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Background: Severe infections caused by carbapenem-resistant Enterobacteriaceae (CRE) have mortality rate exceeding 50%. On the strength of this, this study sought to determine the prevalence of urinary tract infection (UTI) in pregnancy caused by CRE and associated risk factors in University of Calabar Teaching Hospital (UCTH), Nigeria, with the aim of making recommendations that can stem the tide of UTI caused by this bacterial strain in the hospital. Methodology: This was a descriptive cross-sectional study of 349 consecutively selected pregnant women attending antenatal clinic of UCTH, Calabar, Nigeria, between September 2020 and August 2021. Demographic/clinical data and risk factors were collected with semi-structured interviewer-administered questionnaire. Voided mid-stream urine (MSU) sample was collected from each participant and transported to the medical microbiology laboratory of the hospital for microbiological analysis using conventional culture and biochemical identification methods. Antimicrobial susceptibility test (AST) on each isolate was performed by the disk diffusion technique against selected antibiotics. Phenotypic carbapenemase production from presumptive carbapenem resistant isolates following AST was confirmed by the modified Hodge test (MHT). Data analysis was done on SPSS version 19.0. Association of risk factors with prevalence of UTI caused by CRE was determined using Chi square or Fisher Exact test, with p<0.05 considered statistically significant. Results: The prevalence of UTI among the pregnant women was 10.0% (35/349), with prevalence of 6.6% for Escherichia coli (23/349) and 3.5% (12/349) for Klebsiella pneumoniae. Antibiotic susceptibility test result showed that piperacillin-tazobactam was the most active antibiotic in vitro, with 82.9% isolates sensitive to it while sensitivity to imipenem (60.0%) and meropenem (40.0%) was low. A total 17 (48.6%) of the 35 isolates were resistant to carbapenems in the AST and 12 (34.3%) were carbapenemase-producing strains on MHT while 5 (14.3%) were non-carbapenemase-mediated resistance (NCMR). None of the demographic characteristics or risk factors analysed was significantly associated with UTI caused by CRE in the pregnant women (p>0.05). Conclusion: To stem the rising trend of UTIs in pregnancy caused by carbapenem resistant uropathogens, pregnant women receiving antenatal care in UCTH, Calabar should be routinely screened for UTI and offered appropriate treatment if indicated based on microbiological test results [ABSTRACT FROM AUTHOR] more...

Background: Urinary tract infection (UTI) is a common and sometime serious infectious disease diagnosed using conventional urine culture as the 'gold standard' for identifying Escherichia coli, the most common causative agent. However, due to the slow turn-around-time and other challenges of urine culture, this study explores the use of a novel biomolecular polymerase chain reaction (PCR) approach to detect the presence of haemolysin D gene (hlyD) that encodes a unique virulence factor of uropathogenic E. coli (UPEC) for its rapid identification in UTI. Methodology: Primers from UPEC CFT073 and non-pathogenic E. coli K-12 MG1655 strains provided by Nottingham Trent University, England, UK were used to investigate the presence of haemolysin D gene (hlyD) in UPEC. The hlyD primers were developed from hlyD with locus number C_RS01660 on UPEC CFT073 strain using the NCBI, virulence finder, and Island viewer, and used in a PCR assay to target the hlyD in UPEC. Three sets of PCR templates were designed (UPEC, E. coli, and "No template"), each with internal and external controls amplified in a multiplex PCR assay, and agarose gel electrophoresis was used to separate the amplicons, and determine the specificity of hlyD for UPEC. Results: The UPEC genome PCR assays were positive for hlyD and UPEC positive control, and similarly, PCR was positive for E. coli genome positive control, but negative for hlyD. Moreover, the "No template" PCR assay was clean with no amplification product, confirming the absence of PCR contaminations. Conclusion: The hlyD is a unique virulence gene specific for UPEC. PCR assay of this gene is a promising specific and rapid biomolecular diagnostic test that can overcome the limitations of the traditional approaches for detection of UPEC in UTI. [ABSTRACT FROM AUTHOR] more...

