Search PubMed⌕ Search

SEARCH · Search PubMed

Results for “URETHRITIS”

Search indexed PubMed citations on genomics, clinical trials, systematic reviews and public health. Explore titles, authors and supplied subject terms, then open the PubMed record.

Quote a phrase for an exact phrase match. Source license links do not imply unrestricted reuse.

At least 73 records · Page 4Linked to original sources
PubMedDate not supplied

Chlamydia trachomatis-induced urethritis in female partners of men with nongonococcal urethritis.

The rate of isolation of Chlamydia trachomatis from cervical and urethral specimens from 99 culture-positive female partners of men with nongonococcal urethritis who were attending a gynecological outpatient clinic was correlated with the clinical status of the women. The agent was recovered from both sites in 46 women, from the cervix only in 28, and from the urethra only in 25 women. Urethral symptoms were reported by 38 (54%) of those with positive urethral cultures, as compared with six (21%) of those with positive cervical cultures only (P less than 0.01). Significant bacteriuria was found in only three patients with urethral symptoms; two of them had negative urethral cultures for C. trachomatis. Frequencies of cervicitis, rises in titer of antibody, and geometric mean titers of immunofluorescent antibody to C. trachomatis did not differ significantly among the three groups.

Adolescent↗
PubMedDate not supplied

Serotypes of Ureaplasma urealyticum isolated from patients with nongonococcal urethritis and gonorrhea and from asymptomatic urethral carriers.

Ureaplasma urealyticum strains isolated from urethral specimens of 112 patients with nongonococcal urethritis, 17 with gonorrhea, and 33 asymptomatic carriers (controls) were tested by the growth-inhibition test with standard ureaplasma antisera (serotypes 1-8). Cases with more than one serotype (two to four types) were encountered in 36.6% of patients with nongonococcal urethritis, 29.4% of those with gonorrhea, and 21.2% of controls. The most frequently recovered serotypes were type 4 from patients with nongonococcal urethritis (57.1%) and type 2 from patients with gonorrhea and controls (35.2% and 36.3%, respectively). The difference in frequency of serotype 4 between patients with nongonococcal urethritis and controls was statistically significant (P less than .001). An additional serotyping with types 9 and 10 antisera of the nontypable strains from patients with nongonococcal urethritis and controls (17.8% and 21.2%, respectively) revealed three type-9 strains. The results show a need for utilization of serotyping of U. urealyticum in studies of the epidemiology and transmissibility of genital infections with U. urealyticum.

Adult↗
PubMed2004

1-stage urethral reconstruction using colonic mucosa graft for the treatment of a long complex urethral stricture.

PURPOSE: We investigated the possibility of urethroplasty with a free graft of colonic mucosa for long, complex urethral strictures. We report our initial experience with colonic mucosa graft urethroplasty for such urethral strictures in 16 patients. MATERIALS AND METHODS: Between September 2000 and December 2002, 16 patients with a long, complex urethral stricture were treated with colonic mucosal graft urethroplasty. Patients had undergone an average of 2.5 previous unsuccessful repairs. Urethral reconstruction was done with a 10 to 17 cm (median 13) graft of colonic mucosa RESULTS: Patients were followed 6 to 33 months postoperatively. Meatal stenosis that developed in 1 patient 3 months postoperatively needed reoperation. The patient was voiding well with a urinary peak flow of 28.7 ml per second during 9-month followup after reoperation. Hyperplasia of the verumontanum was observed during urethroscopy and transurethral colliculectomy was performed in 1 patient more than 14 months postoperatively. Uroflowmetry showed a urinary peak flow of 46.5 ml per second postoperatively. The other patients were voiding well with a urinary peak flow of greater than 15 ml per second. Urethrogram revealed a patent urethra with an adequate lumen and no significant graft sacculation. CONCLUSIONS: This initial experience in 16 patients indicates that colonic mucosa graft urethroplasty is a feasible procedure for long, complex anterior urethral strictures. The technique may be considered for urethral reconstruction when more conventional procedures have failed.

