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Ronghua W, Ji Z, Gang L, Yun Z, Xubiao N. Cystitis glandularis with concomitant Crohn's disease leading to a paroxysm of Crohn's disease with ulcerated external iliac vessels. BMC Urol 2024; 24:89. [PMID: 38632572 PMCID: PMC11022458 DOI: 10.1186/s12894-024-01470-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2023] [Accepted: 03/29/2024] [Indexed: 04/19/2024] Open
Abstract
•we report the case of a 36-year-old female patient who presented to our hospital with a diagnosis of cystitis glandularis manifesting as a vesicovaginal fistula. She underwent cystoscopic biopsy at a local hospital, but anti-inflammatory treatment was ineffective, and the patient was experiencing low urination frequency and urgency, as well as pain. The patient underwent laparoscopic repair of a cystoscopy-confirmed vesicovaginal fistula. After surgery, the patient experienced a paroxysm of Crohn's disease with multiple small bowel fistulas and erosion of the external iliac vessels that ruptured to form an external iliac vessel small bowel fistula. The fistula was confirmed by surgical exploration, and the patient eventually died.
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Affiliation(s)
- Wu Ronghua
- Department of Urology, Second Affiliated Hospital of Army Medical University, Chongqing, 400037, China
| | - Zheng Ji
- Department of Urology, Second Affiliated Hospital of Army Medical University, Chongqing, 400037, China
| | - Liu Gang
- Department of Intensive Care Unit, Second Affiliated Hospital of Army Medical University, Chongqing, 400037, China
| | - Zhang Yun
- Department of Cardiovascular, Second Affiliated Hospital of Army Medical University, Chongqing, 400037, China
| | - Nie Xubiao
- Department of Gastroenterology, Second Affiliated Hospital of Army Medical University, Chongqing, 400037, China.
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Xiao H, Wang T, Gao B, Liu J, Li S, Ma J. The effects of a galectin-3 inhibitor on bladder pain syndrome in mice with cyclophosphamide-induced cystitis. Neurourol Urodyn 2024; 43:754-766. [PMID: 38356381 DOI: 10.1002/nau.25415] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2023] [Revised: 12/13/2023] [Accepted: 01/09/2024] [Indexed: 02/16/2024]
Abstract
AIMS To explore the effect of blocking galectin-3 in the bladder pain syndrome associated with interstitial cystitis. METHODS A galectin-3 inhibitor was used to treat mice with cyclophosphamide-induced cystitis. The expression of galectin-3 in bladder tissues and urine was examined by immunohistochemistry and enzyme-linked immunosorbent assay (ELISA), respectively. Suprapubic-pelvic pain, bladder voiding, bladder pain-like nociceptive behavior, and referred hyperalgesia were assessed. The weights of the bladders were also measured, and inflammatory cell infiltration and inflammatory cytokine levels were examined by histopathological evaluation. The inflammatory cytokines interleukin 1β (IL-1β), nerve growth factor (NGF), IL-6, and tumor necrosis factor α (TNF-α) were measured by ELISA. RESULTS Increases in galectin-3 levels, inflammation, bladder weight, and bladder pain-related symptoms were observed in bladders with cyclophosphamide-induced cystitis. Administration of the galectin-3 inhibitor significantly mitigated bladder pain-related symptoms and inflammatory response. In response to the 500 μM dose of the galectin-3 inhibitor, nociceptive behaviors, nociceptive score, and bladder-to-body weight ratios were reduced by 65.1%, 65.3%, and 40.3%, respectively, while 500 μM Gal-3 inhibitor increased pelvic pain threshold by 86.7%. Moreover, galectin-3 inhibitor treatment inhibited the inflammation. Compared to untreated CYP-induced mice, there were significant changes in the levels of IL-1β (41.72 ± 2.05 vs. 18.91 ± 2.26 pg/mg tissues), NGF (9.64 ± 0.38 vs. 1.88 ± 0.05 pg/mg tissues), IL-6 (42.67 + 1.51 vs. 21.26 + 2.78 pg/mg tissues, and TNF-α (22.02 ± 1.08 vs. 10.70 ± 0.80 pg/mg tissues) in response to the highest dose of the Gal-3 inhibitor subgroup (500 μM), and 500 μM Gal-3 inhibitor reduced mast cell infiltration ratios by 71.8%. CONCLUSIONS The galectin-3 inhibitor relieved pelvic pain, urinary symptoms, and bladder inflammation in mice with cyclophosphamide-induced cystitis. Thus, galectin-3 inhibitors may be novel agents in interstitial cystitis treatment.
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Affiliation(s)
- Helong Xiao
- Department of Surgery, Hebei Medical University, Shijiazhuang, Hebei, China
- Department of Urology, Hebei General Hospital, Shijiazhuang, Hebei, China
| | - Ting Wang
- Department of Cardiology, The Third Hospital of Hebei Medical University, Shijiazhuang, Hebei, China
| | - Bo Gao
- Department of Urology, Hebei General Hospital, Shijiazhuang, Hebei, China
| | - Junjiang Liu
- Department of Urology, Hebei General Hospital, Shijiazhuang, Hebei, China
| | - Shoubin Li
- Department of Urology, Hebei General Hospital, Shijiazhuang, Hebei, China
| | - Jianguo Ma
- Department of Urology, The Third Hospital of Hebei Medical University, Shijiazhuang, Hebei, China
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Thompson N, Frampton C, Losco G. Radiation cystitis in acute admissions for haematuria. N Z Med J 2024; 137:39-45. [PMID: 38301199 DOI: 10.26635/6965.6321] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/03/2024]
Abstract
AIMS To assess the outcomes of patients with haematuria from radiation cystitis admitted to Christchurch Hospital's Urology Service and identify treatment differences and hospitalisation trends. METHODS From November 2021 to January 2023, a retrospective analysis of 144 acute haematuria admissions was conducted. Data covered demographics, diagnosis, surgeries, complications and hospital stay length. Predictive factors for admissions and surgical interventions were explored. RESULTS Of the 144 admissions, 22 (15.3%) were diagnosed with radiation cystitis. The management strategies for radiation cystitis and non-radiation cystitis patients showed no significant differences in transfusion requirements, anti-bleeding medication usage (finasteride and/or tranexamic acid), or the need for acute or elective surgery. The average length of stay for admission was similar between the groups (radiation cystitis: 3.7 days, non-radiation cystitis: 3.5 days, p<0.05), but the readmission rate was significantly higher for radiation cystitis patients (59.1% vs 25.4%, p<0.01). CONCLUSIONS The management and hospital stay duration were similar for both cohorts; radiation cystitis patients faced increased readmissions, underscoring the necessity for rigorous monitoring and subsequent care. Upcoming research should target refining early interventions and management methods.
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Affiliation(s)
- Nasya Thompson
- Department of Surgery, University of Otago Christchurch, New Zealand
| | - Chris Frampton
- Department of Medicine, University of Otago Christchurch, New Zealand
| | - Giovanni Losco
- Department of Surgery, University of Otago Christchurch; Department of Urology, Te Whatu Ora - Waitaha Canterbury, New Zealand
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Yang W, He C. Klebsiella-caused Bilateral Emphysematous Pyelonephritis and Emphysematous Cystitis in a Patient with Type 2 Diabetes. Balkan Med J 2024; 41:76-77. [PMID: 37815233 PMCID: PMC10767784 DOI: 10.4274/balkanmedj.galenos.2023.2023-8-77] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2023] [Accepted: 09/14/2023] [Indexed: 10/11/2023] Open
Affiliation(s)
- Wei Yang
- Department of Radiology, Jiangsu Province Hospital of Chinese Medicine, Affiliated Hospital of Nanjing University of Chinese Medicine, Nanjing, China
| | - Chendong He
- Department of Radiology, The First Affiliated Hospital of Bengbu Medical College, Bengbu, China
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Chang M, Juruena MF, Young AH. Ketamine cystitis following ketamine therapy for treatment-resistant depression - case report. BMC Psychiatry 2024; 24:9. [PMID: 38166893 PMCID: PMC10763323 DOI: 10.1186/s12888-023-05468-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/04/2023] [Accepted: 12/18/2023] [Indexed: 01/05/2024] Open
Abstract
BACKGROUND Ketamine is a novel and exciting putative antidepressant medication for patients with treatment-resistant depression. A complication commonly seen in frequent and heavy recreational use of ketamine is ulcerative cystitis, which presents with lower urinary tract symptoms (LUTS) and upper renal tract damage and can be seen in over 25% of regular users. Although Ketamine-induced cystitis (KIC) is a recognised complication in recreational use of ketamine, its occurrence in therapeutic use of ketamine in depression has so far not been reported. The exact pathogenesis of KIC is currently unknown, making treatment and prevention advice much more difficult. Early diagnosis of KIC and immediate cessation of ketamine has been shown to improve adverse urinary tract symptoms and prevent further damage. CASE PRESENTATION We present a case of a 28-year-old female who was started on ketamine treatment for depression, and who then developed symptoms of KIC, which was confirmed by urine microscopy, culture and analysis. CONCLUSIONS To our knowledge, this is the first reported case of KIC in a patient receiving treatment-dose ketamine as part of their antidepressant therapy.
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Affiliation(s)
- Minna Chang
- Epsom and St Helier Hospital University and Hospital Trust, Epsom Surrey, KT18 7EG, UK.
| | - Mario F Juruena
- Department of Psychological Medicine, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
- South London and Maudsley (SLaM) NHS Foundation Trust, London, UK
| | - Allan H Young
- Department of Psychological Medicine, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
- South London and Maudsley (SLaM) NHS Foundation Trust, London, UK
- Bethlem Royal Hospital, Monks Orchard Road, Beckenham, Kent, BR3 3BX, UK
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Kusakabe N, Kamijo TC, Wada N, Chiba H, Shinohara N, Miyazato M. Effects of low-intensity extracorporeal shock wave therapy on lipopolysaccharide cystitis in a rat model of interstitial cystitis/bladder pain syndrome. Int Urol Nephrol 2024; 56:77-86. [PMID: 37668867 DOI: 10.1007/s11255-023-03770-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2023] [Accepted: 08/26/2023] [Indexed: 09/06/2023]
Abstract
PURPOSE To investigate the effect of low-intensity extracorporeal shock wave therapy (LiESWT) on lipopolysaccharide (LPS)-induced cystitis in an animal model of interstitial cystitis/bladder pain syndrome (IC/BPS). METHODS Sprague-Dawley rats were divided into three groups: control, cystitis (LPS group, intravesical injection of LPS (1 mg) twice), and cystitis with LiESWT (LiESWT group). On the third and fourth days, LiESWT was administered (0.12 mJ/mm2, 300 shots each time) on the lower abdomen toward the bladder. On the seventh day, the rats underwent pain assessment and a metabolic cage study. Subsequently, a continuous cystometrogram (CMG) was performed under urethane anaesthesia. Immunohistochemical studies were also performed, including S-100 staining, an immunohistochemical marker of Schwann cells in the bladder. RESULTS In the LPS group, the pain threshold in the lower abdomen was significantly lower than that in the control group. In the metabolic cage study, the mean voided volume in the LPS group significantly increased. The CMG also revealed a significant decrease in bladder contraction amplitude, compatible with detrusor underactivity in the LPS group. Immunohistochemical studies showed inflammatory changes in the submucosa, increased fibrosis, and decreased S-100 stain-positive areas in the muscle layer of the LPS group. In the LiESWT group, tactile allodynia and bladder function were ameliorated, and S-100 stain-positive areas were increased. CONCLUSION By restoring nerve damage, LiESWT improved lower abdominal pain sensitivity and bladder function in an LPS-induced cystitis rat model. This study suggests that LiESWT may be a new therapeutic modality for IC/BPS.
