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Huang WL, Chen CC, Hsieh MH, Wang TY. Gas in the kidney, ureter, and bladder in a newly diagnosed diabetes patient. Intern Med 2011; 50:939-40. [PMID: 21498948 DOI: 10.2169/internalmedicine.50.5143] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/06/2022] Open
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102
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Karpukhin IV, Kiiatkin VA, Bobkov AD. [Non-medication treatment of patients with chronic cystitis]. VOPROSY KURORTOLOGII, FIZIOTERAPII, I LECHEBNOI FIZICHESKOI KULTURY 2010:33-35. [PMID: 21381328] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/30/2023]
Abstract
Combined application of ultrasound, modulated sinusoidal currents (MSC), and iodine-bromine baths is known to be a highly efficacious method for the rehabilitative treatment of patients with chronic cystitis in the phase of latent inflammation. The present study has demonstrated that combination of ultrasound with electrotherapeutic sleep and iodine-bromine baths exerts pronounced anti-inflammatory effect and bacteriostatic action whereas modulated sinusoidal currents combined with electrotherapeutic sleep and iodine-bromine baths significantly improve urodynamics in the lower urinary tract and produce marked anesthetic effect. Evaluation of the immediate and long-term results of the treatment of 16 patients presenting with chronic cystitis revealed the absence of exacerbation of infectious and inflammatory processes in the bladder within 6 months after physiotherapy
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103
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Favre G, García-Marchiñena P, Bergero M, Dourado L, González MI, Tejerizo J, Damia O. [Diagnosis and treatment of the encrusted cystitis]. Actas Urol Esp 2010. [PMID: 20470722 DOI: 10.1016/s2173-5786(10)70106-2] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
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104
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105
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Kul'chavenia EV, Breusov AA. [Efficacy of combined treatment of women with chronic cystitis associated with intracellular infections]. UROLOGIIA (MOSCOW, RUSSIA : 1999) 2010:25-29. [PMID: 20973133] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/30/2023]
Abstract
Forty female patients with urethrocystitis received sparfloxacin in a daily dose 400 mg for 20 days in combination with canefron H (50 drops three times a day for 8 weeks). Twenty patients received one more course of canefron H 4 months after etiopathogenetic therapy. The analysis of the treatment results allows the conclusion that sparfloxacin is highly effective in urethrocystitis associated with intracellular infections. Sparfloxacin provides complete urine sterility. 97.5% females after the combined treatment had no recurrences for a year while before the treatment remission lasted for 4.1 +/- 1.7 months. A preventive administration of canefron H improves microcirculation in the bladder wall and prevents recurrence in patients with urethrocystitis associated with intracellular infections given basic sparfloxacin therapy.
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106
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Flores-Carreras O, Martínez-Espinoza CJ, González-Ruiz MI, Montes-Casillas YE. [Contribution of bladder biopsy to the study of urogynaecological patient]. GINECOLOGIA Y OBSTETRICIA DE MEXICO 2010; 78:187-190. [PMID: 20939223] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/30/2023]
Abstract
BACKGROUND One of the characteristics of urinary symptoms in women is their lack of specificity. Patients with stress incontinence or urgency, local irritation, infection, distal stenosis or a neoplastic process have very similar symptoms. OBJECTIVE Determine the frequency of bladder structural lesions detected by urethrocistoscopy in which we performed bladder biopsies. MATERIAL AND METHOD Descriptive, retrospective, analytical study of files and videos of 331 patients treated in Urodifem de Occidente (private Urogynecology Center). Thirty-five biopsies were taken. The statistical analysis was expressed as means standard deviations, ranges, percentages and Fishers test. RESULTS Patients ages range 30-90 years average 60+13.76. Predominant symptoms were: irritative vesical syndrome 62.8%; pelvic pain 45.71%; urge incontinence 31.4%; hematuria 31.4%; vesical voiding dysfunction 11.4%. Principal endoscopic findings: Urethrotrigonitis; glomerular lesions or Hunner ulcers; vesical trabeculations; tumor or suspect lesions. Histopathologic findings were: Interstitial Cystitis 42.9%; chronic Cystitis 11.4%; Cystitis glandularis 8.6%; Cystitis follicular 11.4%; bladder cancer 5.7%; Vesical Papilloma 5.7%. CONCLUSIONS This study supports the practice of vesical biopsy when lesions other than those from chronic infection are observes in the presence of tumors or suspect lesions.