Adolescent↗
PubMed2004

Urethral condyloma acuminata following urethral instrumentation in an elderly man.

A 70-year-old man had undergone urethral dilatation with bougie for 8 months following transurethral resection of the prostate and complained papillary masses at the urethral meatus. Physical and endoscopic examination revealed multiple tumors from the urethral meatus to the bulbous urethra. These tumors were resected transurethrally and 5-FU cream was instilled into urethra. Microscopic examination revealed urethral condyloma acuminata. Human papillomavirus types 6/11 were detected in the condylomas. As high prevalence rate of genital human papillomavirus was reported in penile skin of healthy men, urethral instrumentation including transurethral surgery might cause dissemination of penile skin human papillomavirus into the urethral lumen.

Aged↗
PubMed1980

Urethral supersensitivity and occult urethral neuropathy.

The phenomenon of postural increases in urethral tone in patients with neuropathic bladder dysfunction has been investigated and, using the technique of simulated alterations in posture, a humoral response of urethral smooth muscle has been demonstrated. Serial measurements of circulating catecholamines have shown that a close correlation exists between the contraction of urethral smooth muscle and the variations in circulating catecholamines brought about as part of cardiovascular homeostasis. Identical urethral responses have been recorded in a group of neurologically intact patients who have urethral outflow obstruction, and it is speculated that these patients may have an occult urethral neuropathy.

Blood Pressure↗
PubMed1998

Urethral recurrence of transitional cell carcinoma of the bladder. Predictive value of preoperative latero-montanal biopsies and urethral frozen sections during prostatocystectomy.

OBJECTIVE: The management of the male urethra after cystectomy for bladder cancer continues to be a dilemma. Patients who undergo a cystectomy require either urinary diversion or bladder substitution. Therefore, the use of the urethra to ensure voiding is important. On the other hand, the probable risk of urethral carcinoma recurrence is generally estimated at approximately 10%. The aim of this study was to assess the predictive value of preoperative urethral biopsies, and of frozen sections during cystoprostatectomy, in patients with invasive bladder cancer. METHODS: From 1982 to 1986, 118 male patients underwent a cystoprostatectomy for transitional cell carcinoma of the bladder. All patients underwent endoscopic latero-montanal biopsies 2 weeks preoperatively and urethral frozen cut section during radical prostatocystectomy. RESULTS: Carcinoma was observed in 12 patients on both examinations. All patients underwent en bloc urethrectomy during cystectomy. In the remaining 106 patients, the frozen cut margin was negative (including 9 with positive latero-montanal biopsies), and these patients had the urethra preserved. After a 10-year minimum follow-up, no recurrence was observed in these patients with negative frozen cut-section. No significant risk factors for urethral recurrence were found. Latero-montanal biopsies did not reveal a positive specificity, and this procedure was later abandoned in our institution (in 1986). CONCLUSIONS: The urethral frozen section was the only guideline used for simultaneously performing the urethrectomy. All male patients with negative frozen cut sections should be considered candidates for bladder substitution. A prophylactic urethrectomy is only indicated in patients with carcinoma (minimum carcinoma in situ) in the frozen urethral margin section during cystectomy.

Adult↗
PubMedDate not supplied

Functional urethral obstruction in 3 dogs: clinical and urethral pressure profile findings.

Three dogs with dysuria and urine retention caused by excessive functional urethral resistance are described. All dogs had clinical histories and urologic signs that previously would have been classified as detrusor-urethral dyssynergia. Diagnosis of functional urinary obstruction was established by exclusion of anatomic urinary obstruction and confirmed by urethral pressure profilometry. In 2 cases, multiple pressure deflections recorded in the urethral pressure profile suggested spasm of urethral musculature, whereas in a 3rd dog, abnormally high pressures were recorded along a portion of the proximal urethra. Functional urinary obstruction was associated with prostatitis in 1 dog and with a history of urethral calculi in 1 dog, and no underlying disorder could be identified in the remaining dog. All 3 dogs improved with medical treatments that included alpha adrenergic antagonists. The etiology, diagnosis, and pharmacologic management of functional urinary obstruction are discussed.