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Affiliation(s)
- Naohisa Kusakabe
- Department of System Physiology, Graduate School of Medicine, University of the Ryukyus, 207 Uehara, Nishihara, Okinawa, 903-0215, Japan
- Department of Renal and Genitourinary Surgery, Graduate School of Medicine, Hokkaido University, Sapporo, Japan
| | - Tadanobu Chuyo Kamijo
- Department of System Physiology, Graduate School of Medicine, University of the Ryukyus, 207 Uehara, Nishihara, Okinawa, 903-0215, Japan
| | - Naoki Wada
- Department of Pathology and Oncology, Graduate School of Medicine, University of the Ryukyus, Okinawa, Japan
| | - Hiroki Chiba
- Department of Renal and Genitourinary Surgery, Graduate School of Medicine, Hokkaido University, Sapporo, Japan
| | - Nobuo Shinohara
- Department of Renal and Genitourinary Surgery, Graduate School of Medicine, Hokkaido University, Sapporo, Japan
| | - Minoru Miyazato
- Department of System Physiology, Graduate School of Medicine, University of the Ryukyus, 207 Uehara, Nishihara, Okinawa, 903-0215, Japan.
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Shang M, Gao L, Zhang Y, Ding H. Hypereosinophilic syndrome with eosinophilic cystitis in children. Pediatr Int 2024; 66:e15701. [PMID: 38217096 DOI: 10.1111/ped.15701] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/01/2022] [Revised: 09/21/2023] [Accepted: 09/28/2023] [Indexed: 01/15/2024]
Affiliation(s)
- Mei Shang
- Department of Pediatrics, Shengli Oil Field Central Hospital, Dongyin, China
| | - Lianjun Gao
- Department of Pediatrics, Shengli Oil Field Central Hospital, Dongyin, China
| | - Yingying Zhang
- Department of Pediatrics, Shengli Oil Field Central Hospital, Dongyin, China
| | - Hongfang Ding
- Department of Pediatrics, Shengli Oil Field Central Hospital, Dongyin, China
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Salles LC, de Souza Andrade TH, Lima RSA, da Silva Junior GB. Emphysematous cystitis: A rare form of urinary tract infection. Braz J Infect Dis 2023; 27:103700. [PMID: 37980940 PMCID: PMC10709097 DOI: 10.1016/j.bjid.2023.103700] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2023] [Revised: 10/24/2023] [Accepted: 10/31/2023] [Indexed: 11/21/2023] Open
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Deng K, Chen S, Yang Y, Li J, Zhao L. Xanthogranulomatous cystitis and bilateral ureteral reflux due to bladder neck obstruction: a case report. J Int Med Res 2023; 51:3000605211065945. [PMID: 37940613 PMCID: PMC10637182 DOI: 10.1177/03000605211065945] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2021] [Accepted: 11/18/2021] [Indexed: 11/10/2023] Open
Abstract
Xanthogranulomatous cystitis (XC) is a rare benign disease of chronic granulomatous inflammation. We report a 23-year-old woman with xanthogranulomatous cystitis. She was referred to our hospital with the chief complaint of a 1-year history of frequent, urgent dysuria with recurrent fever. An imaging examination showed bilateral ureteral reflux and a normal bladder. Urodynamic findings suggested bladder outlet obstruction and increased post-void residual urine. Finally, the patient underwent endoscopy, and bladder neck obstruction was confirmed. Additionally, we found multiple granulomatous masses in the bladder. Therefore, we performed transurethral resection of the tumor and bladder neck. A histopathological examination of resected tumor tissue showed xanthogranulomatous cystitis, and the patient received anti-infective therapy. Follow-up cystourethroscopic results and urination symptoms returned to normal, and the bilateral ureteral reflux was gradually reduced.
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Affiliation(s)
- Kaiwen Deng
- Department of Urology, The First People’s Hospital of Zhengzhou, Zhengzhou, China
| | - Songlin Chen
- Department of Urology, The First People’s Hospital of Zhengzhou, Zhengzhou, China
| | - Yinhao Yang
- Department of Urology, The First People’s Hospital of Zhengzhou, Zhengzhou, China
| | - Jihua Li
- Department of Urology, The First People’s Hospital of Zhengzhou, Zhengzhou, China
| | - Limin Zhao
- Department of Pathology, The First People’s Hospital of Zhengzhou, Zhengzhou, China
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Riveros BPP, Mohseni MM. Emphysematous Cystitis: A Rare Urologic Emergency. Am J Case Rep 2023; 24:e941599. [PMID: 37904334 PMCID: PMC10626591 DOI: 10.12659/ajcr.941599] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2023] [Revised: 09/20/2023] [Accepted: 09/12/2023] [Indexed: 11/01/2023]
Abstract
BACKGROUND Emphysematous cystitis is a rare urologic condition typically characterized by abdominal pain, hematuria, and dysuria. In some cases, complications such as bladder rupture, necrosis, and septic shock have been reported. Emphysematous cystitis has been associated with several predisposing medical conditions, such as diabetes mellitus, recurrent urinary tract infections, and immunosuppression, but can also infrequently present in an undifferentiated fashion without these aforementioned risk factors, such as in our patient's case. CASE REPORT We describe a rare case of emphysematous cystitis in a 67-year-old woman presenting to the Emergency Department with hematuria. The patient's presenting symptoms also included severe lower abdominal pain and dysuria. Examination revealed suprapubic tenderness and gross hematuria. Imaging revealed gas within the bladder lumen and throughout the bladder wall. Radiography showed concerns for emphysematous cystitis, without evidence of bladder fistula formation with adjacent bowel loops or cysto-vaginal fistula. After consultation with the Urology Department, the patient was admitted for serial examinations, intravenous antibiotics, and continued monitoring. The patient was discharged in good condition after a 3-day hospitalization. CONCLUSIONS Clinicians evaluating patients for acute urologic symptoms should be alert to the possible diagnosis of emphysematous cystitis, given the potential for deterioration and concomitant complications. Although our patient's presentation included no traditional risk factors for emphysematous cholecystitis, she required hospitalization to ensure progressive improvement. Therefore, prompt management along with appropriate consultation with specialists are crucial to mitigate the risk of adverse outcomes in this rare urologic emergency.
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Tsygankova OV, Evdokimova NE, Timoshchenko OV, Latyntseva LD. [The effect of a medicinal plant preparation on the frequency of episodes of exacerbation of recurrent cystitis and metabolic parameters in patients with type 2 diabetes mellitus taking glyphlosins]. TERAPEVT ARKH 2023; 95:664-669. [PMID: 38158902 DOI: 10.26442/00403660.2023.08.202362] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2023] [Accepted: 10/10/2023] [Indexed: 01/03/2024]
Abstract
BACKGROUND The problem of recurrent urinary tract infections (UTI) in patients with type 2 diabetes mellitus (DM 2) is relevant, especially when there is a combination of predisposing factors, such as female gender, history of UTI episodes, and therapy with sodium glucose cotransporter type 2 (SGLT-2) inhibitors, and the choice of effective and safe means could cause some difficulties, including ina terms of the burden of antibiotic resistance. AIM To evaluate the effectiveness and safety of the phytoproduct Canephron® N for the prevention of exacerbations of recurrent cystitis and the effect on metabolic parameters in patients with type 2 diabetes taking SGLT-2 inhibitors. MATERIALS AND METHODS Prospective, randomized, open, parallel group study in 60 women. The main group took the drug Canephron® N for 3 months. The main parameters for evaluating were the frequency of recurrence of cystitis, level of albuminuria and LDL-cholesterol peroxidation product - malondialdehyde. RESULTS Within 3 months of taking Canephron® N, exacerbations of chronic cystitis were diagnosed 2 times less often, a decrease in albuminuria was found in the form of an increase in the proportion of patients with an optimal level of albuminuria by 20%, a 50% reduction in the frequency of the initial increase in albuminuria, and the absence of moderate albuminuria in all patients at the end of course of therapy. A decrease in the level of MDA by 1.4 times was noted (p=0.019). CONCLUSION Thus, the herbal drug Canephron® N can be used for accompanying therapy and prophylactic treatment in patients with recurrent cystitis on the background of DM 2, taking SGLT-2 inhibitors. The course of therapy should last at least 3 months.
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Affiliation(s)
- O V Tsygankova
- Research Institute of Therapy and Preventive Medicine - branch of the Institute of Cytology and Genetics of the Siberian Branch of the Russian Academy of Sciences
- Novosibirsk State Medical University
| | - N E Evdokimova
- Research Institute of Therapy and Preventive Medicine - branch of the Institute of Cytology and Genetics of the Siberian Branch of the Russian Academy of Sciences
| | - O V Timoshchenko
- Research Institute of Therapy and Preventive Medicine - branch of the Institute of Cytology and Genetics of the Siberian Branch of the Russian Academy of Sciences
| | - L D Latyntseva
- Research Institute of Therapy and Preventive Medicine - branch of the Institute of Cytology and Genetics of the Siberian Branch of the Russian Academy of Sciences
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Zhang L, Chen X, Li M, Lv R, Gu B, Chen Z. Activation of the adenosine A1 receptor in the lumbosacral spinal cord improves bladder overactivity in rats with cystitis induced by cyclophosphamide. Int Urol Nephrol 2023; 55:2183-2191. [PMID: 37330931 DOI: 10.1007/s11255-023-03659-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2023] [Accepted: 06/02/2023] [Indexed: 06/20/2023]
Abstract
PURPOSE To investigate the effect of intrathecal administration of CCPA, an adenosine A1 receptor agonist, on voiding function in rats with cystitis induced by cyclophosphamide (CYP). METHODS Thirty 8-week-old Sprague Dawley rats were randomly divided into a control group (n = 15) and a cystitis group (n = 15). Cystitis was induced by a single intraperitoneal injection of CYP (200 mg/kg, dissolved in physiological saline) in rats. Control rats were injected intraperitoneally with physiological saline. The PE10 catheter reached the level of L6-S1 spinal cord through L3-4 intervertebral space for intrathecal injection. Forty-eight hours after intraperitoneal injection, urodynamic tests were conducted to observe the effect of intrathecal administration of 10% dimethylsulfoxide (vehicle) and 1 nmol CCPA on micturition parameters, including basal pressure (BP), threshold pressure (TP), maximal voiding pressure (MVP), intercontraction interval (ICI), voided volume (VV), residual volume (RV), bladder capacity (BC), and voiding efficiency (VE). Histological changes of the bladder of cystitis rats were studied through hematoxylin-eosin staining (HE staining). Moreover, Western blot and immunofluorescence were used to study the expression of adenosine A1 receptor in the L6-S1 dorsal spinal cord in both groups of rats. RESULTS HE staining revealed submucosal hemorrhage, edema, and inflammatory cell infiltration in the bladder wall of cystitis rats. The urodynamic test showed significant increase in BP, TP, MVP and RV in cystitis rats, while ICI, VV, BC and VE decreased significantly, indicating bladder overactivity. CCPA inhibited the micturition reflex in both control and cystitis rats, and significantly increased TP, ICI, VV, BC, and VE, but had no significant effect on BP, MVP and RV. Western blot and immunofluorescence showed that there was no significant difference in the expression of adenosine A1 receptor in the L6-S1 dorsal spinal cord between the control and cystitis rats. CONCLUSION The findings of this study suggest that intrathecal administration of the adenosine A1 receptor agonist CCPA alleviates CYP-induced bladder overactivity. Furthermore, our results indicate that the adenosine A1 receptor in the lumbosacral spinal cord may be a promising target for treatment of bladder overactivity.
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Affiliation(s)
- Lin Zhang
- Department of Urology, Shanghai Sixth People's Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, 600 Yishan Road, Shanghai, 200233, China
| | - Xun Chen
- Department of Urology, Shanghai Sixth People's Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, 600 Yishan Road, Shanghai, 200233, China
| | - Mingzhuo Li
- Department of Urology, Shanghai Sixth People's Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, 600 Yishan Road, Shanghai, 200233, China
| | - Rong Lv
- Department of Urology, Shanghai Sixth People's Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, 600 Yishan Road, Shanghai, 200233, China
| | - Baojun Gu
- Department of Urology, Shanghai Sixth People's Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, 600 Yishan Road, Shanghai, 200233, China.
| | - Zhong Chen
- Department of Urology, Shanghai Sixth People's Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, 600 Yishan Road, Shanghai, 200233, China.
