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At least 127 records · Page 7Linked to original sources
PubMed1979

Malignant fibrous histiocytoma of the retroperitoneum and genitourinary tract: a clinicopathological correlation and review of the literature.

Malignant fibrous histiocytoma is an uncommon pleomorphic tumor of the soft tissues possibly arising from the histiocyte. A case of malignant fibrous histiocytoma in the retroperitoneal space is reported. Pathologic and clinical features of this lesion as they relate to the retroperitoneum and genitourinary tract are discussed and suggestions for therapy are presented.

Aged↗
PubMed1983

The role of radiation therapy in the palliation of metastatic genitourinary tract carcinomas. A study of the Radiation Therapy Oncology Group.

The Radiation Therapy Oncology Group has conducted several randomized clinical trials to evaluate the efficacy of various radiation therapy schedules in palliating symptomatic brain and bone metastases. Among the patients entered in these studies, there were 225 patients with primary tumors of the genitourinary tract. Of these, 68 patients had cerebral metastases and 157 patients had osseous metastases. These patients were analyzed further as to the effectiveness of radiotherapy in palliation of their symptoms, and the results were compared to those for comparable metastases in patients with other primary sites. Relief of symptoms occurred in 54% of neurologic function (NF) Class III and 28% of NF Class II patients with cerebral metastases. This result compared favorably with those for the total group of patients consisting of patients with brain and bone metastases from various primary sites. Improvement was seen in 80% of patients with headaches and 88% of patients with convulsions. Motor loss improved in 62% of the patients. Of the patients with bone metastases, 81% with prostatic carcinoma and 59% with renal primaries had lessening of pain. Complete relief of pain at eight weeks occurred in 36% of the patients, compared to 24% in the total group. The median survival for patients with solitary bone metastases from a prostatic primary was 39 weeks, compared to 30 weeks for those with multiple metastatic sites.

Bone Neoplasms↗
PubMed1995

Nitric oxide control of lower genitourinary tract functions: a review.

It is apparent that evolving concepts of the regulatory basis for functions in the pelvis must take into account the role exerted by nitric oxide. A recently characterized messenger molecule, nitric oxide has been associated with numerous physiologic processes. Intense investigations of this molecule have extended its importance to several genitourinary functions. Penile erection, micturition, peristalsis of the male excurrent duct system, contractile properties of the prostate, and lumbosacral spinal cord neurotransmission are all functions that may transpire under some degree of control by nitric oxide. Impotence, urinary obstruction, or ejaculatory problems, in turn, may represent alterations of nitric oxide production or action. The strategic manipulation of nitric oxide or its mechanism of action, possibly by pharmacologic means, may restore or produce desired functional effects. These possibilities, therefore, suggest that the advancing knowledge of nitric oxide in the genitourinary tract may be of enormous clinical value in the future.

Humans↗
PubMed1987

Treatment of "difficult genitourinary tract infections".

Treatment of patients with "urinary tract infections" or related conditions is one of the most common reasons for urologic consultation. Some patients have well-defined syndromes, such as bacterial prostatitis or recurrent cystitis, with familiar algorithms for evaluation and treatment. Unfortunately, many patients have "difficult genitourinary tract infections" that challenge the diagnostic acumen of the urologist and, all too often, lead to frustration of the patient. Although making an etiologic diagnosis may be impossible in every case, an organized approach to evaluation and treatment may avoid unnecessary or inappropriate therapy and patient dissatisfaction.

Anti-Bacterial Agents↗
PubMed1990

Microbiological characteristics of Weeksella virosa (formerly CDC group IIf) isolated from the human genitourinary tract.

Weeksella virosa (formerly CDC group IIf) is a nonsaccharolytic, oxidase- and catalase-positive, gram-negative rod which is unable to grow on MacConkey agar. At 48 h of incubation on blood or chocolate agar, the colonies present a characteristic appearance: intensely mucoid, adherent, and cream colored as a result of the production of a nondiffusible yellow pigment. This microorganism has been isolated predominantly from the female genitourinary tract, which indicates the opportunity for sexual transmission. We present the microbiological study of three strains of W. virosa identified in a study of 707 female genital samples, representing an incidence of 0.42%. At the same time, we analyzed the principal biochemical tests used in the identification of this microorganism and the susceptibilities of the organism to the different antimicrobial agents assayed.