This work aimed to standardize and state" the insufficiencies outlined and variation in image quality, among some hospitals in Sudan for a common in specific radiologic examinations. A subjective evaluation of 1,103 image reproductions from "363 special radiologic procedures including Intravenous Urography (IVU), Hysterosalpingography (HSG), GIT barium studies" and Micturating Cystourethrography (MCUG), and the Entrance Air Surface Kerma (ESAK) values recorded for each procedure. The maximum scores ranged as Fully Acceptable; all anatomical structures were found to be i65.9 ±14.9, i53.2 ±21.4, i61.6 ±13.7, 53.2 ±28.86, 62.5 ±15.53 and 64.9 ±18.92 for IVU, voiding Cystourethrography, (barium swallow), (barium meal + barium followthrough), (barium enema) and HSG, respectively. In addition, the ESAK values recorded in this hospital survey were 1.9 ± 0.89, 1.85 ±0.48, 2.3 ± 0.85, and 2.1 ± 0.59 mGy for IVU, Voiding Cystourethrography, "Barium studies and HSG", respectively. The image criteria scoring systems (ICs) were found to be valuable and proposed to endorse in daily practice in the hospitals, and coupled the radiation dose to the patient to the required image quality. This study will help to standardize the image quality of some special examinations typically used in hospitals in Sudan. [ABSTRACT FROM AUTHOR] more...

Objective: Necrotizing enterocolitis (NEC) is the most prevalent gastrointestinal emergency in premature infants and is characterized by a dysfunctional gut microcirculation. Therefore, there is a dire need for in vivo methods to characterize NEC‐induced changes in the structure and function of the gut microcirculation, that is, its vascular phenotype. Since in vivo gut imaging methods are often slow and employ a single‐contrast mechanism, we developed a rapid multicontrast imaging technique and a novel analyses pipeline for phenotyping the gut microcirculation. Methods: Using an experimental NEC model, we acquired in vivo images of the gut microvasculature and blood flow over a 5000 × 7000 μm2 field of view at 5 μm resolution via the following two endogenous contrast mechanisms: intrinsic optical signals and laser speckles. Next, we transformed intestinal images into rectilinear "flat maps," and delineated 1A/V gut microvessels and their perfusion territories as "intestinal vascular units" (IVUs). Employing IVUs, we quantified and visualized NEC‐induced changes to the gut vascular phenotype. Results: In vivo imaging required 60–100 s per animal. Relative to the healthy gut, NEC intestines showed a significant overall decrease (i.e. 64–72%) in perfusion, accompanied by vasoconstriction (i.e. 9–12%) and a reduction in perfusion entropy (19%)within sections of the vascular bed. Conclusions: Multicontrast imaging coupled with IVU‐based in vivo vascular phenotyping is a powerful new tool for elucidating NEC pathogenesis. [ABSTRACT FROM AUTHOR] more...

INTRODUCTION: Ureteric fistula is one of the major morbidities that can arise from pelvic surgeries. It mainly results from gynaecological and obstetric procedures. Intravenous urography is an imaging modality for the upper urinary tract. Its features may be suggestive of ureteric fistula and it is of great value when medicolegal issues arise. It is however expensive and requires expertise. There are other useful and cheap methods for evaluating ureteric fistula including the use of dye test. There is need to determine if IVU (Intravenous urography) should be recommended for women with this disease. The aim of this study was to determine the features of intravenous urography among women with ureteric fistula and therefore determine its relevance in the management of such patients. METHODS: This was a retrospective study conducted at the National Obstetric Fistula Centre, Abakaliki between January 2012 and March 2017. All patients with ureteric fistula during the study period who were assessed with intravenous urography before surgery were included in this study. RESULTS: The mean age was 38 , 16 years. Twelve (92.3%) were Christians. IVU showed hydroureters in 46.15%, hydronephrosis in 53.85%, non-functioning kidney in 46.15% and ureteric stricture in 7.69%. IVU gave an insight into the side with ureteric fistula except in one who had normal result. CONCLUSION: Hydronephrosis, hydroureters and silent (non-functioning) kidneys are features of IVU in women with ureteric fistulas, however these features are not pathognomonic for the disease. more...

