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At least 595 records · Page 33Linked to original sources
PubMed1990

Genitourinary mycobacteria in infertile Egyptian men.

Forty infertile patients with a preliminary diagnosis of genitourinary tuberculosis were selected for our study when they presented with one or more of the following: (1) personal or family history of tuberculosis, (2) sterile pyuria, (3) voiding urinary symptoms, (4) abnormality in the epididymis, (5) hemospermia, and (6) clinically unexplained obligoathenospermia. Direct smear examination by Ziehl-Neelsen stain for 24-hour urine and freshly ejaculated semen for 3 days as well as culture of midstream urine and semen were done on egg media. Urine smear was positive (+)ive in 20 patients (50%), culture was (+)ive in 23 (57.5%), whereas for semen smear was (+)ive in 3 (7.3%) and culture was (+)ive in 5 (20%). Tuberculous mycobacteria were detected in 5 of 23 cases (21.7%). Nontuberculous mycobacteria were detected in 18 of 23 cases (78.3%). Mycobacterium smegmatis was the most common mycobacterium isolated. There was improvement of the seminal picture, though not significant, after therapy.

Adult↗
PubMed1987

Urolithiasis in childhood: current management.

During the past 12 years, 62 children with urinary stones have been treated at the Children's Hospital of Philadelphia. The most common presenting symptoms were abdominal or flank pain (45%), recurrent or persistent pyuria (35%), and gross hematuria (21%). Twenty-two patients had associated congenital urologic anomalies. Infection-related struvite stones were most common and were found in 18 children, of whom 15 were found to have anatomic abnormalities. Eighteen of 28 children evaluated for a metabolic cause were found to have an abnormality, most frequently hypercalciuria. No predisposing factors could be found in 16 of the 62 patients. Forty-four (87%) children had upper urinary tract stones. Twelve of 15 bladder stones were in children with a neuropathic bladder and all were related to infection. Treatment was directed to the correction of anatomic and metabolic predisposing causes, as well as to removing the stones. Fifteen patients passed stones ranging in size from 2 to 6 mm. Forty-six surgical procedures were performed in 43 children. Pyelolithotomy and cystolithotomy were the most frequent procedures. There were three residual stones and five recurrences. Of the 29 operations for upper urinary stones reviewed, 17 might today be considered suitable for percutaneous nephrostolithotripsy or extracorporeal shockwave lithotripsy. Possible future stone management will be discussed in light of this analysis.

Adolescent↗
PubMed1987

Microflora of the urethra in adolescent boys: relationships to sexual activity and nongonococcal urethritis.

Urethral cultures were obtained from 90 adolescent youth, 16 of whom denied previous sexual activity. Among the sexually active boys was a group of 32 with clinically significant pyuria, consistent with the diagnosis of urethritis, on a first-part urinalysis (FPU) specimen. To relate differences in urethral microflora to sexual activity, 42 sexually active patients with a negative FPU were compared with the never sexually active group. The profile of anaerobic, but not aerobic, bacteria isolated from the urethra was related to the presence or absence of previous sexual activity. Mycoplasma species and Ureaplasma urealyticum were isolated from sexually active patients only, and may be markers of sexual activity in adolescent boys. Of the 32 patients with FPU evidence of urethritis, 22 (69%) had cultures positive for Chlamydia trachomatis, and an additional three (9%) had cultures positive for Neisseria gonorrhoeae. The findings in sexually active patients with a positive FPU were otherwise similar to those of sexually active patients without evidence of urethritis. C. trachomatis appears to be the most important agent of urethritis among adolescent boys with a positive FPU.

Adolescent↗
PubMed1988

Historical and clinical factors associated with Chlamydia trachomatis genitourinary infection in female adolescents.