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107
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Sepulveda W, Rompel SM, Cafici D, Carstens E, Dezerega V. Megacystis associated with an umbilical cord cyst: a sonographic feature of a patent urachus in the first trimester. JOURNAL OF ULTRASOUND IN MEDICINE : OFFICIAL JOURNAL OF THE AMERICAN INSTITUTE OF ULTRASOUND IN MEDICINE 2010; 29:295-300. [PMID: 20103802 DOI: 10.7863/jum.2010.29.2.295] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/28/2023]
Abstract
OBJECTIVE The purpose of this series was to report the first-trimester sonographic findings, antenatal course, and outcome in fetuses with a patent urachus. METHODS We conducted a review of ultrasound reports and medical charts from 3 pregnancies complicated by a congenital patent urachus detected in the first trimester. RESULTS All 3 fetuses had megacystis and an umbilical cord cyst close to the fetal abdominal insertion that was detected in the first trimester. In 2 cases, the megacystis resolved spontaneously while the umbilical cord cyst worsened in appearance; among them, massive edema of the umbilical cord was documented in 1, and evidence of partial bladder exstrophy was detected in the third trimester in the other. Both cases required neonatal surgery with no complications. In the remaining case, the fetus died in the early second trimester. Postmortem examination confirmed the diagnosis of a patent urachus, an allantoic cyst, and thrombosis of the umbilical vessels. CONCLUSIONS Megacystis is a warning sign of a patent urachus in the first trimester. The prognosis of this condition is generally good; however, fetal death can occur secondary to compression of umbilical vessels due to the expanding allantoic cyst.
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108
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Cirocchi R, La Mura F, Farinella E, Napolitano V, Milani D, Di Patrizi MS, Trastulli S, Covarelli P, Sciannameo F. Colovesical fistulae in the sigmoid diverticulitis. G Chir 2009; 30:490-492. [PMID: 20109378] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/28/2023]
Abstract
In most cases Colovesical fistulae are complications of diverticular disease and representing the most common kind of colodigestive fistula; less common are colovaginal, colocutaneous, coloenteric and colouterine fistula. In this article we review the literature concerning colovesical fistulae in colorectal surgery for sigmoid diverticulitis and report on two cases that required a surgical treatment, one elective and the other in emergency. In both cases we performed a sigmoid resection with a primary anastomosis and small vesical window-ectomy placing a Foley catheter for about 10 days.
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109
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Galutira PJT, Canonigo BB, Cabansag MRF, Bolong DT, Ong RC, Lopez RA. Presenting manifestations of eosinophilic cystitis in two Filipino children. Int Urol Nephrol 2009; 42:557-63. [PMID: 19866369 DOI: 10.1007/s11255-009-9665-3] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/24/2009] [Accepted: 10/02/2009] [Indexed: 11/27/2022]
Abstract
Eosinophilic cystitis is a very rare clinical disease entity in the pediatric population. We report two cases of Filipino children with eosinophilic cystitis who presented with irritative voiding symptoms, gross hematuria, peripheral eosinophilia, and hydroureteronephrosis and urinary bladder wall thickening visualized on ultrasonography and CT urography. Cystoscopy and transurethral biopsy confirmed the diagnosis. Both patients were started with corticosteroid with or without an antihistamine. Resolution from the signs and symptoms were observed in both patients as documented by disappearance of peripheral eosinophilia, normal urinalysis results, and resolution of the hydroureteronephrosis and urinary bladder wall thickening on ultrasonography on follow-up.
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110
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Reese AC, Stoller ML. Emphysematous cystitis. Urology 2009; 75:1315-6. [PMID: 19854475 DOI: 10.1016/j.urology.2009.08.031] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2009] [Revised: 07/16/2009] [Accepted: 08/10/2009] [Indexed: 11/18/2022]
Abstract
We present the case of a 57-year-old man with emphysematous cystitis. The patient presented with a complaint of several days of lower abdominal pain and gross hematuria. Work-up included an abdominal CT scan that revealed gas within the urinary bladder wall, and cystoscopy confirmed diffuse submucosal emphysema throughout the bladder. The patient was treated conservatively with broad spectrum antibiotics, with prompt resolution of both symptoms and radiographic findings. Emphysematous cystitis is a rare clinically entity, more commonly seen in diabetic, immunocompromised patients. A conservative treatment approach using antibiotics and bladder catheterization is typically successful, with a complication rate of only 18.8%.