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Liu L, Zhao Y, An W, Zhao M, Ding N, Liu H, Ge N, Wen J, Zhang X, Zu S, Sun W. Piezo2 Channel Upregulation is Involved in Mechanical Allodynia in CYP-Induced Cystitis Rats. Mol Neurobiol 2023; 60:5000-5012. [PMID: 37227654 PMCID: PMC10415424 DOI: 10.1007/s12035-023-03386-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2023] [Accepted: 05/13/2023] [Indexed: 05/26/2023]
Abstract
Mechanical sensing Piezo2 channel in primary sensory neurons has been shown contribute to mechanical allodynia in somatic chronic pain conditions. Interstitial cystitis (IC)-associated pain is often triggered by bladder filling, a presentation that mimics the mechanical allodynia. In the present study, we aimed to examine the involvement of sensory Piezo2 channel in IC-associated mechanical allodynia using a commonly employed cyclophosphamide (CYP)-induced IC model rat. Piezo2 channels in dorsal root ganglia (DRGs) was knocked down by intrathecal injections of Piezo2 anti-sense oligodeoxynucleotides (ODNs) in CYP-induced cystitis rats, and mechanical stimulation-evoked referred bladder pain was measured in the lower abdomen overlying the bladder using von Frey filaments. Piezo2 expression at the mRNA, protein, and functional levels in DRG neurons innervating the bladder was detected by RNA-fluorescence in situ hybridization, western blotting, immunofluorescence, and Ca2+ imaging, respectively. We found that Piezo2 channels were expressed on most (> 90%) of the bladder primary afferents, including afferents that express CGRP, TRPV1 and stained with isolectin B4. CYP-induced cystitis was associated with Piezo2 upregulation in bladder afferent neurons at the mRNA, protein, and functional levels. Knockdown of Piezo2 expression in DRG neurons significantly suppressed mechanical stimulation-evoked referred bladder pain as well as bladder hyperactivity in CYP rats compared to CYP rats treated with mismatched ODNs. Our results suggest upregulation of Piezo2 channels is involved in the development of bladder mechanical allodynia and bladder hyperactivity in CYP-induced cystitis. Targeting Piezo2 might be an attractive therapeutic approach for IC-related bladder pain.
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Affiliation(s)
- Lei Liu
- Department of Urology, The Second Hospital of Shandong University, Jinan, Shandong, 250032, P. R. China
| | - Yan Zhao
- Department of Radiology, Shandong Provincial Hospital Affiliated to Shandong First Medical University, Jinan, Shandong, P. R. China
| | - Wenhan An
- Department of Rehabilitation, The Second Hospital of Shandong University, Jinan, Shandong, P. R. China
| | - Mengmeng Zhao
- Department of Urology, The Second Hospital of Shandong University, Jinan, Shandong, 250032, P. R. China
| | - Ning Ding
- Department of Urology, The Second Hospital of Shandong University, Jinan, Shandong, 250032, P. R. China
| | - Hanwen Liu
- Department of Urology, The Second Hospital of Shandong University, Jinan, Shandong, 250032, P. R. China
| | - Nan Ge
- Department of Urology, The Second Hospital of Shandong University, Jinan, Shandong, 250032, P. R. China
| | - Jiliang Wen
- Department of Urology, The Second Hospital of Shandong University, Jinan, Shandong, 250032, P. R. China
| | - Xiulin Zhang
- Department of Urology, The Second Hospital of Shandong University, Jinan, Shandong, 250032, P. R. China
| | - Shulu Zu
- Department of Urology, The Second Hospital of Shandong University, Jinan, Shandong, 250032, P. R. China
| | - Wendong Sun
- Department of Urology, The Second Hospital of Shandong University, Jinan, Shandong, 250032, P. R. China.
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14
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Ligon MM, Liang B, Lenger SM, Parameswaran P, Sutcliffe S, Lowder JL, Mysorekar IU. Bladder Mucosal Cystitis Cystica Lesions Are Tertiary Lymphoid Tissues That Correlate With Recurrent Urinary Tract Infection Frequency in Postmenopausal Women. J Urol 2023; 209:928-936. [PMID: 36715657 DOI: 10.1097/ju.0000000000003196] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2022] [Accepted: 01/19/2023] [Indexed: 01/31/2023]
Abstract
PURPOSE We identify correlates and clinical outcomes of cystitis cystica, a poorly understood chronic inflammatory bladder change, in women with recurrent urinary tract infections. MATERIALS AND METHODS A retrospective, observational cohort of women with recurrent urinary tract infections who underwent cystoscopy (n=138) from 2015 to 2018 were identified using electronic medical records. Cystitis cystica status was abstracted from cystoscopy reports and correlations were identified by logistic regression. Urinary tract infection-free survival time associated with cystitis cystica was evaluated by Cox proportional hazards regression. Exact logistic regression was used to identify factors associated with changes to cystitis cystica lesions on repeat cystoscopy. Biopsies of cystitis cystica lesions were examined by routine histology and immunofluorescence. RESULTS Fifty-three patients (38%) had cystitis cystica on cystoscopy. Cystitis cystica was associated with postmenopausal status (OR: 5.53, 95% CI: 1.39-37.21), pelvic floor myofascial pain (6.82, 1.78-45.04), having ≥4 urinary tract infections in the past year (2.28, 1.04-5.09), and a shorter time to next urinary tract infection (HR: 1.54, 95% CI: 1.01-2.35). Forty-two patients (82%) demonstrated improvement or resolution of lesions. Ten/11 (91%) biopsied cystitis cystica lesions were tertiary lymphoid tissue with germinal centers and resembled follicular cystitis. CONCLUSIONS Cystitis cystica lesions were associated with postmenopausal status, pelvic floor myofascial pain, and number of urinary tract infections in the prior year and predicted worse recurrent urinary tract infection outcomes. Cystitis cystica lesions are tertiary lymphoid tissue/follicular cystitis that may improve or resolve over time with treatment. Identifying cystitis cystica in recurrent urinary tract infection patients may be useful in informing future urinary tract infection risk and tailoring appropriate treatment strategies.
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Affiliation(s)
- Marianne M Ligon
- Department of Obstetrics & Gynecology, Washington University School of Medicine, St Louis, Missouri
| | - Brooke Liang
- Department of Obstetrics & Gynecology, Washington University School of Medicine, St Louis, Missouri
| | - Stacy M Lenger
- Department of Obstetrics & Gynecology and Women's Health, University of Louisville School of Medicine, Louisville, Kentucky
| | - Priyanka Parameswaran
- Department of Obstetrics & Gynecology, Washington University School of Medicine, St Louis, Missouri
| | - Siobhan Sutcliffe
- Department of Surgery, Washington University School of Medicine, St Louis, Missouri
| | - Jerry L Lowder
- Department of Obstetrics & Gynecology, Division of Female Pelvic Medicine and Reconstructive Surgery, Washington University School of Medicine, St Louis, Missouri
| | - Indira U Mysorekar
- Department of Obstetrics & Gynecology, Washington University School of Medicine, St Louis, Missouri
- Department of Medicine, Section of Infectious Diseases and Department of Molecular Virology and Microbiology, Baylor College of Medicine, Houston, Texas
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15
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Wathanavasin W, Susantitaphong P. A case of emphysematous cystitis complicated by unilateral hydronephrosis and septicemia: nephrology picture. J Nephrol 2023; 36:301-302. [PMID: 36098881 PMCID: PMC9469812 DOI: 10.1007/s40620-022-01452-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2022] [Accepted: 08/20/2022] [Indexed: 11/25/2022]
Affiliation(s)
- Wannasit Wathanavasin
- Nephrology Unit, Department of Medicine, Charoenkrung Pracharak Hospital, Bangkok Metropolitan Administration, 8 Tok Road, Bang Kho Laem, Bangkok, 10120, Thailand.
| | - Paweena Susantitaphong
- Division of Nephrology, Department of Medicine, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand
- Research Unit for Metabolic Bone Disease in CKD Patients, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand
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16
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Hughes FM, Odom MR, Cervantes A, Livingston AJ, Purves JT. Why Are Some People with Lower Urinary Tract Symptoms (LUTS) Depressed? New Evidence That Peripheral Inflammation in the Bladder Causes Central Inflammation and Mood Disorders. Int J Mol Sci 2023; 24:2821. [PMID: 36769140 PMCID: PMC9917564 DOI: 10.3390/ijms24032821] [Citation(s) in RCA: 7] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/06/2023] [Revised: 01/27/2023] [Accepted: 01/29/2023] [Indexed: 02/05/2023] Open
Abstract
Anecdotal evidence has long suggested that patients with lower urinary tract symptoms (LUTS) develop mood disorders, such as depression and anxiety, at a higher rate than the general population and recent prospective studies have confirmed this link. Breakthroughs in our understanding of the diseases underlying LUTS have shown that many have a substantial inflammatory component and great strides have been made recently in our understanding of how this inflammation is triggered. Meanwhile, studies on mood disorders have found that many are associated with central neuroinflammation, most notably in the hippocampus. Excitingly, work on other diseases characterized by peripheral inflammation has shown that they can trigger central neuroinflammation and mood disorders. In this review, we discuss the current evidence tying LUTS to mood disorders, its possible bidirectionally, and inflammation as a common mechanism. We also review modern theories of inflammation and depression. Finally, we discuss exciting new animal studies that directly tie two bladder conditions characterized by extensive bladder inflammation (cyclophosphamide-induced hemorrhagic cystitis and bladder outlet obstruction) to neuroinflammation and depression. We conclude with a discussion of possible mechanisms by which peripheral inflammation is translated into central neuroinflammation with the resulting psychiatric concerns.
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Affiliation(s)
- Francis M. Hughes
- Department Urology, Duke University Medical Center, P.O. Box 3831, Durham, NC 27710, USA
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17
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Ness TJ, DeWitte C, Randich A. The Double Insult of Neonatal Cystitis Plus Adult Somatic Inflammation Results in Corticotropin Releasing Factor Type II Receptor-Dependent Bladder Hypersensitivity in Female Rats. J Pain 2022; 23:2167-2178. [PMID: 36089237 PMCID: PMC9729390 DOI: 10.1016/j.jpain.2022.08.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/26/2022] [Revised: 08/23/2022] [Accepted: 08/26/2022] [Indexed: 01/04/2023]
Abstract
The spinal mechanisms of visceral hypersensitivity are poorly understood, particularly when there is an interaction with somatic systems. Recently we demonstrated that rats which were pretreated with neonatal bladder inflammation (NBI) and subsequently pretreated as adults with bladder re-inflammation had augmented reflex and neuronal responses to urinary bladder distension via a corticotropin-releasing factor receptor type II (CRFR2) mechanism. Another insult producing similar augmented responses is somatic inflammation induced by Complete Freund's Adjuvant (CFA) in the hindlimb. Using neurochemical measures and both reflex and neuronal responses to urinary bladder distension as endpoints, the present study probed the role of CRFR2-related mechanisms in bladder hyperalgesia secondary to NBI and CFA-induced hindlimb inflammation. ELISA measures of the lumbosacral spinal cord demonstrated increased CRFR2 protein following pretreatment with NBI+CFA. Intrathecal CRFR2 antagonists blocked the augmentation of visceromotor responses to distension following pretreatment with both NBI+CFA. Lumbosacral dorsal horn neuronal responses to bladder distension in rats pretreated with NBI+CFA were attenuated by the spinal topical administration of a CRFR2 antagonist. These findings are the first demonstration of a somatovisceral interaction working via CRFR2 receptors and support the therapeutic value of these agents in the treatment of painful bladder disorders, particularly when triggered by somatic events. (Word Count 199). PERSPECTIVE: Bladder hypersensitivity occurs following neonatal cystitis and an adult insult such as somatic inflammation. This paper demonstrates that CRFR2-related mechanisms are associated with this hypersensitivity. This supports the therapeutic value of these agents in the treatment of painful bladder disorders, particularly when triggered by somatic events.