Animals↗
PubMedDate not supplied

Diagnosis of urethritis: role of polymorphonuclear leukocyte counts in gram-stained urethral smears.

Polymorphonuclear leukocytes (PMNs) in the gram-stained urethral smears of 236 consecutive sexually active men without gonorrhea were analyzed quantitatively. The frequency distribution of the highest count of PMNs per high-power field (hpf) showed a count of four PMNs to be the "cut-off" point separating men with urethritis from those without urethritis. This cut-off point correlated well with the presence of Chlamydia trachomatis as well as with turbid urine. However, the PMN count in the gram-stained urethral smear was found to be more sensitive than the appearance of the urine in the diagnosis of urethritis among those with minimal symptoms and signs and not harboring C. trachomatis. This study also demonstrated a close similarity as regards clinical features and PMN count in gram-stained urethral smears between those harboring Ureaplasma urealyticum and those with no organisms.

Adult↗
PubMed1995

Urethral pressure response to smooth and skeletal muscle relaxants in anesthetized, adult male cats with naturally acquired urethral obstruction.

The effects of the skeletal muscle-relaxing drug dantrolene sodium alone, and in combination with the alpha 1-adrenergic antagonist prazosin, on the urethral pressure profile were investigated in male cats with obstructive lower urinary tract disease. Decreases in mean segmental intraurethral pressure induced by dantrolene (n = 3) or dantrolene in combination with prazosin (n = 3) were evaluated statistically, using a paired design. Statistical analysis was applied to absolute (mm of Hg) pressure values. Intravenous administration of dantrolene alone (1 mg/kg of body weight, n = 3) significantly decreased pressure in the postprostatic/penile urethral segment, but did not decrease prostatic urethral pressures. Dantrolene in combination with prazosin (0.03 mg/kg IV) caused a 20% pressure decrease in the prostatic segment (P = 0.060). Preprostatic urethral pressure was not significantly affected by either treatment regimen in the small pool of cats studied. There was no difference in baseline pressures (mm of Hg) in the 3 intraurethral segments of these 6 recently obstructed male cats, compared with historic baseline pressures (mm of Hg) in the 3 intraurethral segments of 28 healthy male cats. These results indicate that dantrolene and prazosin may be effective in relaxing intraurethral skeletal and smooth musculature in male cats clinically afflicted with obstructive lower urinary tract disease. However, it is not certain that administration of muscle relaxants would facilitate urethral catheterization and removal of the obstruction in male cats with blockage of the lower urinary tract. Strikingly, results of this study suggest that urethral muscle spasm had a minor role in these cats.

Animals↗
PubMed1997

Endoscopic repair in 154 cases of urethral occlusion: the promise of guided optical urethral reconstruction.