Introduction: Ureteric fistula is one of the major morbidities that can arise from pelvic surgeries. It mainly results from gynaecological and obstetric procedures. Intravenous urography is an imaging modality for the upper urinary tract. Its features may be suggestive of ureteric fistula and it is of great value when medicolegal issues arise. It is however expensive and requires expertise. There are other useful and cheap methods for evaluating ureteric fistula including the use of dye test. There is need to determine if IVU (Intravenous urography) should be recommended for women with this disease. The aim of this study was to determine the features of intravenous urography among women with ureteric fistula and therefore determine its relevance in the management of such patients. Methods: This was a retrospective study conducted at the National Obstetric Fistula Centre, Abakaliki between January 2012 and March 2017. All patients with ureteric fistula during the study period who were assessed with intravenous urography before surgery were included in this study. Results: The mean age was 38 ± 16 years. Twelve (92.3%) were Christians. IVU showed hydroureters in 46.15% hydronephrosis in 53.85%, non-functioning kidney in 46.15% and ureteric stricture in 7.69%. IVU gave an insight into the side with ureteric fistula except in one who had normal result. Conclusion: Hydronephrosis, hydroureters and silent (non-functioning) kidneys are features of IVU in women with ureteric fistulas, however these features are not pathognomonic for the disease. [ABSTRACT FROM AUTHOR] more...

The patient is the most important person in the entire hospital setup and it is the duty of the health care personnel to give special attention to the management of patient to enhance effective service delivery. Waiting time is the total time from registration until consultation with healthcare personnel. It is an aspect of care that patients value most. Objective: The aim of this study was to evaluate Patients' perceived satisfaction with waiting time in Department of Radiology, University of Maiduguri Teaching Hospital, Borno State Nigeria. Method: The study was a cross-sectional prospective survey, that targeted patients who presented at the radiology department for HSG and IVU over the period of six months with a response rate of 70%, (n=70). The mean age of the participants was 33.6years. Data was collected using a 23 item self-completion questionnaire designed in line with the objectives of the study. Data were categorized into groups and analyzed using statistical package for social sciences version 16.0, where descriptive statistics such as the mean, percentages and frequencies were generated and tabulated. Pearson's correlation at p less than 0.01(2 tailed) was used to test for relationship Results: The results showed that 64.3%, (n=45) were female while 35.7%, (n=25) were male, out of these, 42.9% (n=30) were referred for HSG, and 57.1% (n=40) were for IVU. Among the patients referred for IVU, 37.5%, (n=15) were female, and 62.5%, (n=25) were male. Waiting time (before and after investigation) and satisfaction was found to be significant at (p less than 0.01, 2-tailed), with the waiting time. Conclusion: Insufficient number of counter service staff (Receptionist) and insufficient number of Radiologist and Radiographers were some of the factors that affect patient's satisfaction with waiting time, as investigations and reports were delayed more...

Purpose: The procedure of bowel preparation before intravenous urography (IVU) is still a controversial debate and it varies in each health center. Preparation is believed to reduce residual feces and intestinal gas thus improving the quality of visualization of the urinary tract. On the other hand, many radiology and urology studies did not mention the need for preparation before IVU procedure. Preparation before IVU, especially giving laxative agent, gives many adverse effects to the patient. The purpose of this study was to know the difference in quality visualization of the urinary tract in IVU patients with and without preparation in Saiful Anwar hospital Malang. Materials and Methods: A total of 20 patients participated in this study and they were divided into two groups in which each group consists of 10 patients with and without preparation before IVU. Abdominal x-ray and IVU were performed on all patients. Urinary tract visualization quality assessment was done through two methods of assessing the quality of the image by the European Commission Guidelines and of assessing the residue of feces/intestinal gas based on Dadkhah's studies. Results: Results showed the total score of image quality and the residue of feces/intestinal gas was not significantly different in the abdominal plain photo of IVU patients with and without preparation (Mann-Whitney test (p=1.000) and Independent T-test (p=0.5111)). Conclusions: In conclusion, there was no difference in the quality of visualization of the urinary tract in IVU patients with and without preparation in Saiful Anwar hospital Malang. [ABSTRACT FROM AUTHOR] more...

The purpose of this paper is to review current imaging techniques used for diagnostic, disease monitoring and follow-up of idiopathic retroperitoneal fibrosis (IRF), as to provide the reader with up to date information that can be useful in clinical practice. We conducted a PubMed search for original articles, literature reviews and series reports published in English in the past 16 years regarding IRF, mainly focusing on imagistic study of the disease and selected 52 articles which we found most relevant. Today, CT and MRI seem to be the wise choice and the right combination of imaging techniques, with reasonable accessibility of the method and widespread use in clinical practice, but we reviewed all imagistic methods that might be of use, in order to provide the reader with an overview of current information regarding this topic. [ABSTRACT FROM AUTHOR] more...