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111
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Kurokawa T, Sakakibara T. [Case of emphysematous cystitis with retention due to a inflammatory mucous flag of the bladder]. HINYOKIKA KIYO. ACTA UROLOGICA JAPONICA 2009; 55:575-577. [PMID: 19827622] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/28/2023]
Abstract
A 62-year-old man with uncontrolled diabetes mellitus under treatment in the department of internal medicine of our hospital presented with urinary retention. He was referred to our department, because it was impossible to conduct irrigation and catheter drainage after urethral catheterization. Computed tomographic scan showed abnormal air in his bladder and bladder wall. We diagnosed the patient with emphysematous cystitis, but we could not determine the reason for the failure of irrigation. By panendoscopy we found the inflammatory mucous flap in his urethra. This flap was thought to have caused the retention. Urinary catheter drainage is most important for the treatment of emphysematous cystitis. To our knowedge, this is the first report in Japan of a case in which catheter drainage was impossible.
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112
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Wang CC, Chen YJ, Tsao YT, Chen WL. Image of trauma. Emphysematous cystitis. THE JOURNAL OF TRAUMA 2009; 67:414. [PMID: 19667901 DOI: 10.1097/ta.0b013e318187ad37] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/28/2023]
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113
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Christmann M, Heitkamp S, Lambrecht E, Doerries K, Schubert R, Zielen S. Haemorrhagic cystitis and polyomavirus JC infection in ataxia telangiectasia. J Pediatr Urol 2009; 5:324-6. [PMID: 19303816 DOI: 10.1016/j.jpurol.2009.02.198] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/22/2009] [Accepted: 02/16/2009] [Indexed: 11/15/2022]
Abstract
We report the case of a young adolescent with ataxia telangiectasia (AT) and life-threatening haemorrhage from the bladder due to a combination of bladder wall telangiectasis, immunosuppressive therapy and an infection with polyomavirus JC. BK and JC are both members of the polyomavirus family. BK virus is a known cause of haemorrhagic cystitis in bone-marrow and nephropathy in kidney transplant patients, whereas JC virus is mainly associated with progressive multifocal leukoencephalopathy and only rarely found in haemorrhagic cystitis. Although opportunistic infections are uncommon in AT and virus replication was described as being down-regulated in ATM (AT mutated protein)-deficient cells, clinicians should be aware that severe haematuria in a patient with AT and undergoing immunosuppressive therapy is suggestive for polyomavirus JC-induced haemorrhagic cystitis.
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Pérez Fentes D, Blanco Parra M, Lema Grille J, Toucedo Caamaño V, Novás Castro S, Lamas Cedrón P, Villar Núñez M. [Emphysematous cystitis: case report]. ARCH ESP UROL 2009; 62:392-395. [PMID: 19721175] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/28/2023]
Abstract
OBJECTIVE To report one case of emphysematous cystitis and to review its diagnosis and treatment in the related literature. METHOD We report the case of a type II diabetic 91-year-old woman with jaundice, hematuria, vomits, abdominal pain and poor glycemia control. Diagnosis was obtained by plain abdominal X-ray and ultrasonography, and confirmed by CT. E.coli was isolated in urinary culture. RESULTS Antibiotic intravenous therapy with piperacillin-tazo-bactam, urinary bladder catheterization and strict glycemia control. The patient was discharged from hospital on day 5, with 14 additional days of orally administered amoxicillin-clavulanic and bladder catheterization. Complete clinical, radiologic and microbiologic resolution was achieved. CONCLUSIONS Emphysematous cystitis is a rare entity, most common in diabetic women, which results from infection of the urinary bladder with gas-producing pathogens, mainly E.coli. Clinical presentation is variable. Emphysematous cystitis can be diagnosed radiologically, mainly with CT scan. The management consists of broad-spectrum antibiotics, strict glycemic control and bladder drainage. Emphysematous cystitis usually has a benign course, but complications may arise in up to 10-20% of cases, requiring surgical treatment.
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115
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116
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Tablang MVF, Ramanan SV. Emphysematous cystitis: a case report. CONNECTICUT MEDICINE 2009; 73:211-213. [PMID: 19413081] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/27/2023]
Abstract
Emphysematous cystitis is a necrotizing infection of the urinary bladder. We describe a patient afflicted with this disorder, outlining the clinical presentation, diagnosis and treatment of the illness. We also emphasize the importance of early detection and appropriate treatment to achieve a favorable clinical outcome.
