.0 × 109 CFU streptomycin-resistant Escherichia coli per day. In vitro, Gendine-coated urinary catheters reduced the CFU of all organisms tested for biofilm adherence compared with uncoated and silver hydrogel-coated catheters (P < 0.004). Scanning electron microscopy analysis showed that a thick biofilm overlaid the control catheter and the silver hydrogel-coated catheters but not the Gendine-coated urinary catheter. Similar results were found with the rabbit model. Bacteriuria was present in 60% of rabbits with uncoated catheters and 71% of those with silver hydrogel-coated catheters (P < 0.01) but not in those with Gendine-coated urinary catheters. No rabbits with Gendine-coated urinary catheters had invasive bladder infections. Histopathologic assessment revealed no differences in toxicity or staining. Gendine-coated urinary catheters were more efficacious in preventing catheter-associated colonization and urinary tract infections than were silver hydrogel-coated Foley catheters and uncoated catheters.
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Rothenburger, Jamie L., Chelsea G. Himsworth, Krista M. D. La Perle, Frederick A. Leighton, Nicole M. Nemeth, Piper M. Treuting, and Claire M. Jardine. "Pathology of wild Norway rats in Vancouver, Canada." Journal of Veterinary Diagnostic Investigation 31, no. 2 (March 2019): 184–99. http://dx.doi.org/10.1177/1040638719833436.
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To achieve a contemporary understanding of the common and rare lesions that affect wild, urban Norway rats ( Rattus norvegicus), we conducted a detailed pathology analysis of 672 rats from Vancouver, British Columbia, Canada. Grossly evident lesions, such as wounds, abscesses, and neoplasms, were present in 71 of 672 rats (11%) and tended to be severe. The most common and significant lesions were infectious and inflammatory, most often affecting the respiratory tract and associated with bite wounds. We assessed a subset of rats (up to n = 406 per tissue) for the presence of microscopic lesions in a variety of organ systems. The most frequent lesions that could impact individual rat health included cardiomyopathy (128 of 406; 32%), chronic respiratory tract infections as indicated by pulmonary inducible bronchus-associated lymphoid tissue (270 of 403; 67%), tracheitis (192 of 372; 52%), and thyroid follicular hyperplasia (142 of 279; 51%). We isolated 21 bacterial species from purulent lesions in rats with bacterial infections, the most frequent of which were Escherichia coli, Enterococcus sp., and Staphylococcus aureus. Parasitic diseases in rats resulted from infection with several invasive nematodes: Capillaria hepatica in the liver (242 of 672; 36%), Eucoleus sp. in the upper gastrointestinal tract (164 of 399; 41%), and Trichosomoides crassicauda in the urinary bladder (59 of 194; 30%). Neoplastic, congenital, and degenerative lesions were rare, which likely reflects their adverse effect on survival in the urban environment. Our results establish a baseline of expected lesions in wild urban rats, which may have implications for urban rat and zoonotic pathogen ecology, as well as rat control in cities worldwide.
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Sulaiman, A. A., M. S. M. Albayati, and A. A. Rasheed. "Recurrent UTI in Ventriculoperitoneal Shunted Children's." Pakistan Journal of Medical and Health Sciences 15, no. 5 (May 30, 2021): 1353–57. http://dx.doi.org/10.53350/pjmhs211551353.