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Affiliation(s)
- Timothy J Ness
- Department of Anesthesiology and Perioperative Medicine, University of Alabama at Birmingham, Birmingham, Alabama.
| | - Cary DeWitte
- Department of Anesthesiology and Perioperative Medicine, University of Alabama at Birmingham, Birmingham, Alabama
| | - Alan Randich
- Department of Anesthesiology and Perioperative Medicine, University of Alabama at Birmingham, Birmingham, Alabama
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18
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Matsukawa A, Ueda N, Mizuno R, Akiyama M, Sato M, Tei N, Miyake O. [A Case of Panperitonitis Due to Bladder Rupture Caused by Spinal Metastasis of Colorectal Cancer]. Hinyokika Kiyo 2022; 68:271-275. [PMID: 36071019 DOI: 10.14989/actauroljap_68_8_271] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/15/2023]
Abstract
A 74-year-old patient was undergoing treatment for ascending colon cancer (cT4aN2M1a) in the Department of Surgery at our hospital. During treatment for increased lymph node metastasis and spinal metastasis, she complained of numbness in her dorsal thigh. Magnetic resonance imaging showed spinal canal stenosis due to L4 bone metastasis. Immediately after starting radiation therapy for L4 bone metastasis, bladder rupture occurred and led to generalized peritonitis. We performed emergency laparotomy and drainage. Later, the patient's general condition improved, but irreversible neurological symptoms remained, and activities of daily living decreased markedly. This was thought to be caused by weakening of the bladder wall due to chronic cystitis, and hyperextension of the bladder due to neurogenic bladder. Bacteriuria leaked into the abdominal cavity, resulting in generalized peritonitis.
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Affiliation(s)
| | | | - Ryoya Mizuno
- The Department of Urology, Toyonaka Municipal Hospital
| | - Mai Akiyama
- The Department of Urology, Toyonaka Municipal Hospital
| | - Mototaka Sato
- The Department of Urology, Toyonaka Municipal Hospital
| | - Norihide Tei
- The Department of Urology, Toyonaka Municipal Hospital
| | - Osamu Miyake
- The Department of Urology, Toyonaka Municipal Hospital
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19
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Wong CK, Cho LY, Lau WL, Cheung IYY, Yu CHT, Law IC, Leung WC. Candida glabrata fungal ball cystitis is a rare complication of conservative treatment of placenta accreta: a case report. Hong Kong Med J 2022; 28:324-327. [PMID: 35989434 DOI: 10.12809/hkmj219449] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/15/2023] Open
Affiliation(s)
- C K Wong
- Department of Obstetrics and Gynaecology, Kwong Wah Hospital, Hong Kong
| | - L Y Cho
- Department of Obstetrics and Gynaecology, Kwong Wah Hospital, Hong Kong
| | - W L Lau
- Department of Obstetrics and Gynaecology, Kwong Wah Hospital, Hong Kong
| | - I Y Y Cheung
- Department of Pathology, Kwong Wah Hospital, Hong Kong
| | - C H T Yu
- Department of Surgery, Kwong Wah Hospital, Hong Kong
| | - I C Law
- Department of Surgery, Kwong Wah Hospital, Hong Kong
| | - W C Leung
- Department of Obstetrics and Gynaecology, Kwong Wah Hospital, Hong Kong
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20
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Mohd Khairul IO, Nurzam SCH, Hamat RA. Complicated urinary tract infection caused by Corynebacterium urealyticum - A pathogen that should not be forgotten. Med J Malaysia 2022; 77:110-112. [PMID: 35087008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/14/2023]
Abstract
Although Corynebacterium urealyticum has rarely been isolated in diagnostic laboratories, this bacterium can be a significant uropathogen causing significant complications. It causes cystitis and alkaline encrusted cystitis, commonly involved in patients who need prolonged hospitalization and bladder catheterisation. We report here a case of a 19-yearold young man who was diagnosed with N-Methyl Daspartate receptor (NMDAR) encephalitis that requires hospitalization for optimization of rehabilitation treatment in Hospital Kuala Lumpur, Malaysia. His urine culture isolated slow growing gram-positive pleomorphic rods subsequently identified as C. urealyticum. Based on the risk factors, the isolation of C. urealyticum could not be simply dismissed as contaminants. The patient was treated successfully with vancomycin for two weeks.
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Affiliation(s)
- I O Mohd Khairul
- Universiti Putra Malaysia, Faculty of Medicine and Health Sciences, Department of Medical Microbiology, Serdang, Selangor, Malaysia
| | - S C H Nurzam
- Hospital Kuala Lumpur, Pathology Department, Microbiology Unit, Jalan Pahang, Kuala Lumpur, Malaysia
| | - R A Hamat
- Universiti Putra Malaysia, Faculty of Medicine and Health Sciences, Department of Medical Microbiology, Serdang, Selangor, Malaysia.
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21
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Maruo H, Ohsugi K, Maruta K, Kotani T. Infective endocarditis secondary to Klebsiella pneumoniae-associated emphysematous cystitis. BMJ Case Rep 2021; 14:e243497. [PMID: 34413036 PMCID: PMC8378354 DOI: 10.1136/bcr-2021-243497] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/08/2021] [Indexed: 11/04/2022] Open
Abstract
Klebsiella pneumoniae is responsible for about 1.5% of infective endocarditis (IE) cases. IE caused by community-acquired K. pneumoniae infection has rarely been reported. An 80-year-old man presented at our hospital with hypotension and hypoxaemia, and a history of aortic valve stenosis and no history of recent dental treatment. Transthoracic echocardiography at admission showed no signs of heart failure or vegetation. CT revealed typical signs of emphysematous cystitis (EC). The patient was treated for EC-associated septic shock. K. pneumoniae was detected in urine and blood cultures on day 3. Symptoms of heart failure developed on day 6 and clinical examination revealed a heart murmur. An identification of vegetation and perforation of the mitral valve on repeat echocardiography confirmed the diagnosis of IE secondary to K. pneumoniae infection. A surgical valve replacement was performed on day 7. Repeated point-of-care ultrasound played a role in the early diagnosis of IE.
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Affiliation(s)
- Hiroko Maruo
- Department of Intensive Care Medicine, Showa University, Tokyo, Japan
| | - Koichi Ohsugi
- Department of Intensive Care Medicine, Showa University, Tokyo, Japan
| | - Kazuto Maruta
- Department of Thoracic and Cardiovascular Surgery, Showa University, Tokyo, Japan
| | - Toru Kotani
- Department of Intensive Care Medicine, Showa University, Tokyo, Japan
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22
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Magallanes-Gamboa JO, Notario-Barba V, Herrero Domingo A, Marcos-Sánchez F. [Emphysematous cystitis and emphysematous pyelonephritis]. Rev Esp Geriatr Gerontol 2021; 56:364-367. [PMID: 34315613 DOI: 10.1016/j.regg.2021.06.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/18/2020] [Revised: 06/06/2021] [Accepted: 06/28/2021] [Indexed: 11/19/2022]
Abstract
Emphysematous cystitis and emphysematous pyelonephritis are rare entities, difficult to diagnose and with high morbidity and mortality. The non-specificity of the medical history and the little usefulness of laboratory tests contribute to diagnostic delay, which increases the possibility of therapeutic failure. We present 2 cases, one of cystitis and another of emphysematous pyelonephritis, who attended the emergency room due to severe urinary sepsis. Despite severity of the symptoms, conservative management was performed with bladder drainage and antibiotic treatment, without interventions or surgeries, presenting a favorable evolution and resolution of the infectious process. Each case must be individualized to offer the best possible therapeutic alternative.
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Affiliation(s)
| | - Verónica Notario-Barba
- Servicio de Urgencias, Hospital Nuestra Señora del Prado, Talavera de la Reina, Toledo, España
| | - Almudena Herrero Domingo
- Servicio de Medicina Interna, Hospital Nuestra Señora del Prado, Talavera de la Reina, Toledo, España
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23
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Choi J, Choi SK, Lee SH, Yoo KH. Clinical Outcomes and Risk Factor Analysis of Patients Presenting with Emphysematous Cystitis: A 15-Year Retrospective Multicenter Study. ACTA ACUST UNITED AC 2021; 57:medicina57060531. [PMID: 34073208 PMCID: PMC8229240 DOI: 10.3390/medicina57060531] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2021] [Accepted: 05/23/2021] [Indexed: 11/16/2022]
Abstract
Background and objectives: To investigate the risk factors for emphysematous cystitis (EC) compared to those of acute cystitis (AC) to increase clinicians awareness of the possibility for the aggravation of patient status. Materials and methods: We retrospectively reviewed a total of 54 patients who were hospitalized with a diagnosis of EC by abdominal computed tomography (CT) scan from 2006 to 2020. The control group included 92 patients who were hospitalized for the treatment of AC in the same period. We sought to identify the clinical features and predisposing diseases, such as age, sex, diabetes mellitus (DM), hypertension (HTN), cerebrovascular accident (CVA), chronic kidney disease (CKD), neurogenic bladder (NB), history of urinary tract infection (UTI), and emphysematous pyelonephritis (EPN), that were associated with the development of EC. Results: The median (interquartile range (IQR)) age of the patients with EC was older than that of the patients with AC (78.5 (15.3) years (range: 52-100) vs. 70.0 (26.5) years (range: 28-97 years)). Sepsis and mortality occurred only in the EC group (48.1% and 11.1%, respectively). The univariate analysis of predisposing factors revealed that age, DM, HTN, CVA, CKD, and NB were significantly associated with EC. In the multivariate analysis, DM (OR, 6.251; 95% CI, 2.254-17.250; p < 0.001), CKD (OR, 18.439; 95% CI, 3.421-99.404; p = 0.001), NB (OR, 7.374; 95% CI, 1.993-27.285; p = 0.003) were associated with EC. Conclusions: The results of this study revealed that DM, CKD, and NB were significant risk factors for EC. The tendency toward sepsis and high mortality underscore the need for careful observation while treating patients with EC with the risk noted above.
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Affiliation(s)
- Jeonghyouk Choi
- Department of Urology, College of Medicine, Kyung Hee University, Seoul 02447, Korea; (J.C.); (S.-H.L.)
| | - Seung-Kwon Choi
- Department of Urology, Seoul Medical Center, Seoul 02053, Korea;
| | - Sang-Hyub Lee
- Department of Urology, College of Medicine, Kyung Hee University, Seoul 02447, Korea; (J.C.); (S.-H.L.)
| | - Koo-Han Yoo
- Department of Urology, College of Medicine, Kyung Hee University, Seoul 02447, Korea; (J.C.); (S.-H.L.)
- Correspondence:
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24
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Davidson PJ, McGeoch G, Shand B. Assessment of a clinical pathway for investigation of haematuria that reduces the need for cystoscopy. N Z Med J 2020; 133:71-82. [PMID: 33332329] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/12/2023]
Abstract
AIM To evaluate prospectively a clinical pathway for investigation of haematuria that involves an initial screening using a urinary biomarker of bladder cancer (Cxbladder Triage™ (CxbT)) in combination with either a renal ultrasound or a computed tomography imaging. Only test-positive patients are referred for specialist assessment and flexible cystoscopy. METHODS The clinical outcomes of 884 patients with haematuria who presented to their general practitioner were reviewed. Outcome measurements included the findings of laboratory tests, imaging, cystoscopies, specialist assessment and histology. RESULTS Forty-eight transitional cell carcinomas (TCC) and three small cell carcinomas were diagnosed in the study cohort. The clinical pathway missed a solitary, small, low-risk TCC. When combined, imaging and CxbT had a sensitivity of 98.1% and a negative predictive value of 99.9% to detect a bladder cancer. Follow-up for a median of 21 months showed no further new cases of bladder cancer had occurred in the patient cohort. Review of all new bladder cancers diagnosed in the 15 months following the study showed that none had been missed by haematuria assessment using the clinical pathway. CONCLUSIONS The combination of CxbT and imaging reliably identifies patients with haematuria who can be managed safely in primary care without the need for a secondary care referral and a flexible cystoscopy.