This study was intended to measure pediatric entrance surface air kerma (ESAK) and effective dose during micturating cystourethrography (MCU), intravenous urography (IVU) and barium studies (barium meal, enema, and swallow) and to propose a local diagnostic reference level (DRL). ESAK was measured for patients using calibrated thermoluminescent dosimeters (TLDs, GR200A). Effective doses ( E ) were calculated using the National Radiological Protection Board (NRPB) software. A total of 236 special pediatric procedures were investigated. 21.7% of the sample comprised barium procedures, 18.6% were MCU procedures while 59.5% of the sample were IVU procedures. The mean ESAK measurements (mGy) were 2.1±0.8, 3.0±23 and 1.2±0.2 for barium meal, enema and swallow in the same order. The mean patient dose for IVU procedures was 12.4±8.7 mGy per procedure and the mean patient dose per MCU procedure was 5.8±7 mGy. Local DRLs were proposed for all procedures. The patient doses in this study are within the reported values, suggesting that pediatric patients are adequately protected. [ABSTRACT FROM AUTHOR] more...

Intravenous urography (IVU) and CT urography (CTU) are efficient radiological examinations for the evaluation of the urinary system disorders. However patients are exposed to a significant radiation dose. The objectives of this study are to: (i) measure and compare patient radiation dose by computed tomography urography (CTU) and conventional intravenous urography (IVU) and (ii) evaluate organ equivalent dose and cancer risks from CTU and IVU imaging procedures. A total of 141 patients were investigated. A calibrated CT machine (Siemens-Somatom Emotion duo) was used for CTU, while a Shimadzu X ray machine was used for IVU. Thermoluminescence dosimeters (TLD-GR200A) were used to measure patients' entrance surface doses (ESD). TLDs were calibrated under reproducible reference conditions. Patients radiation dose values (DLP) for CTU were 172±61 mGy cm, CTDI vol 4.75±2 mGy and effective dose 2.58±1 mSv. Patient cancer probabilities were estimated to be 1.4 per million per CTU examination. Patients ESDs values for IVU were 21.62±5 mGy, effective dose 1.79±1 mSv. CT involves a higher effective dose than IVU. In this study the radiation dose is considered low compared to previous studies. The effective dose from CTU procedures was 30% higher compared to IVU procedures. Wide dose variation between patient doses suggests that optimization is not fulfilled yet. [ABSTRACT FROM AUTHOR] more...

Abstract: Objective: To compare the outcome of treatment planning using multislice computed tomography (CT) or intravenous urography (IVU) for supine percutaneous nephrolithotomy (PCNL). Patients and methods: The study included 60 patients with renal stones, all treated by supine PCNL, between March 2011 and October 2012. The patients were divided randomly into two equal groups; in group 1 30 patients had the PCNL access planned based on IVU findings, and in group 2 the PCNL access was planned based on multislice CT images. All patients were suitable for PCNL, based on a plain abdominal film and ultrasonography, and with a body mass index of <30kg/m2. The exclusion criteria were renal anomalies and bleeding diathesis. All data from both groups for the mean time taken to gain percutaneous access, operative duration, fluoroscopic time, access difficulty, stone-free rate and intraoperative morbidity were collected and analysed statistically. Results: The mean (SD) time taken to gain percutaneous access was longer in group 1 than group 2, at 22.2 (1.76) vs. 13.1 (1.62) min (P <0.001), as were the operative duration, at 81.9 (14.9) vs. 58.8 (7.6) min (P <0.001), and fluoroscopic time, at 3.5 (1.7) vs. 2.2 (1.3) min (P =0.002). In group 1 there were four cases (13%) in which there were difficulties in establishing percutaneous access, while in group 2 there were none (P =0.003). There was intraoperative morbidity in three patients (10%) in group 1 and two (7%) in group 2. Conclusion: Multislice CT is a safer, more accurate and noninvasive imaging technique than IVU for mapping the pelvicalyceal system. It saves time and is essential in choosing the optimal percutaneous access into the pelvicalyceal system for a safe and successful PCNL. [Copyright &y& Elsevier] more...