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Objective: To determine the rate and the type of recurrent UTI in ventriculoperitoneal shunted children's admitted to Azady Teaching Hospital, Kirkuk.. Methods: From mid 2015 to end of 2020; UTI in ventriculoperitoneal shunted children's . Once infection was suspected , CSF (from shunt reservoir or from ventricular tapping), blood, and urine samples, analysis, and culture taken and empirical antibiotics were recommended. Results: 25.9% of patients with VP shunts had infections which represents 29.3% of the procedures. 40% of infected patients had recurrent episodes. 59.1% of infections occurred throughout the first two months following insertion. Single pathogen was isolated in each episode. E.coli represented 50% of isolated pathogens compared with 18.2% with Staphylococcus epidermidis. Conclusions: There is a high incidence of recurrent UTI in ventriculoperitoneal shunted children's in Azady Teaching Hospital, Kirkuk. when compared withother international centres. Gram negative organisms are the most common cause of the infection. Keywords: Urinary tract infection= UTI ,Renal scar.,BBD = Bladder Bowel Dysfunction; DMSA = dimercaptosuccinic acid; IV
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Abdullah, Vera Iriani, and Jimmy Chandra. "EFEKTIVITAS LATIH KANDUNG KEMIH TERHADAP PERCEPATAN PERKEMIHAN PADA IBU PASCA SALIN DI RSUD KABUPATEN SORONG." Nursing Arts 12, no. 1 (June 28, 2018): 1–5. http://dx.doi.org/10.36741/jna.v12i1.62.
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SDgs targeting in 2030, the global maternal mortality rate can reach 70 per 100.000 live births. In indonesia, bleeding contributes the most maternal mortality and around 16-17% cases are caused by uterine atony due to urinary retention. Which prevents the uterus from contracting properly because the uterus is pushed up and sideways. Vaginal delivery and worries due to pain result in the inability to excrete urine which can cause complication of uremia, infection, sepsis, an even spontaneous rupture of urinary vesicles. Training bladder 2-hours postpartum is one of interventions that can be done so that mother can return to normal urinary pattern and prevent bleeding that results in death. The purpose of this study was measure the effectiveness of bladder training on the acceleration of post partum maternal urination at the Sorong district hospital in 2018. The result of this study we expected to be a reference for complementary therapies to overcome cases of urin retention in post partum mothers. This research method uses a quasi experimental method with a cross sectional approach. The result of hypothesis using kruskal-walls showed a p value >0,05, that’s mean there was no effectiveness of bladder training on the acceleration of post partum maternal urination at the Sorong district hospital.
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Aguiniga, Lizath M., Ryan E. Yaggie, Anthony J. Schaeffer, and David J. Klumpp. "Lipopolysaccharide Domains Modulate Urovirulence." Infection and Immunity 84, no. 11 (August 15, 2016): 3131–40. http://dx.doi.org/10.1128/iai.00315-16.
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Uropathogenic Escherichia coli (UPEC) accounts for 80 to 90% of urinary tract infections (UTI), and the increasing rate of antibiotic resistance among UPEC isolates reinforces the need for vaccines to prevent UTIs and recurrent infections. Previous studies have shown that UPEC isolate NU14 suppresses proinflammatory NF-κB-dependent cytokines (D. J. Klumpp, A. C. Weiser, S. Sengupta, S. G. Forrestal, R. A. Batler, and A. J. Schaeffer, Infect Immun 69:6689–6695, 2001, http://dx.doi.org/10.1128/IAI.69.11.6689-6695.2001 ; B. K. Billips, A. J. Schaeffer, and D. J. Klumpp, Infect Immun 76:3891–3900, 2008, http://dx.doi.org/10.1128/IAI.00069-08 ). However, modification of lipopolysaccharide (LPS) structure by deleting the O-antigen ligase gene ( waaL ) enhanced proinflammatory cytokine secretion. Vaccination with the Δ waaL mutant diminished NU14 reservoirs and protected against subsequent infections. Therefore, we hypothesized that LPS structural determinants shape immune responses. We evaluated the contribution of LPS domains to urovirulence corresponding to the inner core ( waaP , waaY , and rfaQ ), outer core ( rfaG ), and O-antigen ( waaL , wzzE , and wzyE ). Deletion of waaP , waaY , and rfaG attenuated adherence to urothelial cells in vitro . In a murine UTI model, the Δ rfaG mutant had the most severe defect in colonization. The mutation of rfaG , waaL , wzzE , and wzyE resulted in an inability to form reservoirs in mouse bladders. Infection with the LPS mutant panel resulted in various levels of urinary myeloperoxidase. Since the Δ waaL mutant promoted Th 1 -associated adaptive responses in previous studies (B. K. Billips, R. E. Yaggie, J. P. Cashy, A. J. Schaeffer, and D. J. Klumpp, J Infect Dis 200:263–272, 2009, http://dx.doi.org/10.1086/599839 ), we assessed NU14 for Th 2 -associated cytokines. We found NU14 infection stimulated TLR4-dependent bladder interleukin-33 (IL-33) production. Inoculation with rfaG , waaL , wzzE , and wzyE mutants showed decreased IL-33 production. We quantified antigen-specific antibodies after infection and found significantly increased IgE and IgG1 in Δ waaP mutant-infected mice. Our studies show LPS structural constituents mediate multiple aspects of the UPEC life cycle, including the ability to acutely colonize bladders, form reservoirs, and evoke innate and adaptive immune responses.