PURPOSE: We determined whether optical urethral reconstruction, with the use of a Béniqué bougie in the proximal urethra and transrectal digital guidance, is effective for the treatment of long and severe urethral occlusions. However, with some skill the procedure can be done without the bougie for the treatment of short occlusions. MATERIALS AND METHODS: During a 9-year period 154 men with complete urethral occlusion underwent core through optical urethrotomy via transrectal digital guidance, using the Béniqué bougie in 89 (58%). A total of 400 urethrotomies was performed. All lesions were in the posterior urethra except 8 in the pendulous portion. There were 64 war related injuries (41.6%). Combined voiding and retrograde urethrography was not useful to measure the length of the occlusion due to failure of proximal urethral filling. Guided optical urethral reconstruction consisted of optical urethrotomy performed with a Béniqué bougie introduced proximally through the suprapubic catheter site and into the proximal urethra with the index finger of the operator in the rectum. The same procedure was performed blindly without use of the bougie in 65 patients (42%), and in 43 with lesions shorter than 1 cm. and 4 with multiple annular lesions. We also used the blind technique successfully to reestablish 18 occlusions longer than 1 cm. For optimal epithelialization of the urethral tract we suggest leaving a silicone catheter indwelling for 3 months. No prophylactic antibiotics were given. RESULTS: Of the patients 54 (35%) were cured after 1 procedure, whereas the remaining 100 (65%) required 1 to 9 additional urethrotomies (mean 3). Patients with an uninstrumented urethra who were treated initially with suprapubic catheterization required 1 to 6 urethrotomies (mean 2), compared to 1 to 10 (mean 3) for those who had undergone a prior procedure. Hematuria occurred in 9% of the patients, symptomatic urinary tract infection in 7% and slight extravasation in 3.2%. One patient had stress incontinence. CONCLUSIONS: Our procedure is effective, simple, safe, repeatable, inexpensive and minimally invasive, and it does not require special or sophisticated guiding instruments, which are necessary for previously described techniques. It can be performed with or without use of a Béniqué bougie depending on the extent of the lesion and skill of the surgeon. The outcome can be judged from the symptomatic response of the patient, and flow studies and urethrography are not mandatory during routine followup.

Adolescent↗
PubMed1993

Time-series analysis of urethral electrical conductance measurements in the assessment of unstable urethral pressure: results in normal patients and in those with genuine stress incontinence.

It is well established that urethral pressure variations occur in patients with or without urinary incontinence, but to what extent they contribute to a patient's symptoms remains unclear. Previous work has suggested that in stress incontinent patients, a rise in bladder neck electrical conductance (BNEC) occurs simultaneously with a fall in urethral pressure, and that this represents bladder neck opening. Six patients with genuine stress incontinence (gsi), and six normal controls underwent simultaneous urethral pressure and BNEC measurements, the results being subjected to time-series analysis, to determine whether the previous finding could be confirmed statistically, and to establish whether a similar association was present in normal women. All six patients with gsi and five of the normal patients had unstable urethral pressure. Estimated cross-correlation of differenced data for the two parameters showed a significant negative correlation at zero time lag in three patients with gsi and two of the control group. There was no significant correlation between the two parameters in the other seven patients. We conclude that the previous finding of a correlation between urethral pressure variation and BNEC, suggesting bladder neck opening occurs as urethral pressure falls in patients with gsi is confirmed, but appeared to be present in only 50% of patients; the finding is just as likely in normal patients, and therefore whilst it may be of relevance to the severity of symptoms, could not be held to have any aetiological significance.

Adult↗
PubMed1994

Simultaneous measurement of urethral opening pressure and urethral cross-sectional area during voiding cystometry.

OBJECTIVE: To assess a new technique for measuring urethral opening pressure and urethral cross-sectional area during the course of routine voiding cystometry. PATIENTS AND METHODS: Twenty-eight male patients were studied, 24 of whom had cystometric evidence of bladder outlet obstruction, the other four being unobstructed. Urethral opening pressure was measured using an adapted fluid bridge test and urethral cross-sectional area was measured using the method described in the preceding paper. RESULTS: The mean urethral opening pressure in the obstructed patients was 68 cm/H2O (range 38-124) against a mean of 19 cm/H2O (range 16-22) in the unobstructed group. The mean urethral cross-sectional area in the obstructed group was 2.6 mm2 (range 0.9-7.9) compared with a mean of 14.2 mm2 (range 10.8-19.9) in the unobstructed patients. CONCLUSION: This technique allows measurement of the parameters of bladder outlet obstruction described by Schäfer during routine voiding cystometry, without specialized equipment. This provides a simple method for quantification of urinary outflow obstruction and should prove useful in the assessment of new treatment modalities.

Adult↗
PubMed2000

The relationships of urethral and pelvic floor muscles and the urethral pressure measurements in women with stress urinary incontinence.