For many years, intravenous urography (IVU) was the modality of choice for diagnosing urinary tract abnormalities. IVU has many drawbacks including poor diagnostic accuracy in diagnosis and characterization of parenchymal lesions, also in cases of nonfunctioning kidneys. It has little diagnostic role to detect the cause of obstruction in absence of radio-opaque stones along the course of the urinary tract (UT). In the last two decades, with the era of the computed tomography (CT), CT has become the gold standard for diagnosis of urinary stones, while multiphasic CT urography (CTU) has become the most useful diagnostic tool in different UT abnormalities including complex congenital anomalies, trauma, infection and tumors. Also, the "one-stop-shop" use of CTU in different anomalies including vascular, parenchymal, and urothelial evaluation has a great impact in management of patients. CT has many disadvantages over IVU including its high cost and the higher radiation dose but it is more effective than IVU. [ABSTRACT FROM AUTHOR] more...

Objective: To report our experience with open dismembered pyeloplasty for uretero-pelvic junction obstruction. Methods: Retrospective study was conducted in the Department of Urology, Jinnah Postgraduate Medical Centre, Karachi for a period of five and half years from May, 2006 to December, 2011. All patients with uretero-pelvic junction obstruction were entered into a database to record patients clinical features, diagnostic tools, operative and post-operative details and follow-up. Over a five-years period, 13 procedures were performed. After clinical evaluation all patient had extensive haematological and radiological workup for diagnosis of uretero-pelvic junction obstruction. All were subjected to open pyeloplasties, out of these 13 patients; one had an aberrant lower pole vessel compressing uretero-pelvic-junction. All procedures were stented. Repair was done with 3/0 vicryl sutures all patients were catheterized and wound drained. Results: Mean operating time was 60 - 100 minutes with about 100cc blood loss requiring no transfusion. The mean follow up was one year. One patient developed post-operative haematuria and was managed conservatively. Two patients developed fever secondary to urinary tract infection despite adequate treatment of urinary tract infection according to culture and sensitivity pre-operatively. One patient developed surgical emphysema detected post-operatively, which required tube thoracostomy. Neither patient developed recurrent symptoms nor had any evidence of obstruction on the renogram on follow-up. Objectively all patients were followed up by intravenous urogram, stress renogram, Urine C/S. Subjective and objective follow-up revealed success in 100% of patients whereas success is defined as no or minimal holder on DTPA renogram, improving renal function and decreasing dilatation on successive intravenous urogram. All patients had a mean post-operative hospital stay of 02 - 04 days Folley catheter was removed after 10-days, double-j- stents were removed after two to three weeks. Conclusion: Our success rate following open pyeloplasty with limited follow-up was 100%. It is comparable with International data. Recent international trend is toward Uretro-pelvic Junction Obstruction (UPJO) repair with laparoscopic approach, they are claiming success rate of 95%. [ABSTRACT FROM AUTHOR] more...

Abstract: Background: Urolithiasis affects 5–15% of the population, with 70% of suffers between the ages 18 and 50. Guidelines detail Intravenous Urography (IVU) as the ‘gold standard’ for diagnosis; however advances in Computed Tomography Urography (CTU) have led to adoption of this alternative test. The radiation risks from CTU have not been widely reported. Objectives: To compare IVU and CTU for diagnostic accuracy and radiation risk. Consideration criteria: Prospective, randomised control trials, diagnostic accuracy and adverse effects studies comparing IVU and CTU accuracy and/or radiation dose were included. Participants were adults with confirmed or suspected urolithiasis. Search strategy: A search of the databases; AMED, CINAHL, Cochrane Library, EMBASE, MEDLINE and Science Direct, was conducted between 1995 and week 40, 2009. Secondary searches of reference lists and main subject journals were completed. Methods of review: A systematic review method was employed using ‘a priori’ standardised forms, by two independent reviewers, to select studies, assess quality and extract data. Results: Ten studies from 283 potential references met the inclusion criteria. Diagnostic accuracy results showed consensus that CTU provides better sensitivity with comparable specificity to IVU. Dose results showed CTU to be associated with greater dose and risk of cancer than IVU. Conclusion: Decisions regarding which test should be used for urolithiasis should be taken with regard to their age and associated risk from ionising radiation. IVU represents a specific and low dose method of assessment. [Copyright &y& Elsevier] more...