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Affiliation(s)
- Peter J Davidson
- Urologist, Department of Urology, Christchurch Hospital, Christchurch
| | - Graham McGeoch
- Clinical Leader, Canterbury Initiative, Canterbury District Health Board, Christchurch
| | - Brett Shand
- Clinical Writer and Analyst, Canterbury Initiative, Canterbury District Health Board, Christchurch
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25
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Zwaans BMM, Nicolai HE, Chancellor MB, Lamb LE. Prostate cancer survivors with symptoms of radiation cystitis have elevated fibrotic and vascular proteins in urine. PLoS One 2020; 15:e0241388. [PMID: 33119677 PMCID: PMC7595289 DOI: 10.1371/journal.pone.0241388] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2020] [Accepted: 10/13/2020] [Indexed: 01/22/2023] Open
Abstract
Radiation for pelvic cancers can result in severe bladder damage and radiation cystitis (RC), which is characterized by chronic inflammation, fibrosis, and vascular damage. RC development is poorly understood because bladder biopsies are difficult to obtain. The goal of this study is to gain understanding of molecular changes that drive radiation-induced cystitis in cancer survivors using urine samples from prostate cancer survivors with history of radiation therapy. 94 urine samples were collected from prostate cancer survivors with (n = 85) and without (n = 9) history of radiation therapy. 15 patients with radiation history were officially diagnosed with radiation cystitis. Levels of 47 different proteins were measured using Multiplex Luminex. Comparisons were made between non-irradiated and irradiated samples, and within irradiated samples based on radiation cystitis diagnosis, symptom scores or hematuria. Statistical analysis was performed using Welch’s t-test. In prostate cancer survivors with history of radiation therapy, elevated levels of PAI 1, TIMP1, TIMP2, HGF and VEGF-A were detected in patients that received a radiation cystitis diagnosis. These proteins were also increased in patients suffering from hematuria or high symptom scores. No inflammatory proteins were detected in the urine, except in patients with gross hematuria and end stage radiation cystitis. Active fibrosis and vascular distress is detectable in the urine through elevated levels of associated proteins. Inflammation is only detected in urine of patients with end-stage radiation cystitis disease. These results suggest that fibrosis and vascular damage drive the development of radiation cystitis and could lead to the development of more targeted treatments.
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Affiliation(s)
- Bernadette M. M. Zwaans
- Department of Urology, William Beaumont Hospital, Royal Oak, Michigan, United States of America
- Oakland University William Beaumont School of Medicine, Rochester, Michigan, United States of America
| | - Heinz E. Nicolai
- Departamento de Urología, Universidad de Chile, Santiago, Chile
- Hospital Clínico San Borja Arriarán, Santiago, Chile
| | - Michael B. Chancellor
- Department of Urology, William Beaumont Hospital, Royal Oak, Michigan, United States of America
- Oakland University William Beaumont School of Medicine, Rochester, Michigan, United States of America
| | - Laura E. Lamb
- Department of Urology, William Beaumont Hospital, Royal Oak, Michigan, United States of America
- Oakland University William Beaumont School of Medicine, Rochester, Michigan, United States of America
- * E-mail:
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26
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Hayashi T, Fujita K, Hayashi Y, Hatano K, Kawashima A, McConkey DJ, Nonomura N. Mutational Landscape and Environmental Effects in Bladder Cancer. Int J Mol Sci 2020; 21:ijms21176072. [PMID: 32842545 PMCID: PMC7503658 DOI: 10.3390/ijms21176072] [Citation(s) in RCA: 17] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2020] [Revised: 08/20/2020] [Accepted: 08/21/2020] [Indexed: 12/23/2022] Open
Abstract
Bladder cancer is the most common cancer of the urinary tract. Although nonmuscle-invasive bladder cancers have a good prognosis, muscle-invasive bladder cancers promote metastases and have a poor prognosis. Comprehensive analyses using RNA sequence of clinical tumor samples in bladder cancer have been reported. These reports implicated the candidate genes and pathways that play important roles in carcinogenesis and/or progression of bladder cancer. Further investigations for the function of each mutation are warranted. There is suggestive evidence for several environmental factors as risk factors of bladder cancer. Environmental factors such as cigarette smoking, exposure to chemicals and gases, bladder inflammation due to microbial and parasitic infections, diet, and nutrition could induce several genetic mutations and alter the tumor microenvironment, such as immune cells and fibroblasts. The detailed mechanism of how these environmental factors induce carcinogenesis and/or progression of bladder cancer remains unclear. To identify the relationship between the mutations and the lifestyle could be useful for prevention and treatment of bladder cancer.
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Affiliation(s)
- Takuji Hayashi
- Department of Urology, Graduate School of Medicine, Osaka University, 2-2 Yamada-oka, Suita, Osaka 565-0871, Japan; (T.H.); (Y.H.); (K.H.); (A.K.); (N.N.)
- Greenberg Bladder Cancer Institute, Johns Hopkins University School of Medicine, Baltimore, MA 21287-2101, USA;
| | - Kazutoshi Fujita
- Department of Urology, Graduate School of Medicine, Osaka University, 2-2 Yamada-oka, Suita, Osaka 565-0871, Japan; (T.H.); (Y.H.); (K.H.); (A.K.); (N.N.)
- Department of Urology, Faculty of Medicine, Kindai University, Ohno-higashi, Osakasayama, Osaka 589-8511, Japan
- Correspondence: ; Tel.: +81-6-6879-3531; Fax: +81-6-6879-3539
| | - Yujiro Hayashi
- Department of Urology, Graduate School of Medicine, Osaka University, 2-2 Yamada-oka, Suita, Osaka 565-0871, Japan; (T.H.); (Y.H.); (K.H.); (A.K.); (N.N.)
| | - Koji Hatano
- Department of Urology, Graduate School of Medicine, Osaka University, 2-2 Yamada-oka, Suita, Osaka 565-0871, Japan; (T.H.); (Y.H.); (K.H.); (A.K.); (N.N.)
| | - Atsunari Kawashima
- Department of Urology, Graduate School of Medicine, Osaka University, 2-2 Yamada-oka, Suita, Osaka 565-0871, Japan; (T.H.); (Y.H.); (K.H.); (A.K.); (N.N.)
| | - David J. McConkey
- Greenberg Bladder Cancer Institute, Johns Hopkins University School of Medicine, Baltimore, MA 21287-2101, USA;
| | - Norio Nonomura
- Department of Urology, Graduate School of Medicine, Osaka University, 2-2 Yamada-oka, Suita, Osaka 565-0871, Japan; (T.H.); (Y.H.); (K.H.); (A.K.); (N.N.)
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Xiao N, Tang R, Ge B, Zhao H, Wang J. Poor bladder compliance due to malacoplakia with xanthogranulomatous cystitis: A case report. Medicine (Baltimore) 2020; 99:e20852. [PMID: 32590783 PMCID: PMC7328967 DOI: 10.1097/md.0000000000020852] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
Abstract
RATIONALE Either malacoplakia or xanthogranulomatous cystitis (XC) is a rare chronic infection disease of urinary bladder, which often mimics bladder masses undifferentiated from malignance and results in severe lower urinary tract symptoms. The malacoplakia combined with XC is even rarer in the literature. PATIENT CONCERNS A 64-year-old female, who presented with nocturia, frequency of micturition, severe urgency with occasional urinary incontinence, and recurrent hematuria for >2 years, was diagnosed with azotemia and anemia. In addition, two 1.0 × 1.0 cm masses of bladder were detected by computer tomography. DIAGNOSES Malacoplakia combined with xanthogranulomas cystitis was diagnosed histologically. Video urodynamic test showed poor bladder compliance (9 mL/comH2O), markedly decreased maximum bladder capacity (120 mL), and right vesicoureteral reflux at a low intravesical pressure level (25 cmH2O). INTERVENTIONS Transurethral resection of bladder masses was carried out after treatment of urinary infection by intravenous piperacillin-tazobactam. Oral Ciprofloxacin and Tolterodine were postoperatively used to prevent recurrent lower urinary tract infections and alleviate detrusor overactivity. OUTCOMES The treatment did not alleviate azotemia, frequency, urgency with incontinence, and bilateral hydroureteronephrosis, but the patient refused to undergo bladder augmentation on account of her poor economic status. LESSONS Malacoplakia or/and xanthogranulomas cystitis may lead to poor bladder compliance and video urodynamic study should be considered in patients with refractory chronic lower urinary tract symptoms.
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Affiliation(s)
- Ning Xiao
- Department of Urology, The Second Affiliated Hospital of GuiLin Medical University, Guilin
- Continence Research Clinic, The Central Hosptial of Shaoyang, Shaoyang, China
| | - RongYu Tang
- Continence Research Clinic, The Central Hosptial of Shaoyang, Shaoyang, China
| | - Bo Ge
- Department of Urology, The Second Affiliated Hospital of GuiLin Medical University, Guilin
| | - HuaSheng Zhao
- Continence Research Clinic, The Central Hosptial of Shaoyang, Shaoyang, China
| | - JianFeng Wang
- Continence Research Clinic, The Central Hosptial of Shaoyang, Shaoyang, China
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Abstract
Urinary tract infections (UTIs) in children are among the most common bacterial infections in childhood. They are equally common in boys and girls during the first year of life and become more common in girls after the first year of life. Dividing UTIs into three categories; febrile upper UTI (acute pyelonephritis), lower UTI (cystitis), and asymptomatic bacteriuria, is useful for numerous reasons, mainly because it helps to understand the pathophysiology of the infection. A single episode of febrile UTI is often caused by a virulent Escherichia coli strain, whereas recurrent infections and asymptomatic bacteriuria commonly result from urinary tract malformations or bladder disturbances. Treatment of an upper UTI needs to be broad and last for 10 days, a lower UTI only needs to be treated for 3 days, often with a narrow-spectrum antibiotic, and asymptomatic bacteriuria is best left untreated. Investigations of atypical and recurrent episodes of febrile UTI should focus on urinary tract abnormalities, whereas in cases of cystitis and asymptomatic bacteriuria the focus should be on bladder function.
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Affiliation(s)
- Kjell Tullus
- Renal Unit, Great Ormond Street Hospital for Children, London, UK.
| | - Nader Shaikh
- Children's Hospital of Pittsburgh, Pittsburgh, PA, USA
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Chávez-Valencia V, Orizaga-de-La-Cruz C, Aguilar-Bixano O, Lagunas-Rangel FA. Coexistence of emphysematous cystitis and bilateral emphysematous pyelonephritis: a case report and review of the literature. CEN Case Rep 2020; 9:313-317. [PMID: 32328853 DOI: 10.1007/s13730-020-00479-5] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2019] [Accepted: 04/12/2020] [Indexed: 01/04/2023] Open
Abstract
Emphysematous pyelonephritis (EPN) is a necrotizing infection characterized by the production of gas in the renal parenchyma, collecting system or perirenal tissue. Meanwhile, emphysematous cystitis (EC) is a clinical entity characterized by the presence of gas inside and around the bladder wall. Interestingly, although both diseases are common in patients with diabetes mellitus, these are rarely combined. We report a rare case of a 56-year-old diabetic male suffering from fever, headache and vomiting and in which a diagnosis of septic shock was established due to coexistence of EC and bilateral EPN. The emphysematous diseases improved with a conservative treatment approach using antibiotic therapy and glycemic control, we highlight that the nephrectomy was not necessary in our patient despite the fact that he presented risk factors that predict the failure of conservative treatment.
