- Renal function is associated with prognosis in stent-change therapy for malignant ureteral obstruction. [Journal Article]
- ICInvestig Clin Urol 2018; 59(6):376-382
- CONCLUSIONS: Internal ureteral stenting was effective for maintaining renal function in malignant ureteral obstruction. However, it did not restore renal function, which is related to the prognosis of the patients. Therefore, to improve patients' renal function and prognosis, patients who require stenting must be quickly recognized and treated.
- Factors associated with hematuric struvite crystalluria in cats. [Journal Article]
- JFJ Feline Med Surg 2018 Nov 05; :1098612X18809176
- CONCLUSIONS: The present study provides estimates of the strengths of association between HSC and certain signalment and clinical characteristics of cats. This information could help clinicians to perform a more directed screening for struvite crystalluria in certain cat populations. Follow-up studies that build on the findings of this study could explore the clinical importance of HSC in cats.
- A case report of infantile cystic nephroblastoma. [Journal Article]
- DPDiagn Pathol 2018 Oct 27; 13(1):84
- CONCLUSIONS: This is an extremely rare case of infantile cystic NB. We diagnosed the NB cells that appeared in the peritoneal fluid by intraoperative rapid cytology. Cytological examination proved to be a very useful technique for determining the clinical stage of NB. Additionally, we propose that massive tumor degeneration and necrosis be considered as a pathogenic mechanism of cyst formation in NB.
- Reduced Recurrence of Low-Grade Papillary Bladder Tumors Associated with Asymptomatic Bacteriuria. [Journal Article]
- UUrology 2018 Oct 22
- CONCLUSIONS: Patients with papillary TaLG tumors and chronic asymptomatic bacteriuria had fewer recurrences, fewer numbers of recurrent tumors, and longer tumor-free survival times than similarly staged uninfected patients. Bladder-resident bacteria may reduce bladder tumor recurrences through local immune mechanisms.
- Removal of intramural trapped intrauterine device by cystoscopic incision of bladder wall. [Video-Audio Media]
- IBInt Braz J Urol 2018 Sep 20; 44
- A healthy 37 - year - old woman referred to our clinic with one - year history of recurrent urinary tract infection, dysuria and frequency. Her past medical history informed us that an IUD (Copper TC...
A healthy 37 - year - old woman referred to our clinic with one - year history of recurrent urinary tract infection, dysuria and frequency. Her past medical history informed us that an IUD (Copper TCu380A) had been inserted 11 years ago. Eleven months after the IUD insertion she had become pregnant, unexpectedly. At that time, she had undergone gynecological examination and abdominal ultrasound study. However, the IUD had not been found, and the gynecologist had made the diagnosis of spontaneous fall out of the IUD. She had experienced normal pregnancy and caesarian section with no complications. On physical examination, pelvic examination was normal and no other abnormalities were noted. Urinalysis revealed microhematuria and pyuria. Urine culture was positive for Escherichia coli. Ultrasound study revealed a calculus of about 10 mm in the bladder with a hyperdense lesion. A plain abdominal radiograph was requested which showed a metallic foreign body in the pelvis. We failed to remove the IUD by cystoscopic forceps because it had strongly invaded into the uterine and bladder wall. Despite previous papers suggesting open or laparoscopic surgeries in this situation (1, 2), we performed a modified cystoscopic extraction technique. We made a superficial cut in the bladder mucosa and muscle with J - hook monopolar electrocautery and extracted it completely with gentle traction. This technique can decrease the indication of open or laparoscopic surgery for extraction of intravesical IUDs. In the other side of the coin, this technique may increase the risk of uterovesical fistula. Therefore, the depth of incision is important and the surgeon should cut the bladder wall superficially with caution. Although present study is a case report which is normally classified as with low level of evidence, it seems that our modified cystoscopic extraction technique is a safe and useful method for extraction of partially intravesical IUDs.
- The uncertainties of the diagnosis and treatment of a suspected urinary tract infection in elderly hospitalized patients. [Journal Article]
- ERExpert Rev Anti Infect Ther 2018; 16(10):763-770
- The diagnostic criteria for a urinary tract infection (UTI) and proper treatment of elderly patients hospitalized with nonspecific symptoms is uncertain. Areas covered: A nonsystematic literature rev...