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Kuo, Hann-Chorng. "Clinical Outcome of Augmentation Enterocystoplasty for Patients with Ketamine-induced Cystitis." Pain Physician 3, no. 20;3 (March 7, 2017): E431—E436. http://dx.doi.org/10.36076/ppj.2017.e436.
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Background: Ketamine abuse has become a global phenomenon in recent years. Ketamineinduced cystitis (KC) is a new clinical syndrome which can result in severely inflamed bladder and intractable bladder pain. Currently there is no guideline for managing patients with KC. Objectives: To analyze the clinical outcome of patients with KC managed with augmentation enterocystoplasty (AE). Study Design: Retrospective interventional study. Setting: A tertiary teaching hospital, Hualien Tzu Chi Hospital. Methods: We retrospectively collected and analyzed the medical records and videourodynamic (VUD) test results of 26 patients who underwent AE as treatment for refractory KC during the period 2009 – 2014. All of these patients abused ketamine with nasal snorting, at least 3 grams per dose, twice per week for 6 months. Data from VUD studies performed before AE and 3 – 6 months after surgery that were analyzed in this study included cystometric bladder capacity (CBC), post-void residual (PVR) urine volume, maximum urinary flow rate (Qmax), voided volume, and bladder compliance. A self-report questionnaire was used to assess patient satisfaction with AE. Results: Patients included 14 women and 12 men aged 20 – 43 years (mean age, 28.5 years) with an average duration of ketamine abuse of 4.7 years (range, 1 – 10 years). All patients had contracted bladder, 9 had hydronephrosis, and 10 had vesicoureteral reflux (VUR). There was significant improvement in CBC (52.7 ± 29.7 v 327 ± 69.4 mL, P < 0.0001), Qmax (6.94 ± 4.32 v 13.7 ± 4.96 mL/s, P < 0.0001), PVR (8.08 ± 19.2 v 82.6 ± 91.5 mL, P < 0.0001), voided volume (44.1 ± 28.3 v 250.7 ± 133.4 mL, P < 0.0001), and bladder compliance (11.1 ± 11.9 v 54 ± 43, P < 0.0001) after AE. Hydronephrosis resolved in 7 patients after AE and VUR resolved in all patients who underwent AE with ureteral reimplantation. All patients who stopped using ketamine were free of bladder pain postoperatively. However, 10 patients who reused ketamine had recurrent bladder pain and recurrent urinary tract infection. Limitations: Small number of patients limits scope of study. Conclusions: AE is effective at treating KC-induced bladder pain and restoring normal lower urinary tract function. However, absolute cessation of ketamine is the key to success in KC treatment. Key words: Ketamine-induced cystitis, augmentation enterocystoplasty, bladder pain, contracted bladder, inflammation, surgery
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Balducci, Federica, Luisa De Risio, Anita Shea, Sara Canal, Fabio Stabile, and Marco Bernardini. "Neurogenic urinary retention in cats following severe cluster seizures." Journal of Feline Medicine and Surgery 19, no. 2 (July 10, 2016): 246–50. http://dx.doi.org/10.1177/1098612x15602739.