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117
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Marques MR, Matos C, Oliveira S. [Enteritis and cystitis - a cause of abdominal pain in lupus]. ACTA REUMATOLOGICA PORTUGUESA 2009; 34:241-245. [PMID: 19569279] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/28/2023]
Abstract
We present a case of a 28-year-old black female patient with a previous diagnosis of overlapping syndrome of lupus and rheumatoid arthritis, treated with corticosteroids and methotrexate, who was admitted to our department due to abdominal pain with vomits and diarrhea for 15 days. On complementary evaluation elevated C-reactive protein and erythrocyte sedimentation rate, lactate dehydrogenase and amylase levels were detected, C3 was reduced, blood, faeces, peritoneal fluid and urine cultures were negative; abdominal computerized tomography disclosed jejunal thickening with parietal edema, bilateral ureterohydronephrosis and bladder parietal thickening; on endoscopy with biopsy there was chronic pangastritis and duodenitis; cystoscopy with biopsy showed chronic cystitis. Those aspects suggested lupus enteritis and cystitis which appear rarely associated and have poor prognosis. This patient was treated with high dose corticosteroids followed by azathioprine and prednisolone, with clinical and imaging improvement.
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118
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Yeh CL, Hsu KF. Bilateral emphysematous pyelonephritis and cystitis in an ESRD patient presenting with septic shock. Acta Clin Belg 2009; 64:160-1. [PMID: 19432030 DOI: 10.1179/acb.2009.027] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/31/2022]
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119
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Mancino P, Dalessandro M, Falasca K, Ucciferri C, Pizzigallo E, Vecchiet J. Acute urinary retention due to HSV-1: a case report. LE INFEZIONI IN MEDICINA 2009; 17:38-40. [PMID: 19359825] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/27/2023]
Abstract
Complications in urinary tract nervous routes due to herpes viruses as VZV and HSV-2 are well known. Acute urinary retention and chronic neuropathic pain are not rare when sacral dermatomes are involved by these viruses. However, an analogous condition has not yet been clearly ascribed to HSV-1 infection. We present a 32-year-old immunocompetent patient with fever, lumbar pain and acute urinary retention who had never had herpetic clinical manifestations. Urodynamic studies diagnosed a neurologic bladder with an absent filling sensation. Cystoscopic assessment revealed the presence of reddened and isolated small mucosal areas in the bladder walls. The search for herpes viruses in plasma and CSF by PCR assay were positive for HSV-1. After treatment with antiviral therapy the disease resolved. Intermittent catheterization was necessary and voiding dysfunction resolved after three weeks by its appearance. Neurological damage to the central nervous system (CNS) and/or PNS due to HSV-1 seems to be the most likely reason. The course of disease was benign and self-remitting.
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120
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Sun JT, Wang HP, Lien WC. Life-threatening urinary tract infection. QJM 2009; 102:223. [PMID: 18784192 DOI: 10.1093/qjmed/hcn115] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
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121
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Suárez Laurés A, Pobes A, Pérez-Carral JR, Quiñones Ortiz L. [Pneumaturia and kidney polycystosis in adults]. Nefrologia 2009; 29:183-184. [PMID: 19396336 DOI: 10.3265/nefrologia.2009.29.2.4834.en.full] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/27/2023] Open
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122
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Zheglova ES, Babak SV, Novikov AI. [Antibacterial therapy of patients with urolithiasis: efficacy and safety]. ANTIBIOTIKI I KHIMIOTERAPIIA = ANTIBIOTICS AND CHEMOTERAPY [SIC] 2009; 54:48-52. [PMID: 20415265] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/29/2023]
Abstract
Retrospective analysis provided data on the efficacy and safety of antimicrobial therapy in the treatment of urinary tract infections in 21 patients with urolithiasis in an urological unit of a municipal multiprofile hospital. For estimation of the antimicrobial therapy efficacy ATC/DDD method was used (The Anatomical Therapeutic Chemical Classification System with Defined Daily Doses). The analysis showed that the isolates (> 50%) were highly resistant to the majority of the antibiotics prescribed by the physicians for the empirical therapy within 90% DU (Drug Utilization). Moreover, adverse reactions to the antibiotics were recorded in 9.5% of the patients. It was concluded that in the routine practice of the physicians, the antibiotic therapy was not corrected with the microbiological view and the pharmacotherapy efficacy was not duely estimated. Such a situation requires cooperation of clinical pharmacologists and clinicians, periodical analysis of the drug misuse and therapeutic drug monitoring to solve the problem.