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Affiliation(s)
- Venice Chávez-Valencia
- Department of Nephrology, Hospital General Regional Hospital No 1, Instituto Mexicano del Seguro Social, Bosques de los Olivos No. 101. Av. La Goleta Mpo Charo, CP: 61301, Morelia, Michoacán, Mexico.
| | - Citlalli Orizaga-de-La-Cruz
- Department of Nephrology, Hospital General Regional Hospital No 1, Instituto Mexicano del Seguro Social, Bosques de los Olivos No. 101. Av. La Goleta Mpo Charo, CP: 61301, Morelia, Michoacán, Mexico
| | - Omar Aguilar-Bixano
- Department of Nephrology, Hospital General Regional Hospital No 1, Instituto Mexicano del Seguro Social, Bosques de los Olivos No. 101. Av. La Goleta Mpo Charo, CP: 61301, Morelia, Michoacán, Mexico
| | - Francisco Alejandro Lagunas-Rangel
- Department of Genetics and Molecular Biology, Centro de Investigación y de Estudios Avanzados del Instituto Politécnico Nacional (CINVESTAV), Mexico, Mexico
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Nausch B, Pace S, Pein H, Koeberle A, Rossi A, Künstle G, Werz O. The standardized herbal combination BNO 2103 contained in Canephron ® N alleviates inflammatory pain in experimental cystitis and prostatitis. Phytomedicine 2019; 60:152987. [PMID: 31257118 DOI: 10.1016/j.phymed.2019.152987] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/03/2019] [Revised: 06/03/2019] [Accepted: 06/08/2019] [Indexed: 06/09/2023]
Abstract
BACKGROUND Urinary tract infections are among the most common types of infections and give rise to inflammation with pain as one of the main symptoms. The herbal medicinal product Canephron® N contains BNO 2103, a defined mixture of pulverized rosemary leaves, centaury herb, and lovage root, and has been used in the treatment of urinary tract infections for more than 25 years. PURPOSE To test the hypothesis that BNO 2103 reduces pain in cystitis and prostatitis by virtue of anti-inflammatory properties, and to reveal potential mechanisms underlying the anti-inflammatory features. STUDY DESIGN BNO 2103 was studied for anti-inflammatory and analgesic properties in three animal models in vivo, and the mode of action underlying the anti-inflammatory features was investigated in human leukocytes and cell-free assays in vitro. METHODS To assess the anti-inflammatory and analgesic efficacy of BNO 2103 we employed cyclophosphamide-induced cystitis and carrageenan-induced prostatitis in rats, and zymosan-induced peritonitis in mice. Human neutrophils and monocytes as well as isolated human 5-lipoxygenase and microsomal prostaglandin E2 synthase-1-containing microsomes were utilized to assess inhibition of leukotriene and/or prostaglandin E2 production by HPLC and/or ELISA. RESULTS When given orally, BNO 2103 reduced inflammation and hyperalgesia in experimental cystitis in rats, while individual components of BNO 2103 also reduced hyperalgesia. Furthermore, BNO 2103 reduced hyperalgesia in rats with carrageenan-induced prostatitis. Cell-based and cell-free studies implicate inhibition of prostaglandin E2 and leukotriene B4 biosynthesis as potential mechanisms underlying the analgesic and anti-inflammatory effects. CONCLUSION Our data support the hypothesis that BNO 2103 reduces pain by virtue of its anti-inflammatory properties, possibly related to suppression of prostaglandin E2 and leukotriene B4 formation, and suggest that this combination has the potential to treat clinical symptoms such as inflammatory pain. Thus BNO 2103 may represent an alternative to reduce the use of antibiotics in urinary tract infections.
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Affiliation(s)
- Bernhard Nausch
- Bionorica SE, Kerschensteinerstrasse 11-15, 92318 Neumarkt, Germany.
| | - Simona Pace
- Department of Pharmaceutical/Medicinal Chemistry, Institute of Pharmacy, Friedrich-Schiller-University Jena, Philosophenweg 14, 07743 Jena, Germany
| | - Helmut Pein
- Department of Pharmaceutical/Medicinal Chemistry, Institute of Pharmacy, Friedrich-Schiller-University Jena, Philosophenweg 14, 07743 Jena, Germany
| | - Andreas Koeberle
- Department of Pharmaceutical/Medicinal Chemistry, Institute of Pharmacy, Friedrich-Schiller-University Jena, Philosophenweg 14, 07743 Jena, Germany
| | - Antonietta Rossi
- Department of Pharmacy, School of Medicine, University of Naples Federico II, Via D. Montesano 49, I-80131 Naples, Italy
| | - Gerald Künstle
- Bionorica SE, Kerschensteinerstrasse 11-15, 92318 Neumarkt, Germany
| | - Oliver Werz
- Department of Pharmaceutical/Medicinal Chemistry, Institute of Pharmacy, Friedrich-Schiller-University Jena, Philosophenweg 14, 07743 Jena, Germany.
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31
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Kurz M. [Macrohaematuria in Anticoagulated Patients]. Praxis (Bern 1994) 2019; 108:279-282. [PMID: 30890085 DOI: 10.1024/1661-8157/a003229] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/09/2023]
Abstract
Macrohaematuria in Anticoagulated Patients Abstract. Macrohaematuria should always be clarified as a symptom, regardless of whether anticoagulation exists. The most common causes are haemorrhagic cystitis and in men prostate hyperplasia. The most important other differential diagnoses are urothelial carcinoma and urolithiasis. Primary diagnostics include a rapid urine test, urine culture and sonography of the urinary tract. The complete examination is performed by cystoscopy and computer tomography. Coagulation should always be checked. Light bleeding can be clarified urologically on an outpatient basis, while patients with haemodynamically relevant and/or tamponing haemorrhages should always be admitted on an inpatient basis. Anticoagulated, bleeding patients also require the full attention of urologists, internists and anaesthetists due to the underlying internal diseases.
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Affiliation(s)
- Michael Kurz
- 1 Facharztpraxis für Urologie, speziell operative Urologie, Zürich
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32
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Ko K, Lee WK, Oh CY, Lee SH, Cho ST, Bang WJ, Shin TY, Choo MS, Cho JS, Lee YG, Yang DY. Is A Combination of Antibiotics and Non-Steroidal Anti-Inflammatory Drugs More Beneficial Than Antibiotic Monotherapy For The Treatment of Female Acute Uncomplicated Cystitis? A Randomized Controlled Pilot Study. Urol J 2018; 15:365-369. [PMID: 30221336 DOI: 10.22037/uj.v0i0.3716] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
Purpose: To compare the efficacy of non-steroidal anti-inflammatory drugs (NSAIDs) combination therapy to single-agent antibiotic therapy for the resolution of symptoms during two restricted activity days in patients with acute uncomplicated cystitis (AUC)Materials and Methods: We performed a prospective, randomized control pilot study. A total of 55 patients were enrolled. Group I (n=28) was treated with cepodoxime (100 mg twice per day), and Group II (n=27) was treated with cepodoxime (100 mg) and aceclofenac (100 mg) twice per day; both groups were treated for three days. Upon dysuria after each administration, the participants entered a value on a numerical pain scale. The primary outcome was whether there were any differences in the decrease rate in pain scale between the two groups.Result: The average age of the 55 patients was 49.9 ± 13.5 years, and prior to the clinical visit, the patients ex-perienced an average of 2.4 ± 2.2 days of dysuria symptoms. The average numerical pain scale score for dysuria was 4.98 ± 2.18. Thirty-four patients (61.8%) showed positive culture results, and E. coli was the most commonly found bacteria, cultured in 32 patients.Fifty-one patients visited the clinic on day 7, and 42 (76.4%) reported symptom improvement, while nine patients (16.3%) had persistent symptoms. The follow-up numerical pain score was 0.39 ± 1.02 points. The pain score was dramatically decreased after medication. No difference was observed in the magnitude of the pain scale reduction between the two groups (P = 0.134). However, group II showed faster symptom resolution (P = 0.035) at the third administration (day 1.5).Conclusion: Combination therapy with NSAIDs and antibiotics for AUC patients can improve symptoms faster during two restricted activity days when patients have difficulty performing daily living activities.
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Affiliation(s)
- Kyungtae Ko
- Department of Urology, Hallym University Kangdong Sacred Heart Hospital, Seoul, Korea.
| | - Won Ki Lee
- Department of Urology, Hallym University Chuncheon Sacred Heart Hospital, Chuncheon, Korea
| | - Cheol Young Oh
- Department of Urology, Hallym University Hallym Sacred Heart Hospital, Gyeonggi, Korea
| | - Seong Ho Lee
- Department of Urology, Hallym University Dongtan Sacred Heart Hospital, Hwaseong, Korea
| | - Sung Tae Cho
- Department of Urology, Hallym University Kangnam Sacred Heart Hospital, Seoul, Korea
| | - Woo Jin Bang
- Department of Urology, Hallym University Hallym Sacred Heart Hospital, Gyeonggi, Korea
| | - Tae Young Shin
- Department of Urology, Hallym University Chuncheon Sacred Heart Hospital, Chuncheon, Korea
| | - Min Soo Choo
- Department of Urology, Hallym University Chuncheon Sacred Heart Hospital, Chuncheon, Korea
| | - Jin Seon Cho
- Department of Urology, Hallym University Dongtan Sacred Heart Hospital, Hwaseong, Korea
| | - Young Goo Lee
- Department of Urology, Hallym University Hallym Sacred Heart Hospital, Gyeonggi, Korea
| | - Dae Yul Yang
- Department of Urology, Hallym University Kangdong Sacred Heart Hospital, Seoul, Korea
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Yang CC, Miller JL, Omidpanah A, Krieger JN. Physical Examination for Men and Women With Urologic Chronic Pelvic Pain Syndrome: A MAPP (Multidisciplinary Approach to the Study of Chronic Pelvic Pain) Network Study. Urology 2018; 116:23-29. [PMID: 29604315 PMCID: PMC6237096 DOI: 10.1016/j.urology.2018.03.021] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2018] [Revised: 03/12/2018] [Accepted: 03/20/2018] [Indexed: 11/17/2022]
Abstract
OBJECTIVE To examine the feasibility of implementing a standardized, clinically relevant genitourinary examination for both men and women, and to identify physical examination findings characteristic of urologic chronic pelvic pain syndrome (UCPPS). MATERIALS AND METHODS This study analyzed 2 samples: men and women with UCPPS who participated in the Multidisciplinary Approach to the Study of Chronic Pelvic Pain (MAPP) Research Network Epidemiology and Phenotyping (EP) Study, and age-matched controls who were either positive for chronic fatigue syndrome or healthy (pain-free). We compared physical examination findings in both positive and healthy controls with UCPPS cases: findings from both the EP examinations and from an extended genitourinary examination. RESULTS EP and extended examinations were performed on 143 participants: 62 UCPPS cases (30 women, 32 men), 42 positive controls (15 women, 27 men), and 39 healthy controls (22 women, 17 men). EP examinations showed that pelvic floor tenderness was more prevalent in cases (55.0%) than in positive (14.6%) or healthy controls (10.5%). Extended examinations revealed specific areas of tenderness in the pelvic floor musculature. Cases were also more likely than healthy controls to report tenderness in multiple areas, including suprapubic, symphysis pubis, and posterior superior iliac spine, and on bimanual examination. No comparative findings were specific to biological sex, and no evidence of pudendal neuropathy was observed on extended examination of cases or controls. CONCLUSION The extended genitourinary examination is an easily administered addition to the assessment of men and women during evaluation for UCPPS. Physical findings may help to better categorize patients with UCPPS into clinically relevant subgroups for optimal treatment.