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Case series summary Four cats that presented with severe cluster seizures developed neurogenic urinary retention in the postictal phase. None of the cats had previous seizures. Micturition was reported as normal in all cats for 3 or more years before seizure onset. All cats required a continuous rate infusion of propofol to control the seizure activity. In all cats manual bladder expression was performed every 8 h until recovery of normal micturition. One cat was started on phenoxybenzamine to reduce internal urethral sphincter tone. All cats recovered normal micturition within 4 weeks of the last cluster of seizures. Relevance and novel information Transient neurogenic urinary retention has not previously been reported in cats or dogs following severe cluster seizures. Urinary retention should be considered a potential postictal deficit, requiring prompt recognition and treatment to avoid urinary tract infection and detrusor muscle atony.
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Parikesit, Dyandra, Indra Wicaksono, Muhamad Iqbal Tawfid, Fina Widia, and Harrina Erlianti Rahardjo. "Voiding profile in recipients post renal transplant: A prospective observational study." F1000Research 8 (October 31, 2019): 1836. http://dx.doi.org/10.12688/f1000research.21024.1.
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Background: Renal transplantation (RTX) is thought to have high survival rates. However, patients with long-term dialysis have decreased bladder function due to disuse. High urine production after RTX surgery might cause patients to have urinary symptoms, thus decreasing their quality of life. The aim of this study was to evaluate voiding characteristics of patients after RTX surgery. Methods: All patients were diagnosed with chronic kidney disease (CKD) and underwent kidney transplantation from a living donor. Anthropometric parameters, physical examinations, cause of CKD, daily urine production, types and duration of dialysis, and basic laboratory examination were collected before transplant surgery. Post-operative examinations included laboratory examination, international prostate symptom score (IPSS; for male patients only), overactive bladder symptom score (OABSS), uroflowmetry, and post void residue (PVR). Results: 71 patients were evaluated with a mean age of 46 ± 17.9 years, with male and female ratio of 52:19. Significant negative correlation was seen between duration of dialysis and daily urine production (r: -0.68, p<0.01). Majority of patients had a maximum flow rate of >15 cc/s (70.4 %) with average flow of 22 ± 9.8 cc/s. The majority of patients had PVR <100 cc (91.5%) with median PVR of 33.5 cc (range, 2.3 – 142 cc). IPSS result showed that frequency [2 (0 – 5)] and nocturia [2 (0 – 5)] are the main problem in these patients (n = 52). OABSS questionnaire also showed that frequency (OABSS 1; score 1 [1-2]) and nocturia (OABSS 2; score 2 [0-3]) was the main symptoms reported by patients. Conclusion: After RTX, the majority of patients experienced urinary frequency and nocturia problems due to various causes such as increased daytime and nighttime urine production, urinary tract infection, changes in bladder capacity (both small and large), and a decrease in bladder compliance.
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Wormer, Blair A., Samuelw Ross, Amanda L. Walters, and Timothy S. Kuwada. "Bladder Fill after Laparoscopic Inguinal Hernia Repair Reduces Time to Discharge." American Surgeon 83, no. 4 (April 2017): 385–89. http://dx.doi.org/10.1177/000313481708300427.