The diagnostic criteria for a urinary tract infection (UTI) and proper treatment of elderly patients hospitalized with nonspecific symptoms is uncertain. Areas covered: A nonsystematic literature review of the variable approaches in diagnosing and treating hospitalized elderly patients with a suspected UTI. Expert commentary: Bacteriuria and/or pyuria cannot confirm the diagnosis of a UTI because of the high prevalence in the elderly regardless of presentation so urine cultures are not indicated in those hospitalized for diseases outside the urinary tract. The microscopic urinalysis is imprecise and inaccurate, and lowers the sensitivity in detecting a bacteremic UTI if used to confirm a positive dipstick test result. There is some evidence that cancelling urine cultures in the absence of a positive dipstick (negative leukocyte esterase and nitrite) is safe and prevents unnecessary antibiotic therapy. Urinary catheterization to obtain a urine sample is common in the elderly and it is unclear if changes in antibiotic therapy based on culture results outweighs the risks of the procedure. In hospitalized elderly patients without septic shock, it is unclear when it is safe to withhold antibiotic therapy, and when patients with criteria used to define severe sepsis need immediate treatment with broad-spectrum antibiotics.
- Frequency of Infection during Fever Episodes among Long-Term Care Residents. [Journal Article]
- JGJ Gerontol Geriatr Res 2018; 7(2)
- CONCLUSIONS: Data from this study suggest that approximately two-thirds of fever episodes involve infection among women in long-term care facilities. These data may guide provider assessments of fever in older adult women in long-term care facilities.
- Urinary cell-free microRNA biomarker could discriminate bladder cancer from benign hematuria. [Journal Article]
- IJInt J Cancer 2018 Sep 05
- The most common symptom of bladder cancer (BC) is hematuria. However, not all patients with hematuria are diagnosed with BC. Here, we explored a novel method to discriminate BC from hematuria under n...
The most common symptom of bladder cancer (BC) is hematuria. However, not all patients with hematuria are diagnosed with BC. Here, we explored a novel method to discriminate BC from hematuria under non-malignant conditions by measuring differences in urinary cell-free microRNA (miRNA) expression between patients with BC and those with hematuria. A multicenter study was performed using 543 urine samples obtained from the National Biobank of Korea, including 326 BC, 174 hematuria, and 43 pyuria without cancer. The urinary miR-6124 to miR-4511 ratio was considerably higher in BC than in hematuria or pyuria, and enabled the discrimination of BC from patients with hematuria at a sensitivity of >90% (P<0.001). Conclusively, the proposed non-invasive diagnostic tool based on the expression ratio of urinary cell-free miR-6124 to miR-4511 can reduce unnecessary cystoscopies in patients with hematuria undergoing evaluation for BC, with a minimal loss in sensitivity for detecting cancer. This article is protected by copyright. All rights reserved.
- Microscopic Bacteriuria Detected by Automated Urinalysis for the Diagnosis of Urinary Tract Infection. [Journal Article]
- JPedJ Pediatr 2018; 202:238-244.e1
- CONCLUSIONS: Microscopic bacteriuria measured by automated urinalysis augments the diagnostic value of pyuria for identifying presumptive UTI in young children aged <2 years. Bacteriuria is diagnostically inferior to microscopic pyuria, and in children with bacteriuria without pyuria, presumptive UTI is unlikely.
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- Prostatitis, a rare presentation of granulomatosis with polyangiitis, successfully treated with rituximab and prednisone. [Journal Article]
- BCBMJ Case Rep 2018 Aug 14; 2018
- A previously healthy 21-year-old man presented with an 8-month history of weight loss, lethargy and dysuria unresponsive to empiric antibiotics and paraurethral drainage of a prostatic abscess. Urina...
A previously healthy 21-year-old man presented with an 8-month history of weight loss, lethargy and dysuria unresponsive to empiric antibiotics and paraurethral drainage of a prostatic abscess. Urinalysis showed pyuria, but cultures failed to grow any organisms. Additionally, he developed new onset sensorineural hearing loss. CT of the chest showed two right-sided cavitary lesions. CT of the abdomen and pelvis demonstrated a prostatic abscess. A prostate biopsy demonstrated necrotising granulomatous prostatitis. A lung biopsy showed necrotising granulomatous inflammation. He was diagnosed with granulomatosis with polyangiitis (GPA). He was successfully treated with rituximab and prednisone. At 6-month follow-up, he continued to be in remission with resolution of his symptoms. This case demonstrates a rare presentation of prostatitis as the presenting symptom of GPA. As far as we know, this case is the first documented report of rituximab and prednisone as successful therapy for prostatitis secondary to GPA.