Female↗
PubMed1978

Bacteremic Haemophilus influenzae genitourinary tract infections in adults.

Six cases of bacteremia associated with genitourinary (GU) tract infections in adults due to Haemophilus influenzae occurred during a 42-month period at the Health Sciences Centre in Winnipeg, Canada. Four cases were associated with pregnancy or abortion, one with acute salpingitis, and one with urinary tract manipulation. Four of the five strains available for serotyping were nontypable. Clinical conjunctivitis was present in one patient, and infants born to two other patients developed purulent conjunctivitis from which H influenzae was grown. These six cases, and others from the literature, include a wide spectrum of GU tract infections due to this organism. With the rising incidence of severe infections in adults due to this organism, and the widespread emergence of ampicillin-resistant strains, H influenzae must be considered a GU tract pathogen.

Adolescent↗
PubMed1988

Release of calcitonin gene-related peptide-like immunoreactivity (CGRP-LI) from organs of the genitourinary tract in rats.

Calcitonin gene-related peptide-like immunoreactivity (CGRP-LI) was detected in the rat urinary bladder, ureter and vas deferens and was depleted by systemic capsaicin desensitization. Exposure to capsaicin in vitro produced a prompt increase in CGRP-LI outflow in superfusates of these tissues, while a second application of the drug was ineffective indicating desensitization. These findings provide further evidence for a transmitter role of CGRP from peripheral endings of sensory nerves and the involvement of CGRP-LI in the specific motor response to capsaicin in the rat genitourinary tract.

Animals↗
PubMed2005

Tachykinins and tachykinin receptors: effects in the genitourinary tract.

Tachykinins (TKs) are a family of peptides involved in the central and peripheral regulation of urogenital functions through the stimulation of TK NK1, NK2 and NK3 receptors. At the urinary system level, TKs locally stimulate smooth muscle tone, ureteric peristalsis and bladder contractions, initiate neurogenic inflammation and trigger local and spinal reflexes aimed to maintain organ functions in emergency conditions. At the genital level, TKs are involved in smooth muscle contraction, in inflammation and in the modulation of steroid secretion by the testes and ovaries. TKs produce vasodilatation of maternal and fetal placental vascular beds and appear to be involved in reproductive function, stress-induced abortion, and pre-eclampsia. The current data suggest that the genitourinary tract is a primary site of action of the tachykininergic system.

Adult↗
PubMed2001

Injury to the genitourinary tract and functional reconstruction of the urethra.

In the field of trauma and reconstruction, some aspects have changed significantly, whereas others continue to refine concepts that have developed over recent years. In urethral reconstruction, procedures are becoming more complex. The morbidity of the lithotomy position has been recognized for years. Recent literature has clarified the argument over the 'best stirrup', and time in lithotomy has been identified as a significant contributor to morbidity. Implantation of the AMS-800 sphincter has been examined in irradiated patients. The complication and revision rate is higher but not so high as to preclude consideration of its use. A number of articles have examined the use of cystoscopy in all cases of complicated pelvic surgery and in specific urethral suspension procedures. This has been recognized by urologists for years; it is a new concept in the gynecology literature. Cystoscopy continues to be routinely used, as many 'routine cases' when examined with cystoscopy are found to be associated with complications to the genitourinary tract. The non-operative management of renal trauma is expanded to select blunt grade 5 renal injuries. A series examined the use of computed tomography scan for bladder injuries and found it to be both sensitive and specific.

Humans↗
PubMed2005

Effect of insulin treatment on tissue size of the genitourinary tract in BB rats with spontaneously developed and streptozotocin-induced diabetes.