Five hundred sixty-eight adolescent female patients receiving routine gynecologic care at urban clinics were screened by culture for Chlamydia trachomatis infection at both the urethra and endocervix. Culture results for 562 were available from either or both sites. Positive cultures were obtained from 139 (25%). Urethral infection was not associated with either urinary tract symptoms or sterile pyuria, but urethral or endocervical infection was associated with cervical friability (P = less than 0.0001), endocervical mucopus (P = 0.0001), cervical erythema (P = 0.0002), and cervical ectopy or erosion (P = 0.01). Increased chlamydial infection rates were associated with older age (P = 0.01), history of more frequent intercourse (P = 0.01), and history of more than one lifetime partner (P = 0.023), with a marginal association for being black (P = 0.05). Method of contraception, reason for attending clinic, age at menarche, age at first intercourse, years sexually active, number of sexual partners in preceding 6 months, parity, and prior history of sexually transmitted disease were not associated with having chlamydial genitourinary infection.

Adolescent↗
PubMed1999

The quality of medical textbooks: bladder cancer diagnosis as a case study.

PURPOSE: This study was conducted to determine whether there is an inherent bias in medical texts that influences physicians to favor certain signs and symptoms over others when evaluating patients with bladder cancer. MATERIALS AND METHODS: Numerous sources, primarily textbooks from various medical specialties, were reviewed (italics are added for emphasis). Attention was paid to the criteria the authors suggested for use in the diagnosis of bladder cancer. RESULTS: Although most authors agree on a core of presenting signs and symptoms, some concentrate strongly on hematuria with the result of down playing the importance of other findings such as irritative voiding symptoms. The concern is that this approach may lead to delay in the diagnosis of tumors, some of which may be highly aggressive, which present with dysuria and pyuria but no hematuria. CONCLUSIONS: Inconsistencies do exist in the literature regarding which diagnostic criteria to use in selecting those patients to be evaluated for bladder cancer. Recommendations are made for ways to improve standardization.

Humans↗
PubMed1991

Prediction of septicemia following endourological manipulation for stones in the upper urinary tract.

We investigated 117 patients undergoing percutaneous nephrolithotomy, percutaneous nephrostomy, ureterorenoscopy, the push-back or push-bang procedure for ureteral stones, Double-J* ureteral stenting plus extracorporeal shock wave lithotripsy (ESWL), ESWL alone or cystoscopy. Blood samples obtained before, during and 1 hour after the procedure were cultured and assayed for endotoxin and tumor necrosis factor. Also, culture was done of the urine preoperatively and postoperatively, and the stones when they could be retrieved. There was a temporal relationship among bacteremia, endotoxemia and elevation of tumor necrosis factor. An unexpected finding was peroperative endotoxemia in a significant number of patients with stones. Risk factors noted for postoperative bacteremia, endotoxemia and/or elevation of tumor necrosis factor included preoperative endotoxin level, type of procedure, presence of preoperative bacteriuria and pyuria. With respect to the procedure the risk was greatest after the push-back method and least after cystoscopy (push-back method greater than percutaneous nephrolithotomy/percutaneous nephrostomy greater than Double-J stenting plus ESWL greater than ureterorenoscopy greater than ESWL greater than cystoscopy). If the risk factors are measured preoperatively it may be possible to identify the risk of postoperative bacteremia/endotoxemia and, therefore, septic shock postoperatively. Our patients appear to be a good clinical model to investigate the problems related to septicemia.

Adolescent↗
PubMed1991

Monoclonal antibody Due ABC 3 directed against transitional cell carcinoma. II. Prospective trial on the diagnostic value of immunocytology using monoclonal antibody Due ABC 3.

Recently, the development of monoclonal antibody Due ABC 3 directed against transitional cell carcinoma has been reported. With this monoclonal antibody an in vitro test system for diagnosis and followup of patients with transitional cell carcinoma has been developed. The clinical value of this assay, designated as quantitative immunocytology, was evaluated in a prospective trial and compared to conventional cytology. We investigated 74 voided urine specimens obtained from patients with histologically proved transitional cell carcinoma and 60 specimens from donors without clinical evidence of transitional cell carcinoma. Sensitivity was 66% versus 47% for immunocytology and conventional cytology. Specificity of conventional cytology (92%) was higher compared to immunocytology (58%). Statistical analysis demonstrated a significantly higher sensitivity of the combined analysis of conventional cytology and immunocytology (p less than 0.001) compared to conventional cytology alone, without significant differences in specificity. The results obtained with immunocytology were impaired by the great number of nonevaluable specimens. Poor preservation of cells, severe pyuria or an insufficient number of urothelial cells prevented evaluation in 25% of the cases, while only 6% could not be evaluated by conventional cytology. The ability of immunocytology to improve the sensitivity of conventional cytology makes this technique a promising adjunct to the noninvasive diagnosis of transitional cell carcinoma.