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Affiliation(s)
- Claire C Yang
- Department of Urology, University of Washington, Seattle, WA.
| | - Jane L Miller
- Department of Urology, University of Washington, Seattle, WA
| | - Adam Omidpanah
- Initiative for Research and Education to Advance Community Health (IREACH), Washington State University, Seattle, WA
| | - John N Krieger
- Department of Urology, University of Washington, Seattle, WA
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El-Aaser AA, El-Merzabani MM, El-Bolkainy MN, Ibrahim AS, Zakhary NI, El-Morsi B. A Study on the Etiological Factors of Bilharzial Bladder Cancer in Egypt: 5-Urinary Nitrite in a Rural Population. Tumori 2018; 66:409-14. [PMID: 7414706 DOI: 10.1177/030089168006600401] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Urinary nitrite was present in 5.6 % of 2379 individuals from a rural population infested with « Schistosoma haematobium ». A higher frequency was observed in symptomatic patients with active bilharzial cystitis (25 %) and patients with bladder cancer associated with schistosomiasis (66.2 %); conversely, urinary nitrite was absent in normal urban individuals. The frequency of urinary nitrite was higher in females (6.4%) than males (4.6%), and was more frequent in adults than extremes of age. The presence of urinary nitrite was associated with urinary infection and was commonly accompaned by cellular atypia in urine, in the form of dysplasia. Under these circumstances, carcinogenic nitrosamines are liable to be produced in the bladder from urinary nitrite and amines. These observation support the possible role of urinary bacterial infection, commonly associated with bilharzial cystitis, in bladder carcinogenesis.
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35
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Slesarevskaya MN, Kuzmin IV, Al-Shukri SK. [NefroCAPS phytolysin in complex management of women with chronic recurrent cystitis]. Urologiia 2018:30-34. [PMID: 29634131] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/08/2023]
Abstract
RELEVANCE Recurrent lower urinary tract infections (UTI) in women are one of the most challenging problems of modern urology, which is associated both with their high incidence and increasing resistance of uropathogens to antibacterial drugs. Due to this fact, the phytotherapy of infectious and inflammatory diseases of the urinary tract has received increased attention. AIM To investigate the effectiveness of Phytolysin nefroCAPS in the complex management of women with chronic recurrent cystitis. MATERIALS AND METHODS 50 women with chronic recurrent cystitis underwent a complex examination. They were divided into two groups depending on the treatment they received. Patients of the 1st group (n=27) received a combination therapy: fosfomycin (monural) 3 g (single dose) and Phytolysin nefroCAPS one capsule three times daily for three months. Patients of the 2nd group (n=23) were administered a single 3-g dose of fosfomycin (monural). RESULTS Follow-up examinations were performed 1, 3 and six months after initiation of the treatment. In patients of the 1st group, clinical manifestations of the disease disappeared earlier, and they had fewer recurrences than the patients of the 2nd group. Also, bacteriological study of urine showed a more persistent antimicrobial effect among patients of the 1st group. CONCLUSION In patients with chronic recurrent cystitis, plant-based preparation Phytolysin nefroCAPS administered concurrently with an antibacterial drug is more effective than antibiotic monotherapy.
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Affiliation(s)
- M N Slesarevskaya
- Department of Urology, First Pavlov State Medical University of St. Petersburg, St. Petersburg, Russia
| | - I V Kuzmin
- Department of Urology, First Pavlov State Medical University of St. Petersburg, St. Petersburg, Russia
| | - S Kh Al-Shukri
- Department of Urology, First Pavlov State Medical University of St. Petersburg, St. Petersburg, Russia
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36
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Biogeau J, Lamandé M, Ripault H, Léger I, Dardaine-Giraud V. [Emphysematous cystitis: Report of one case]. Rev Med Interne 2018; 39:192-194. [PMID: 29395295 DOI: 10.1016/j.revmed.2017.12.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2017] [Revised: 12/02/2017] [Accepted: 12/28/2017] [Indexed: 11/18/2022]
Abstract
INTRODUCTION Emphysematous cystitis is a rare urinary tract infection characterized by gas in the bladder wall and lumen. CASE REPORT We report a 92-year-old women admitted with confusion and abdominal pain without fever. Her past medical history included diabetes, urinary incontinence, high blood pressure and mild cognitive impairment. A computed tomography scan (CT scan) revealed emphysematous cystitis. The patient completely recovered within ten days. The main characteristics and the treatment of this uncommon disorder are presented. CONCLUSION Clinicians should be aware of this diagnosis: early management is essential to reduce morbidity and mortality.
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Affiliation(s)
- J Biogeau
- Service de soins de suite et réadaptation gériatrique, CHRU de Tours, CHU de Tours, 2, allée Gaston-Pagès, 37100 Tours, France.
| | - M Lamandé
- Service de soins de suite et réadaptation gériatrique, CHRU de Tours, CHU de Tours, 2, allée Gaston-Pagès, 37100 Tours, France
| | - H Ripault
- Service de soins de suite et réadaptation gériatrique, CHRU de Tours, CHU de Tours, 2, allée Gaston-Pagès, 37100 Tours, France
| | - I Léger
- Service de soins de suite et réadaptation gériatrique, CHRU de Tours, CHU de Tours, 2, allée Gaston-Pagès, 37100 Tours, France
| | - V Dardaine-Giraud
- Service de soins de suite et réadaptation gériatrique, CHRU de Tours, CHU de Tours, 2, allée Gaston-Pagès, 37100 Tours, France
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37
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Hadzik-Błaszczyk M, Zielonka TM, Krupa R, Rusinowicz T, Życińska K. [Emphysematous cystitis in a patient with type-1diabetes mellitus - diagnostic difficulties]. Wiad Lek 2018; 71:1424-1428. [PMID: 30448821] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/09/2023]
Abstract
A case report of 28 year old female with medical history of bed controlled type 1 diabetes mellitus complicated by autonomic neuropathy in the form of gastroparesis, suffered by emphysematous cystitis caused by Escherichia coli was described. Emphysematous cystitis is a rare urinary tract infection connected with the presence of gas in the bladder lumen or/and within the bladder wall, which occurs mainly in women, in older age, suffering from type 2 diabetes, complicated by microangiopathy, neuropathy, with urinary tract obstruction and weakness of immunity system. Diagnostic difficulties and the delay in correct diagnosis in described case were caused by the dominated complaint of the upper gastrointestinal tract and difficulties in interpretation of imaging methods, such as abdominal X-ray and ultrasound scan. Eventually the use of computed tomography allowed to achieved an accurate diagnosis and choose appropriate treatment. It is possible that this is the first case of emphysematous cystitis described in Poland.
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Affiliation(s)
| | - Tadeusz M Zielonka
- Katedra I Zakład Medycyny Rodzinnej, Warszawski Uniwersytet Medyczny, Warszawa, Polska
| | - Renata Krupa
- Katedra I Zakład Medycyny Rodzinnej, Warszawski Uniwersytet Medyczny, Warszawa, Polska
| | - Tomasz Rusinowicz
- Katedra I Zakład Medycyny Rodzinnej, Warszawski Uniwersytet Medyczny, Warszawa, Polska
| | - Katarzyna Życińska
- Katedra I Zakład Medycyny Rodzinnej, Warszawski Uniwersytet Medyczny, Warszawa, Polska
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Abstract
INTRODUCTION Spontaneous rupture of the urinary bladder is a rare, difficult to diagnose surgical emergency with a high mortality, there are many causes for spontaneous rupture of the urinary bladder, but we only found 2 reports on this condition in our literature search. A 36-year-old male patient was admitted with "whole abdominal pain associated with hematuria for 5 hours." Our patient did not have a history of definite allergy, but a long-term history of alcohol abuse. This patient was followed up for 1 year, and the cystoscopy recheck showed that the bladder lesion had healed. CONCLUSIONS Since eosinophilic cystitis is associated with long-term alcohol consumption, we recommended that the patient should stop drinking and taking antihistamines.
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Affiliation(s)
| | - Guangyuan Zhang
- School of Medicine, Southeast University
- Department of Urology Surgery, Zhongda Hospital, Southeast University, Nanjing, China
| | - Lei Zhang
- School of Medicine, Southeast University
- Department of Urology Surgery, Zhongda Hospital, Southeast University, Nanjing, China
| | - Chao Sun
- School of Medicine, Southeast University
- Department of Urology Surgery, Zhongda Hospital, Southeast University, Nanjing, China
| | - Ning Liu
- School of Medicine, Southeast University
- Department of Urology Surgery, Zhongda Hospital, Southeast University, Nanjing, China
| | - Ming Chen
- School of Medicine, Southeast University
- Department of Urology Surgery, Zhongda Hospital, Southeast University, Nanjing, China
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Spivak LG, Enikeev DV, Platonova DV. [Experience of using phytolysin in combination therapy of chronic cystitis in patients with urate nephrolythisis]. Urologiia 2017:32-36. [PMID: 28952689] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/07/2023]
Abstract
AIM To evaluate the effectiveness of the herbal preparation Phytolysin in the comprehensive management of urate nephrolithiasis against the background of chronic cystitis exacerbation. MATERIALS AND METHODS The study comprised 21 patients aged 19 to 57; 11 of them (the study group) received ciprofloxacin 500 mg once daily for 7 days, Phytolysin (for 1 month) and Blemaren (for 3 months), while 10 patients of control group were treated with antibacterial therapy and Blemaren. The clinical evaluation of the patients included laboratory testing and ultrasound imaging. RESULTS The combination therapy resulted in a decrease in leukocyturia and bacteriuria. There was no tendency to relapse. The occurrence of relapse was identified by dysuria, urgent and frequent urination, suprapubic pain and results of laboratory testing (leukocyturia, bacteriuria >103) on days 15, 29, 57, 85 and 112 of the study. CONCLUSIONS The findings suggest that the use of Phytolysin can be an effective and safe way to prevent exacerbation of chronic cystitis in patients with urate nephrolithiasis.
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Affiliation(s)
- L G Spivak
- I.M. Sechenov First MSMU of Minzdrav of Russia, Moscow, Russia
| | - D V Enikeev
- I.M. Sechenov First MSMU of Minzdrav of Russia, Moscow, Russia
| | - D V Platonova
- I.M. Sechenov First MSMU of Minzdrav of Russia, Moscow, Russia
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Piraprez M, Ben Chehida M, Fillet M. [Case report : Emphysematous cystitis]. Rev Med Liege 2017; 72:384-387. [PMID: 28892312] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/07/2023]
Abstract
The emphysematous cystitis is a rare condition characterized by the presence of air in the wall and/or the bladder lumen. The clinical expression of this cystitis is variable. Some patients complain of abdominal pain or urinary symptoms. Other may present only pneumaturia or be totally asymptomatic. This condition is considered as potentially severe since it can lead to an emphysematous pyelonephritis with septicemia and septic shock. Peritonitis may also occur in case of necrosis and perforation of the bladder wall. However, this negative development can be avoided by a diagnosis and an early treatment, and the emphysematous cystitis become therefore of good prognosis. We are here stating the case of a patient with an emphysematous cystitis with symptoms of pneumaturia and lower urinary tract symptoms.
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Affiliation(s)
- M Piraprez
- Service d'Urologie, CHU de Liège, Site Sart Tilman, Liège, Belgique
| | - M Ben Chehida
- Service d'Urologie, CHU de Liège, Site Sart Tilman, Liège, Belgique
| | - M Fillet
- Service d'Urologie, CHU de Liège, Site Sart Tilman, Liège, Belgique
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Nolazco JI, González MI, Favre G, Gueglio G, Tejerizo JC. A case of emphysematous cystitis caused by Klebsiella pneumoniae. Can J Urol 2017; 24:8932-8933. [PMID: 28832314] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/07/2023]
Abstract
Emphysematous cystitis is a rare type of urinary tract infection that is characterized by air pockets within the bladder wall and lumen, which come from gas that is mainly produced by gram-negative bacteria, notably Escherichia coli. This infection is more common in older women with poorly controlled diabetes. An abdominal computerized tomography (CT) scan is the gold standard method to make the diagnosis. The infection can be life-threatening, so prompt treatment is essential. We present a case of a 39-year-old woman with poorly controlled type 2 diabetes who developed emphysematous cystitis after a bilateral adrenalectomy. The infection was diagnosed by a CT scan that revealed gas in the bladder wall. A urine culture revealed 106 colonies/mL of Klebsiella pneumoniae. After a month of treatment with intravenous antibiotics (vancomycin plus meropenem plus colistin), bladder drainage, and strict glycemic control, the patient had a good outcome.