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Laparoscopic inguinal herniorrhaphy (LIH) has a relatively high risk of urinary retention. Bladder dysfunction may delay discharge after LIH. We hypothesized that filling the bladder before Foley catheter removal decreases time to discharge (TTD) after LIH. A secondary aim was to determine incidence of postoperative urinary retention (POUR) after bladder fill (BF). We reviewed a consecutive series of total extraperitoneal and transabdominal preperitoneal LIH procedures performed by a single surgeon at our institution from 2010 to 2013. All patients were catheterized during LIH, and selected patients received a 200-mL saline BF before Foley catheter removal. Patients were required to void >250 mL before discharge. TTD and incidence of POUR were compared between the BF and no-BF groups. A total of 161 LIH cases were reviewed. BF was performed in 89/161 (55%) of cases. TTD was significantly shorter in the BF versus the no-BF group (222 vs 286 minutes, respectively; P < 0.01). Patient and operative characteristics were similar between the BF and no-BF groups (P > 0.05). Incidence of POUR in the BF and the no-BF group was 10.1 and 16.7 per cent, respectively; however, this difference was not significant (P = 0.22). No postoperative urinary tract infection occurred in either group. In conclusions, postoperative BF significantly reduces TTD after LIH. Further studies may help to determine whether shorter postanesthesia care unit time and lower POUR rates associated with BF can lower LIH procedural costs and increase patient satisfaction.
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Kim, Byung Soo, Bum Sik Tae, Ja Hyeon Ku, Cheol Kwak, Hyeon Hoe Kim, and Chang Wook Jeong. "Rate and association of lower urinary tract infection with recurrence after transurethral resection of bladder tumor." Investigative and Clinical Urology 59, no. 1 (2018): 10. http://dx.doi.org/10.4111/icu.2018.59.1.10.
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El-Reshaid, Kamel, and Shaikha Al-Bader. "Moderate and Timely Water Intake Followed By Micturition Reduces Frequency of Recurrent Urinary Tract Infections and the Prevalence of Virulent Uropathogens in Adult Women." International Journal of Innovative Research in Medical Science 5, no. 08 (August 1, 2020): 268–70. http://dx.doi.org/10.23958/ijirms/vol05-i08/923.
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Urinary tract infection (UTI) is the most common type of infection in women. Preventive measures included local hygiene, clothing, diet, limiting activities, and prophylactic antibiotics. In this study; we evaluated the role of a simple technique of 5-timely oral water flushing of the urinary bladder in its prevention. The technique entailed an intake of 250 ml of plain water followed by micturition 15-30 minute later at; early morning, 30 minute after the 3 daily meals and 1 hour before night sleep. Moreover, married women had an additional similar bolus intake 30 minute before sexual intercourse and micturition immediately after coitus. This prophylactic regimen has been evaluated in 422 adult non-menopausal females with high-rate of recurrent UTI (>2 UTI/year) for a median duration of 33 months. Married women; had higher rate of UTI/patient year and incidence of non-E coli bacteriuria compared to non-married ones. Our prophylactic technique resulted in; (a) decrease in UTI rate/patient year on follow up from 2.3(0.8) to 0(0.3), (b) clearance of bacteriuria in 69% of women, and decrease of non-E coli pathogens from 31% to 2% (p< 0.001). The latter was due to limiting the use of antibiotics. Married women had similar encouraging results. In conclusion; moderate and timely water intake followed by micturition reduces frequency of recurrent urinary tract infections and the prevalence of virulent uropathogens in adult women.
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Shrestha, Ranjana, Ganesh Dangal, Sonu Bharati, Aruna Karki, Hema Kumari Pradhan, Kabin Bhattachan, Rekha Poudel, Nishma Bajracharya, and Kenusha Devi Tiwari. "Outcome of Trans-obturator Tape Procedure in the treatment of Stress Urinary Incontinence at Kathmandu Model Hospital." Nepal Journal of Obstetrics and Gynaecology 15, no. 1 (June 7, 2020): 24–27. http://dx.doi.org/10.3126/njog.v15i1.29335.
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Aims: To evaluate the improvement in the quality of life of women with stress urinary incontinence who were treated with trans-obturator tape procedure.
Methods: This is a cross-sectional study of treatment of stress urinary incontinence using trans-obturator tape at Kathmandu Model Hospital from February 2018 to December 2019. The outcome of the procedure in terms of improvement in quality of life and surgical complications were assessed.