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Ferraro A, Pastori G, Favaro E, Marcon R, Lazzarin R, De Luca M. [Pneumaturia in a hemodialyzed diabetic. Case report]. GIORNALE ITALIANO DI NEFROLOGIA : ORGANO UFFICIALE DELLA SOCIETA ITALIANA DI NEFROLOGIA 2008; 25:570-573. [PMID: 18828119] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/26/2023]
Abstract
The emphysematous cystitis is a rare condition, usually with a favorable prognosis; it is characterized by the presence of air in the bladder lumen and/or wall caused by the fermentation of glucose due to the action of microorganisms. Here the case is described of a hemodialyzed diabetic oligoanuric patient suffering from frequent symptomatic relapses of urinary tract infection, with air in the bladder and reported pneumaturia. The diagnostic workup aimed to exclude the presence of enterovesical fistulas, which are a possible cause of the presence of air in the urinary tract. The air was produced by bacteria isolated in the urine culture. Both the dysuric symptoms and the gas disappeared after appropriate antibiotic treatment.
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124
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Aziz A, Maillette A. Emphysematous cystitis and sepsis: a case report. THE CANADIAN JOURNAL OF UROLOGY 2008; 15:4118-4121. [PMID: 18570722] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/26/2023]
Abstract
Emphysematous cystitis is a rare disease that is usually caused by aerobic bacteria. The clinical course can vary from asymptomatic cystitis to fulminant sepsis. We present a case of a 68-year-old man with emphysematous cystitis with sepsis where early diagnosis and conservative treatment led to a favorable outcome.
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125
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Chuang YC, Yoshimura N, Huang CC, Wu M, Chiang PH, Chancellor MB. Intravesical botulinum toxin A administration inhibits COX-2 and EP4 expression and suppresses bladder hyperactivity in cyclophosphamide-induced cystitis in rats. Eur Urol 2008; 56:159-66. [PMID: 18514386 DOI: 10.1016/j.eururo.2008.05.007] [Citation(s) in RCA: 75] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2008] [Accepted: 05/06/2008] [Indexed: 11/19/2022]
Abstract
BACKGROUND Cyclooxygenase 2 (COX-2) elevation and subsequent prostaglandin E(2) (PGE(2)) production play a major role in bladder inflammation and hyperactivity. EP4 receptor, a subtype of PGE(2) receptors, mediates tissue inflammation and hypersensitivity. OBJECTIVE To investigate the effect of intravesical botulinum toxin A (BoNT-A) on COX-2 and EP4 expression in cyclophosphamide (CYP)-induced cystitis in rats. DESIGN, SETTING, AND PARTICIPANTS Experimental (N=40) and control animals (N=20) were injected with CYP (75 mg/kg intraperitoneally) or saline on days 1, 4, and 7. BoNT-A (1 ml, 20 unit/ml) or saline were administered into the bladder and retained for 1 h on day 2. INTERVENTION Waking cystometrograms (CMGs) were performed. Bladder and L6 and S1 spinal cord were harvested on day 8. MEASUREMENTS CMG parameters, histology, and COX-2 and EP4 expression by immunostaining or western blotting were measured. RESULTS AND LIMITATIONS CYP induced increased bladder inflammatory reaction, bladder hyperactivity, and COX-2 and EP4 expression in the bladder and spinal cord. The CYP effects were suppressed by BoNT-A treatment. BoNT-A treatment decreased inflammatory reaction (56.5% decrease), COX-2 expression (77.8%, 61.7%, and 54.8% decrease for bladder, L6, and S1 spinal cord, respectively), EP4 expression (56.8%, 26.9%, and 84.2% decrease for bladder, L6, and S1 spinal cord, respectively), and suppressed bladder hyperactivity (intercontraction interval, 107% increase and contraction amplitude, 43% decrease). CONCLUSIONS CYP injection activated COX2 and EP4 expression in the bladder and spinal cord and induced bladder inflammation and hyperactivity, which effects were suppressed by BoNT-A treatment. These findings suggest a potential benefit of EP4-targeted pharmacotherapy and BoNT-A treatment for bladder inflammatory conditions.
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