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Saenko VS, Kapsargin FP, Pesegov SV, M V. [Troyakov. Experience in using hytolysin in the integrated management of urinary tract infections and methapylactics of nephrolithiasis]. Urologiia 2017; 3_2017:16-21. [PMID: 28845934 DOI: 10.18565/urol.2017.3.16-21] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/07/2023]
Abstract
RELEVANCE Urinary tract infection (UTI) are a risk factor for diseases leading to impairment of renal function and kidney stone disease (KSD). Growing resistance of uropathogens to antibacterial agents is a challenging issue in most countries of the world. Urolithiasis is the second most prevalent urologic condition following urinary tract infections and has a pronounced tendency to recur. Rational stone metaphylaxis leads to a significant reduction in the incidence of recurrent stones. In recent decades, there has been a markedly increasing interest in plant-based therapies in managing urologic diseases. AIM To evaluate the effectiveness of phytotherapeutic medication Phytolysin in the integrated management of UTI and metaphylaxis of urolithiasis. MATERIALS AND METHODS Comprehensive evaluation of the effectiveness of Phytolysin was conducted at the Department of Urology, I.M. Sechenov First MSMU and Department of Urology, Andrology and Sexology, Voino-Yasenetsky Krasnoyarsk SMU in 40 women with episodes of exacerbation of chronic cystitis and 30 patients of both sexes during the postoperative metaphylaxis of the KSD. The age of the patients ranged from 20 to 68 years (mean age 40+/-2,8 years). RESULTS Adding Phytolysin to the integrated management results in the improvement in general clinical signs and laboratory parameters of blood and urine, leads to a decrease in the level of leukocyturia, bacteriuria and an increase in diuresis and urinary alkalinization, reduces the number relapses of UTI and stone formation. CONCLUSION Phytolysin is an effective and safe medication.
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Affiliation(s)
- V S Saenko
- I.M. Sechenov First Moscow State Medical University of Minzdrav of Russia, Department of Urology, University Clinic of Urology 2, R.M. Fronshteyn Urology Clinic, Moscow, Russia
- Voino-Yasenetsky Krasnoyarsk State Medical University, Department of Urology, Andrology and Sexology, IPE, Krasnoyarsk, Russia
| | - F P Kapsargin
- I.M. Sechenov First Moscow State Medical University of Minzdrav of Russia, Department of Urology, University Clinic of Urology 2, R.M. Fronshteyn Urology Clinic, Moscow, Russia
- Voino-Yasenetsky Krasnoyarsk State Medical University, Department of Urology, Andrology and Sexology, IPE, Krasnoyarsk, Russia
| | - S V Pesegov
- I.M. Sechenov First Moscow State Medical University of Minzdrav of Russia, Department of Urology, University Clinic of Urology 2, R.M. Fronshteyn Urology Clinic, Moscow, Russia
- Voino-Yasenetsky Krasnoyarsk State Medical University, Department of Urology, Andrology and Sexology, IPE, Krasnoyarsk, Russia
| | - V M
- I.M. Sechenov First Moscow State Medical University of Minzdrav of Russia, Department of Urology, University Clinic of Urology 2, R.M. Fronshteyn Urology Clinic, Moscow, Russia
- Voino-Yasenetsky Krasnoyarsk State Medical University, Department of Urology, Andrology and Sexology, IPE, Krasnoyarsk, Russia
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Fan CY, Huang WY, Lin KT, Lin CS, Chao HL, Yang JF, Lin CL, Kao CH. Lower Urinary Tract Infection and Subsequent Risk of Prostate Cancer: A Nationwide Population-Based Cohort Study. PLoS One 2017; 12:e0168254. [PMID: 28046120 PMCID: PMC5207623 DOI: 10.1371/journal.pone.0168254] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2016] [Accepted: 11/08/2016] [Indexed: 12/28/2022] Open
Abstract
Purpose We investigated whether lower urinary tract infection (LUTI), including cystitis or urethritis, is associated with an increased risk of developing prostate cancer (PCa), in a nationwide population-based cohort study. Methods We identified 14,273 men newly diagnosed with LUTI (9347 with cystitis, and 4926 with urethritis) between 1998 and 2011, from the Taiwan Longitudinal Health Insurance Database 2000. Each patient was randomly frequency-matched with 4 men without LUTI, based on age and index year of diagnosis. Cox’s proportional hazard regression analysis was performed to estimate the effect of LUTI on the PCa risk. Results The risk of developing PCa was significantly higher in the cystitis cohort (adjusted HR = 1.46, 95% CI = 1.20–1.78) and in the urethritis cohort (adjusted HR = 1.72, 95% CI = 1.26–2.34) than in the group without LUTI. Further analyses indicated that patients with more than 5 medical visits for LUTI per year had a significantly greater risk of developing PCa. Conclusion We found that cystitis or urethritis may play an etiological role in the development of PCa in Taiwanese men, particularly in those with repeated medical visits for cystitis or urethritis. Further studies are warranted on the association between LUTI and PCa in other countries, particularly where the prevalence of PCa is high.
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Affiliation(s)
- Chao-Yueh Fan
- Department of Radiation Oncology, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan
| | - Wen-Yen Huang
- Department of Radiation Oncology, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan
- Institute of Clinical Medicine, National Yang-Ming University, Taipei, Taiwan
| | - Kuen-Tze Lin
- Department of Radiation Oncology, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan
| | - Chun-Shu Lin
- Department of Radiation Oncology, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan
| | - Hsing-Lung Chao
- Department of Radiation Oncology, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan
| | - Jen-Fu Yang
- Department of Radiation Oncology, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan
| | - Cheng-Li Lin
- Management Office for Health Data, China Medical University Hospital, Taichung, Taiwan
- College of Medicine, China Medical University, Taichung, Taiwan
| | - Chia-Hung Kao
- Graduate Institute of Clinical Medical Science and School of Medicine, College of Medicine, China Medical University, Taichung, Taiwan
- Department of Nuclear Medicine and PET Center, China Medical University Hospital, Taichung, Taiwan
- Department of Bioinformatics and Medical Engineering, Asia University, Taichung, Taiwan
- * E-mail:
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Buffington CAT, Westropp JL, Chew DJ, Bolus RR. Clinical evaluation of multimodal environmental modification (MEMO) in the management of cats with idiopathic cystitis. J Feline Med Surg 2016; 8:261-8. [PMID: 16616567 DOI: 10.1016/j.jfms.2006.02.002] [Citation(s) in RCA: 94] [Impact Index Per Article: 11.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/12/2006] [Indexed: 11/25/2022]
Abstract
This prospective observational study evaluated client-reported recurrence of lower urinary tract signs (LUTS) and other signs of abnormalities in cats with idiopathic cystitis after institution of multimodal environmental modification (MEMO). Forty-six client-owned indoor-housed cats with idiopathic cystitis, diagnosed based on a history of recurrent LUTS and evidence of absence of urolithiasis or bacterial urinary tract infection were studied. In addition to their usual care, clients were offered recommendations for MEMO based on a detailed environmental history. Cases were followed for 10 months by client contact to determine the effect of MEMO on LUTS and other signs. Significant ( P<0.05) reductions in LUTS, fearfulness, nervousness, signs referable to the respiratory tract, and a trend ( P<0.1) toward reduced aggressive behavior and signs referable to the lower intestinal tract were identified. These results suggest that MEMO is a promising adjunctive therapy for indoor-housed cats with LUTS, and should be followed up with prospective controlled clinical trials.
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Affiliation(s)
- C A Tony Buffington
- Department of Veterinary Clinical Sciences, The Ohio State University Veterinary Hospital, 601 Vernon L. Tharp Street, Columbus, OH 43210-1089, USA.
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Sinnott JD, Howlett DC. Urinary frequency and dysuria in an older woman. BMJ 2016; 354:i4587. [PMID: 27625371 DOI: 10.1136/bmj.i4587] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
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Noonan EM, Farrell TW. Primary Care of the Prostate Cancer Survivor. Am Fam Physician 2016; 93:764-770. [PMID: 27175954] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/05/2023]
Abstract
This summary of the American Cancer Society Prostate Cancer Survivorship Care Guidelines targets primary care physicians who coordinate care of prostate cancer survivors with subspecialists. Prostate cancer survivors should undergo prostate-specific antigen screening every six to 12 months and digital rectal examination annually. Surveillance of patients who choose watchful waiting for their prostate cancer should be conducted by a subspecialist. Any hematuria or rectal bleeding must be thoroughly evaluated. Prostate cancer survivors should be screened regularly for urinary incontinence and sexual dysfunction. Patients with predominant urge incontinence symptoms, which can occur after surgical and radiation treatments, may benefit from an anticholinergic agent. If there is difficulty with bladder emptying, a trial of an alpha blocker may be considered. A phosphodiesterase type 5 inhibitor can effectively treat sexual dysfunction following treatment for prostate cancer. Osteoporosis screening should occur before initiation of androgen deprivation therapy, and patients treated with androgen deprivation therapy should be monitored for anemia, metabolic syndrome, and vasomotor symptoms. Healthy lifestyle choices should be encouraged, including weight management, regular physical activity, proper nutrition, and smoking cessation. Primary care physicians should be vigilant for psychosocial distress, including depression, among prostate cancer survivors, as well as the potential impact of this distress on patients' family members and partners.
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Affiliation(s)
| | - Timothy W Farrell
- University of Utah School of Medicine and VA Salt Lake City Geriatric Research, Education, and Clinical Center, Salt Lake City, UT, USA
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Dhaliwal HS, Sekhon GS, Rai N, Nampoothiri RV. An unusual medical cause of abdominal pain diagnosed by urological abnormalities. Lancet 2016; 387:e25. [PMID: 26584736 DOI: 10.1016/s0140-6736(15)00806-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Affiliation(s)
- Harpal S Dhaliwal
- Department of Gastroenterology & Hepatology, GTBS (C) Hospital, Ludhiana, Punjab, India.
| | - G S Sekhon
- Department of Rheumatology, GTBS (C) Hospital, Ludhiana, Punjab, India
| | - Nitish Rai
- Department of Medicine, Postgraduate Institute of Medical Education and Research, Chandigarh, India
| | - Ram V Nampoothiri
- Department of Medicine, Postgraduate Institute of Medical Education and Research, Chandigarh, India
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Yamamichi G, Nakagawa M, Okusa T, Taniguchi A, Iwanishi T, Matsuzaki K, Tanigawa G, Tsutahara K, Imamura R, Takao T, Yamaguchi S. [Emphysematous Cystitis and Acute Focal Bacterial Nephritis: A Case Report]. Hinyokika Kiyo 2016; 62:99-103. [PMID: 27018414] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/05/2023]
Abstract
A 96-year-old woman was diagnosed with colitis in our hospital. Her past history was breast cancer and lung cancer but no diabetes mellitus. She suddenly complained of lower abdominal pain. Abdominal computed tomography (CT) revealed intramural gas in the bladder wall and multiple poor contrasting area in her right kidney, which suggested emphysematous cystitis and acute focal bacterial nephritis. Indwelling urethral catheter was performed for bladder drainage and the treatment with antibiotics started. Urine culture revealed Klebsiella pneumoniae and blood culture was negative. After 3 weeks, the abdominal CT confirmed the decrease of gas within the bladder wall and improvement of contrasting area in the right kidney.
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Affiliation(s)
| | | | - Takuya Okusa
- The Department of Urology, Osaka General Medical Center
| | | | | | | | - Go Tanigawa
- The Department of Urology, Osaka General Medical Center
| | | | | | - Tetsuya Takao
- The Department of Urology, Osaka General Medical Center
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Teles F, Santos LGDA, Tenório CEL, Marinho MR, Moraes SRDR, Câmara DDB, Santos RO, Lins CRU, Costa AFP. Lupus cystitis presenting with hidronephrosis and gastrointestinal
involvement. J Bras Nefrol 2016; 38:478-482. [PMID: 28001179 DOI: 10.5935/0101-2800.20160077] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/11/2015] [Accepted: 02/01/2016] [Indexed: 11/20/2022] Open
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