Antibodies, Monoclonal↗
PubMed1990

Computerized tomography in acute pyelonephritis: the clinical correlations.

Computerized tomography was performed on 19 patients diagnosed as having uncomplicated acute pyelonephritis. The relationship was investigated among the laboratory findings, presence of flank pain, clinical course and severity of the lesions detected by computerized tomography. In patients febrile for less than 2 weeks healing as assessed by computerized tomography took an average of 76 days. However, in patients with repeated febrile episodes occurring for longer than 2 weeks healing was delayed until an average 232 days after onset. Computerized tomography findings generally correlated well with the erythrocyte sedimentation rate, C-reactive protein level, and presence of pyuria and flank pain. However, in patients with a prolonged course computerized tomography proved to be a more reliable indicator of progress than either the results of laboratory tests or the symptoms. In conclusion, computerized tomography was useful in the diagnosis, assessment of severity and evaluation of healing of acute pyelonephritis.

Blood Sedimentation↗
PubMed1990

Anastomotic suture granuloma following radical retropubic prostatectomy.

We report 2 cases of symptomatic suture granuloma formation after erosion of the silk suture (used to ligate the dorsal venous complex) into the urethrovesical anastomosis. Irritative or obstructive voiding complaints, sterile pyuria or hematuria found after radical retropubic prostatectomy mandates urological evaluation, including cystoscopy to rule out anastomotic suture granuloma formation. Although erosion appears to be a rare occurrence, we recommend use of absorbable suture to control the dorsal venous complex and avoid this possible complication.

Aged↗
PubMed1988

Xanthogranulomatous pyelonephritis in a renal allograft.

We report a case of xanthogranulomatous pyelonephritis in a cadaver kidney allograft. The patient had diabetic glomerulosclerosis. The predisposing factors that led to this condition included hyperglycemia, a previous rejection reaction and Escherichia coli urinary infection. Persistent fever, pyuria, bacilluria and a nonfunctioning allograft resulted in allograft nephrectomy. The diagnosis was made on histological examination. Diagnostic criteria for xanthogranulomatous pyelonephritis in the allografted kidney are similar to those in the native kidney.

Adult↗
PubMed1988

Erosion of an inflatable penile prosthesis reservoir into the bladder, presenting as bladder calculi.

We report a case of erosion of an inflatable penile prosthesis reservoir int the bladder 4 years after implantation for organic impotence. In contrast to previously reported cases this complication was not associated with incontinence, urinary tract infection or a revision procedure. Microscopic hematuria was present but there was no pyuria. Diagnosis evaded radiographic and cystoscopic confirmation. Bladder erosion of the reservoir was discovered incidentally during treatment of bladder calculi.

Erectile Dysfunction↗
PubMed1988

Torulopsis glabrata urinary infections: a review.

During a 12-year prospective period 9 referral patients were treated for proved Torulopsis urinary infections. Of the 9 patients 7 had irritative voiding symptoms and pyuria was present in 8. To estimate incidence of infection, a retrospective review was performed between January 1982 and December 1983. A total of 105 urine specimens from 57 hospitalized patients yielded Torulopsis glabrata. Two patients suffered symptomatic invasive infections. Patients were treated with antifungal therapy only when invasive symptomatic infections persisted despite elimination of predisposing factors. 5-Fluorocytosine eradicated Torulopsis funguria in 4 of 6 patients in whom it was used. Prolonged therapy with ketoconazole was also successful. Surgical removal of associated stones or fungal coagulum was sometimes required.

Adult↗
PubMed1987

Mast cell involvement in interstitial cystitis.