OBJECTIVES: To investigate the relationships between urethral and paraurethral anatomy and urethral pressure measurements in women with stress urinary incontinence (SUI). MATERIALS AND METHODS: A total of 83 women with SUI and 33 with frequency urgency syndrome but not SUI were included in the study. The parameters of transrectal sonography of the urethra and urethral pressure profilometry were compared among the subjects with each of four types of SUI and non-SUI subjects. RESULTS: Videourodynamic study revealed that 26 women had type 0 SUI, 39 had type 1 SUI, 19 had type 2 SUI and 9 had type 3 SUI. The urethral striated muscular area was significantly smaller in subjects with type 3 SUI than in subjects with type 0 SUI and in non-SUI subjects. The thickness of the urethropelvic ligaments was thinner in subjects with SUI than in non-SUI subjects. Maximal urethral closure pressure (MUCP) was also significantly smaller in subjects with SUI than in non-SUI subjects. Pressure transmission ratio (PTR) was lower in subjects with type 1, 2 and 3 SUI than in subjects with type 0 SUI and no SUI. Pelvic floor contractility was significantly lower for subjects with type 3 SUI than for the other groups of subjects. Leak point pressure (LPP) showed a significantly progressive decrease from type 1 to 3 SUI subjects. CONCLUSIONS: This study found that SUI in women is a condition in which the urethral and paraurethral structures become progressively deficient. The intrinsic and extrinsic structural deficiencies result in a lower MUCP, smaller PTR, insufficient pelvic floor contractility on the urethra, and a lower LPP in SUI patients.

Adult↗
PubMed2001

The nature of urethral injury in cases of pelvic fracture urethral trauma.

PURPOSE: We examine the urethral injury associated with pelvic fracture that is said to be due to a shearing force through the membranous urethra which inevitably destroys the urethral sphincter mechanism. MATERIALS AND METHODS: A total of 20 asymptomatic cases were prospectively studied, including symptomatically, radiologically, endoscopically and urodynamically, 1 to 4 years after an apparently successful anastomotic repair of a pelvic fracture urethral distraction defect. RESULTS: There was evidence of urethral sphincter function, including urodynamically in 11 (55%), endoscopically in 13 (65%) and functionally in 17 (85%) patients. CONCLUSIONS: These findings, coupled with surgical observation, suggest that the urethral injury associated with pelvic fracture is avulsion of the membranous urethra from the bulbar urethra rather than a shearing through the membranous urethra, and that some degree of urethral sphincter function is preserved in a significant percentage of patients.

Accidents, Traffic↗
PubMed2001

Inefficient urethral milking secondary to urethral dysfunction as an additional risk factor for incontinence after radical prostatectomy.

PURPOSE: Continence after radical prostatectomy is thought to depend completely on the striated urethral sphincter. However, some patients complain only of occasional post-void dribbling. Therefore, we determined whether urethral dysfunction may be another cause of incontinence. MATERIALS AND METHODS: The sensory threshold of electric stimulation was measured by double ring electrodes in the membranous urethra and 2.5 cm. distal in 29 men before and in 29 after radical retropubic prostatectomy. In addition, voiding cystourethrography was performed in 66 patients before and in 49 after surgery to determine complete post-void urethral emptying or milking. RESULTS: The mean sensory threshold of the membranous urethra was 15 +/- 3 mA. preoperatively versus 38 +/- 17 postoperatively (p <0.0001). The sensory threshold 2.5 cm. further distal was 12 +/- 5 mA. before and 10 +/- 4 after radical prostatectomy, which was not statistically significant. Postoperatively in completely continent patients and in those with dribbling the mean threshold was 32 +/- 12 and 43 +/- 18 mA. in the membranous urethra (p = 0.09), and 11 +/- 4 and 9 +/- 4 mA. in the bulbar urethra, respectively, which was not statistically significant. Of the 66 patients 36 (55%) showed post-void urethral milking before surgery but only 8 of 49 (16%) showed it postoperatively (chi-square test p <0.0001), including 7 who were completely continent and 1 who complained of occasional post-void dribbling. CONCLUSIONS: After radical prostatectomy sensitivity of the membranous but not of the bulbar urethra is affected, correlating with postoperative continence. In addition, post-void dribbling seems to be associated with the loss of urethral milking. We conclude that preserving urethral function is another important continence factor after radical prostatectomy.