To examine the differences between spontaneous and streptozotocin (STZ)-induced diabetes, four parallel studies were performed; three studies of diabetes-prone BB (BBDP/Wor) rats maintained for 8, 16, and 32 weeks and one study of STZ-injected diabetes-resistant BB (BBDR/Wor) rats maintained for 32 weeks. Each diabetic study has three groups of rats: a control group; a euglycemic group, which received sufficient amounts of insulin; and a hyperglycemic group, which received a suboptimal dose of insulin. The extent of tissue weight changes was generally shown to be less dramatic in the euglycemic diabetic than in the hyperglycemic diabetic rats. STZ-induced diabetes increased the bladder weight more dramatically (up to 3-fold) than did spontaneous diabetes (up to 2-fold). Furthermore, a significant decrease in the size of the adrenal gland (20%) and testis (10%) is observed only with spontaneous diabetes, whereas a significant decrease in the size of the ventral prostate (30%) is observed only with STZ-induced diabetes, although the serum testosterone levels are similar in both groups. Our data demonstrate that there are differences in the effect of insulin treatment on the tissue size of the genitourinary tract between spontaneously developed and streptozotocin-induced diabetes in BB rats.

Animals↗
PubMed1992

Gas-forming infections in genitourinary tract.

Diabetes mellitus associated with urinary tract infections and ureteral obstruction can be predisposing factors leading to emphysematous pyelonephritis. Fever, flank pains, and a palpable renal mass, associated with dehydration and hyperglycemia, were the most frequent presenting symptoms associated with emphysematous pyelonephritis. Computerized tomography (CT) scan is the best method to identify a renal or perirenal abscess and its ramifications. Intravenous antibiotic therapy is determined by blood and urine cultures. Mortality was zero in patients treated by nephrectomy. One patient who had incision and drainage of a renal abscess died of sepsis, and 1 patient died of sepsis following incision and drainage of a prostatic abscess. Patients with cystitis emphysematosa require antibiotic therapy and relief of bladder outlet obstruction. Prostatic abscess is best treated by perineal incision and drainage. Periurethral scrotal abscesses should be incised, drained, and the overlying necrotic skin debrided. Early diagnosis and aggressive medical and surgical management of gas-forming infections of the genitourinary tract are vital.

Abscess↗
PubMed1996

Enoxacin: a reappraisal of its clinical efficacy in the treatment of genitourinary tract infections.

Enoxacin is a 6-fluoronaphthyridinone antibacterial agent with good in vitro activity against Neisseria gonorrhoeae and most Gram-negative urinary tract pathogens. It is less active in vitro against Acinetobacter spp., Pseudomonas aeruginosa, and most Gram-positive bacteria, than against Gram-negative organisms. Enoxacin is rapidly absorbed, with a high oral bioavailability (87 to 91%). Of the absorbed dose, 44 to 56% is excreted unchanged in the urine, with peak urinary concentrations (>500 mg/L within 4 hours) remaining high (>100 mg/L) for up to 24 hours, sufficient to inhibit most urinary tract pathogens. Single (400 mg) and multiple oral dose regimens (100 to 600 mg twice or 3 times daily for 5 to 14 days) of enoxacin are as effective for the treatment of patients with complicated or uncomplicated urinary tract infections as other antibacterial agents such as amoxicillin, cefuroxime axetil, cotrimoxazole (trimethoprim-sulfamethoxazole) or trimethoprim. Noncomparative data suggest that enoxacin is also an effective agent for the treatment of prostatitis. Single 400 mgoral doses of enoxacin produce >/- 95% bacteriological cure rates in gonococcal infections, comparable to those produced by single intramuscular doses of ceftriaxone 250 mg. Perioperative doses of oral enoxacin 200 mg provide effective prophylaxis against postoperative bacteriuria after transurethral resection of the prostate. Concomitant administration of enoxacin with a number of commonly used therapeutic agents (e.g. antacids, methylxanthines, warfarin) affects the pharmacokinetic properties of either enoxacin or the coadministered agents. Enoxacin is reasonably well tolerated, with the incidence of adverse experiences ranging from 0 to 24%. Adverse events are mainly gastrointestinal, neurological or dermatological and resolve with minimal intervention. Overall, although enoxacin exhibits a number of clinical characteristics that are similar to those of other agents for the treatment of genitourinary tract infections, the advantages offered by this agent generally do not outweigh those of alternative fluoroquinolone agents. Thus, it is likely to prove to be yet another addition to the list of agents available for the management of these infections.

Anti-Infective Agents↗
PubMed1992

Rare and unusual tumors of the genitourinary tract.