A prospective study was designed to examine the relationship of mast cells, and eosinophilic leukocyte density and mediator levels to clinical and histological parameters of interstitial cystitis. Interstitial cystitis and control patients underwent bladder biopsy with histological examination, and quantification of intact and degranulated mast cell and eosinophilic leukocyte density. In addition, bladder tissue histamine content, urinary prostaglandin E2 excretion rates, and serum and urinary major basic protein levels were determined. A strong relationship among detrusor mast cell density, especially degranulated, and degree of epithelial loss, submucosal inflammation, epithelial ulceration, urinary pyuria and response to treatment was noted. Bladder tissue histamine content and urinary prostaglandin E2 excretion were increased in the interstitial cystitis patients. Eosinophil density in bladder biopsies was low uniformly, and interstitial cystitis and control patients showed no statistical difference. In addition, serum and urinary major basic protein levels were below the accepted normal lower limits for this protein. Therefore, our study demonstrates a relationship between the mast cell and the inflammatory process of interstitial cystitis. No similar relationship was noted for the eosinophil.

Biopsy↗
PubMed1983

Paecilomyces pyelonephritis complicating nephrolithiasis and review of Paecilomyces infections.

We report a case of Paecilomyces variotii isolated from the renal pelvis at ureterolithotomy. The patient presented with nephrolithiasis, acute flank pain, fever and pyuria, which resolved postoperatively. Paecilomyces has infected the cornea, prosthetic lens implants, lacrimal sac, maxillary sinuses, prosthetic mitral and aortic valves, skin and a ventriculoperitoneal shunt.

Humans↗
PubMed1980

Fungal cystitis: awareness, diagnosis and treatment.

We report 4 cases of fungal cystitis. All patients had severe urgency, frequency and nocturia with sterile pyuria and microhematuria. Significant fungal growth was observed on routine blood agar cultur. Bladder biopsy was necessary to rule out tumor. Of the patients none responded to watchful waiting, 1 responded to intermittent daily bladder instillation of amphortericin B, 2 improved with oral 5-fluorocytosine, in addition to amphotericin B bladder instillations, and 1 required intravenous amphotericin B after unsuccessful response to 5-fluorocytosine and amphotericin B bladder treatments.

Amphotericin B↗
PubMed1980

Anaerobic urinary tract infection owing to Bacteroides fragilis in a chronic hemodialysis patient.

A chronic maintenance hemodialysis patient with severe oliguria and persistent anaerobic urinary tract infection owing to Bacteroides fragilis is presented. Review of the literature shows that the incidence of anaerobic pathogens in random urine cultures is high but that the incidence of clinically significant infection is low. Since the urethra harbors anaerobic organisms suprapubic aspiration of urine and culture are indicated to confirm true anaerobic urinary tract infection. Anaerobic infections are associated with urinary tract abnormalities and pyuria. The various therapeutic maneuvers that were used to treat the infection are discussed, including antibiotic instillation into the bladder and nephrectomy.

Bacteroides Infections↗
PubMed1979

Self-catheterization for decompensated bladder: a review of 100 cases.

The non-neurogenic decompensated bladder is a poorly defined entity. In an attempt to elucidate this condition 100 consecutive patients with non-neurogenic decompensated bladders were studied, etiology was sought and treatment with intermittent self-catheterization was done. Of the patients 34 per cent were able to resume voiding. Bacteriuria and pyuria were decreased from 90 to 18 per cent. Complications were few and over-all acceptance was excellent. A definition of non-neurogenic decompensated bladder was established.

Adolescent↗
PubMed1979

Coccidioidomycosis of the prostate gland and its therapy.

A case of disseminated coccidioidomycosis was diagnosed from a prostatic biopsy. Patients with sterile pyuria, prostatic nodules or symptoms of prostatitis who have lived in or traveled through an endemic area need careful evaluation of the lower genitourinary tract. Immunological treatment with a transfer factor currently is under investigation. Miconazole may offer a promise for future treatment of this fungal infection and, particularly, for patients with impaired renal function.

Amphotericin B↗