Aged↗
PubMed1993

Comparison of stressed simultaneous urethral pressure profiles between anesthetized continent and incontinent bitches with urethral sphincter mechanism incompetence.

The popular urodynamic technique of stressed urethral pressure profilometry used for investigation of genuine stress incontinence in women was adapted and applied to bitches. The aim was to assess the suitability and reproducibility of the technique in the canine species, and to determine whether differences seen in continent and incontinent women were found in bitches. Resting and stressed simultaneous urethral pressure profiles were obtained for 25 continent and 25 incontinent bitches, the latter diagnosed as having urethral sphincter mechanism incompetence. The stressed urethral pressure profiles were produced by ballottement of the abdomen during catheter withdrawal. The degree of stress induced was consistent and had got short-term reproducibility. Highly significant (P < 0.001) differences in the percentage of negative spikes extending below the resting intravesical pressure were found between continent and incontinent bitches. Significant differences were not observed in the pressure transmission profiles between continent and incontinent bitches; both groups had a gradual decrease in pressure transmission from the bladder neck to the external urethral orifice. The distance from the start of the urethral pressure profile to the first negative peak (attributable to respiration or ballottement) on the subtracted profile was compared with the radiographic distance that the bladder neck was positioned with respect to the cranial pubic brim, taking body weight and continence status into account. Body weight and continence status did not have significant effect on the relation in either instance.(ABSTRACT TRUNCATED AT 250 WORDS)

Analysis of Variance↗
PubMed1993

[The active forces of continence. Illustration by quantified analysis of the electromyographic signal of the urethral striated sphincter combined with urethral pressure studies].

Continence in women, ensured by a constantly positive urethral closing pressure, is the result of two phenomena: purely passive factors (urethral pressure and compliance, transmission of bladder pressure to the urethra) and active factors mediated by a voluntary and reflex neuromuscular mechanism (contraction, reflexivity, sphincter endurance). In order to define these active forces of continence, we simultaneously studied the quantitative electromyographic activity of the striated sphincter and the bulbocavernosus muscle and variations in the urethral and vesical pressure under various conditions (rest, coughing, stimulation of the pudendal nerve). During coughing, the urethral pressure peak occurred earlier (100 milliseconds) than the vesical peak, associated with hypertransmission of 20%, the bulbocavernosus muscle contracted first, followed by contraction of the striated urethral sphincter (150 ms delay) and this electrical activity preceded the rise in vesical and urethral pressures. Stimulation of the pudendal nerve eliminated the possibility of an artefact related to coughing and induced the same sequence of events.

Adult↗
PubMed1988

Effects of indwelling catheters on the urethral mucosa (polypoid urethritis).

Indwelling catheters are almost invariably associated with characteristic mucosal lesions of the urinary bladder, commonly referred to as polypoid cystitis. In the present study, 20 male patients with indwelling catheters (due to benign prostatic hyperplasia) for 1-12 months were studied. Three non-catheter bearing male patients served as controls. Biopsies were taken from the posterior urethra in all patients and from the bladder in 16 of the 20 patients with indwelling catheters. All patients with catheters had endoscopic lesions in the urethra. The lesions varied from polypoid to bullous or oedematous, with or without hemorrhagic discoloration. In 11 of 20 patients the urethral lesions were histologically almost identical to polypoid cystitis. In the remaining 9 patients the reaction was less pronounced, and oedema, with or without mucosal hemorrhage, dominated. Due to the similarity between the catheter associated bladder lesions and the urethral lesions we suggest the term polypoid urethritis for the urethral lesions. There was no correlation between type of catheter used or how long it was used and the mucosal lesions. The results suggest mechanical irritation and/or pressure exerted by the catheter on the mucosa is responsible for the development of polypoid urethritis.

Aged↗