Results: Out of 16 cases of stress urinary incontinence half of them were post-menopausal. One each had intra-operative bladder injury, urinary retention and urinary tract infection; 14 cases improved completely by a week, one had some improvement and one didn’t improve. At six months follow-up one case had no improvement and one developed urge incontinence.
Conclusions: Trans-obturator tape has been found a good procedure for the treatment of stress urinary incontinence in our setting and hence led to high rate of improvement in quality of life with minimal and minor complications.
Key words: Complications; quality of life; stress urinary incontinence; trans-obturator tape
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Cardoso, Simone Aparecida Caetano, and Luiz Faustino dos Santos Maia. "Cateterismo vesical de demora na UTI adulto: o papel do enfermeiro na prevenção de infecção do trato urinário." Revista Recien - Revista Científica de Enfermagem 4, no. 12 (December 15, 2014): 5. http://dx.doi.org/10.24276/2358-3088.2014.4.12.5-14.
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As infecções em Unidade de Terapia Intensiva estão associadas à gravidade clinica dos pacientes. O objetivo deste trabalho foi descrever o papel do enfermeiro na prevenção de infecção do trato unário relacionado ao cateterismo vesical de demora na UTI adulto. Trata-se de um de revisão integrativa bibliográfica, onde foram usadas as bases de dados de Enfermagem da Biblioteca Virtual em Saúde. A importância de estudos para prevenção destas infecções relacionadas ao cateter vesical de demora, o que fundamentalmente é responsabilidade do enfermeiro no desenvolvimento do seu exercício profissional. Ao descrever as intervenções de enfermagem associada à prevenção de infecção do cateterismo vesical na UTI adulto, os resultados relatam que as intervenções necessitam ser realizadas de maneira correta para minimizar o índice de infecções na unidade de terapia intensiva, tendo como sugestão a utilização dos protocolos baseados nas pesquisas cientificas.Descritores: Enfermagem, Prevenção, Infecção no Trato Urinário. Catheterization delay of bladder in adult ICU: nurses 'role in infection prevention of urinary tractAbstract: Infections in the Intensive Care Unit are associated with clinical severity. The objective of this study was to describe the role of nurses in preventing infection of the unary tract related to bladder catheterization delay in the adult ICU. This is a bibliographic integrative review, where the bases were used Virtual Library of Nursing in Health data. The importance of studies for the prevention of these infections related to indwelling catheters, which is fundamentally the nurses responsibility in the development of their care. Describing the nursing interventions associated with prevention of infection of the bladder catheterization in adult ICU, the results reported that the interventions must be performed correctly to minimize the rate of infections in the intensive care unit, with the suggestion the use of protocols based in scientific research.Descriptors: Nursing, Prevention, Infection in the Urinary Tract. Cateterización retraso de vejiga en UCI adulto: papel del enfermero en prevención de infecciones de las vías urinariasResumen: Las infecciones en la unidad de cuidados intensivos se asocian con la gravedad clínica. El objetivo de este estudio fue describir el papel de las enfermeras en la prevención de la infección del tracto unario relacionados con la vejiga retraso cateterismo en la UCI de adultos. Se tratar de una revisión integradora bibliográfica, donde se utilizaron las bases de la Biblioteca Virtual de Enfermería en Datos de Salud. La importancia de los estudios para la prevención de estas infecciones relacionadas con catéteres permanentes, que es fundamentalmente la responsabilidad personal de enfermería en el desarrollo de su cuidado. Al describir las intervenciones de enfermería relacionados con la prevención de la infección de la sonda vesical en la UCI de adultos, los resultados indicaron que las intervenciones deben realizarse correctamente para minimizar la tasa de infecciones en la unidad de cuidados intensivos, con la sugerencia de la utilización de protocolos basados en la investigación científica.Descriptores: Enfermería, Prevención, Infecciones en el Tracto Urinario.