The entity of small cell undifferentiated carcinoma of the urinary tract is clearly recognized, though treatment still poses considerable difficulties. Small cell undifferentiated carcinoma may lead to systemic symptoms by hormone production, even in patients with localized tumors. The survival rates of adults with Wilms' tumor approach only 50% of those seen in children. Cisplatin may be effective in relapsing patients. Cancer of the female urethra should be treated by combined surgery and radiotherapy. One should differentiate between urachal and nonurachal adenocarcinoma. DNA ploidy seems to be an important prognostic parameter in adenocarcinoma of the bladder. After orchiectomy, adjuvant chemotherapy is recommended even in testis-confined malignant lymphoma. Organ-preserving surgery and radiotherapy should be used in malignant lymphoma of the bladder. Patients with uncommon urologic tumors should be treated at larger cancer centers. Alternatively, the clinician should at least enter relevant information on patients seen with these malignancies into collective databases. This review summarizes the clinical aspects of rare and unusual tumors of the genitourinary tract in adults.

Adenocarcinoma↗
PubMed2004

New murine model for the study of Chlamydia trachomatis genitourinary tract infections in males.

The lack of an experimental model has significantly limited the understanding of the pathogenesis of Chlamydia trachomatis infections in males. In an attempt to establish a model using the natural route of infection, we inoculated male mice in the meatus urethra. To establish the 50% infectious dose (ID(50)), C3H/HeN (H-2(k)) male mice were inoculated in the meatus urethra with doses ranging from 10(1) to 10(7) inclusion-forming units (IFU) of C. trachomatis mouse pneumonitis biovar (MoPn) and were euthanized at 10 days postinfection (p.i.). Approximately 50% of the animals inoculated with 5 x 10(4) IFU had positive cultures of the urethra, urinary bladder, epididymides, and/or testes. Subsequently, to characterize the course of the infection, a group of animals was inoculated with 10(6) IFU/mouse (20 times the ID(50)). Positive cultures from the urethra, urinary bladder, epididymides, and testes were obtained from the animals. The infection peaked in the first 2 weeks p.i. and subsequently declined over the 7 weeks of observation. C. trachomatis-specific antibodies were first detected in serum by 2 weeks p.i. and rose over the period of observation. The titers of immunoglobulin G2a (IgG2a) were 16-fold higher than those of IgG1. A lymphoproliferative assay using splenocytes and local lymph nodes showed a strong cell-mediated immune response. Levels of gamma interferon were significantly higher than those of interleukin-4 in the supernatants from stimulated lymphocytes. An acute inflammatory infiltrate consisting of polymorphonuclear leukocytes was detected in the urethra at 1 week p.i. At 3 weeks p.i., a mixed acute and chronic inflammatory infiltrate was observed in the urethra that by 5 to 6 weeks was mainly composed of mononuclear cells. Similar findings were also observed in the urinary bladder, although the inflammatory infiltrate was delayed by approximately a week relative to that in the urethra. Sections of the epididymides showed a focal acute inflammatory infiltrate at 2 weeks p.i. Immunohistochemical staining demonstrated multiple chlamydial inclusions in the epithelium of the urethra and urinary bladder. No chlamydial inclusions were observed in the epididymides or testes. In conclusion, inoculation of male mice in the meatus urethra with C. trachomatis MoPn results in an infection of the genitourinary tract that closely parallels that described in humans. This model should help to characterize the pathogenesis of chlamydial infections in males and to test therapeutic and preventive measures.

Animals↗
PubMed1995

Predisposing factors of systemic fungal infections of the genitourinary tract.

We reviewed 50 patients with genitourinary fungal infections between 1982 and 1992. Infections were classified as simple--localized to the bladder and complex--demonstrated evidence of upper tract and/or systemic infection. Predisposing factors of fungal infections, including diabetes mellitus, prolonged Foley catheter drainage and corticosteroid use, were not significantly different. The incidence of obstructive uropathy (88% versus 20%), malnutrition (88% versus 48%), neoplasia (56% versus 16%), renal failure (24% versus 8%) and prolonged antibiotic use (60% versus 32%) were significantly greater in patients with complex infections. The incidence of fungemia in patients with complex infections was 81% with an associated mortality rate of 36%. Of the patients with complex infections 56% required urological intervention. Given the high incidence of obstructive uropathy with complex fungal infections, upper tract imaging is essential.

Adolescent↗