Abstract: Objective: To determine the diagnostic accuracy of ultra-low dose contrast-enhanced CT (ULDCECT) and its ability to measure differential renal function (DRF) in patients presenting clinically with acute ureteric colic by comparison to IVU (using an equivalent radiation exposure) and DMSA, respectively. Patients and methods: Fifty-three patients presenting clinically with acute ureteric colic underwent IVU, ULDCECT and DMSA on the same day of their hospital admission. Diagnostic accuracy of ULDCECT and IVU was compared to interventional findings and clinical outcome. Estimation of DRF by ULDCECT was derived through measurement of enhancing renal volumes and DMSA. Results: ULDCECT had superior sensitivity (97%) and specificity (100%) in the identification of renal tract stone disease compared to IVU (84 and 95% respectively), with comparable radiation exposure (1.7mSv versus 1.4mSv). Furthermore, ULDCECT revealed non-urological pathology in eight patients (15%), including perforated abdominal viscus and acute appendicitis. There was a very good correlation of ULDCECT and DMSA-derived DRF (regression of near unity, Pearson''s correlation coefficient of 0.72 (p <0.0001)). Conclusion: ULDCECT provides diagnostically accurate imaging in patients presenting with acute ureteric colic and significantly outperforms IVU for a comparable radiation burden. Use of ULDCECT instead of conventional CT-KUB may significantly reduce lifetime radiation exposure of ureteric colic patients without loss of diagnostic accuracy. [Copyright &y& Elsevier] more...

The ESPR working groups have addressed intravenous urography (IVU), uro-CT and MR-urography (MRU) in childhood as the last in the series of recommendations for paediatric uroradiology. The aim of this process was again to standardise paediatric uroradiologic imaging and to reduce invasiveness and radiation dose. As for the existing recommendations, the new proposals are consensus-based because evidence is lacking, use and indications have changed, or approaches on how to perform the examination in children differ in the literature (MRU). As in the previous recommendations, a thorough review of the literature and existing guidelines and recommendations has been performed. The proposals were discussed within the group and with non-member experts and colleagues from other partner disciplines. These recommendations aim to serve as a quality measure in order to standardise the procedures and thus grant comparable good quality results throughout different institutions. [ABSTRACT FROM AUTHOR] more...

OBJECTIVES To evaluate the utility of routine excretory intravenous urography (IVU) for detecting subsequent upper urinary tract cancer (UUTC) during the follow-up of patients with superficial bladder cancer. PATIENTS AND METHODS The study included 413 patients who had transurethral resection (TUR) of superficial bladder cancer between January 1986 and December 2003, and were followed for at least 1 year. After TUR, patients were followed by periodic cystoscopy, urinary cytology and IVU. The risk factors for UUT recurrence after TUR were analysed, and based on this outcome, we then determined whether routine IVU should be used for patients with superficial bladder cancer. RESULTS During the observation period, UUTCs developed in 20 of the 413 patients (4.8%) within a median of 33 months from the initial TUR to the detection of UUTCs. Among several factors examined, only multiplicity was significantly associated with UUT recurrence after TUR. Of the 20 patients with secondary UUTCs, only two, who had multiple superficial bladder cancers at initial presentation, were diagnosed as having UUTCs by routine IVU, while the remaining 18 presented with symptoms suggesting possible UUT recurrence before IVU, including macrohaematuria (10 patients), intravesical recurrence (five), positive urinary cytology (five), abdominal pain (three) and high fever (two). CONCLUSIONS Most patients with recurrent UUTCs presented with some subjective and/or objective symptoms, and routine IVU failed to detect recurrent diseases in such patients. Therefore, routine IVU may not be required for all patients who have TUR of superficial bladder cancer. [ABSTRACT FROM AUTHOR] more...

OBJECTIVE To clarify the prevalence of disease as determined by age, sex and the degree of haematuria at presentation, and to ascertain the merits of using ultrasonography (US), i.v. urography (IVU) or both when imaging the upper urinary tract, in a prospective cohort of patients attending a protocol-based haematuria clinic. PATIENTS AND METHODS In a two-tier protocol, as a part of first-line investigation, all 4020 patients attending the clinic between October 1998 and August 2003 had US and flexible cystoscopy. Subsequently, IVU was used where indicated following abnormal first-line tests and in patients with persistent haematuria where no abnormality had been detected. RESULTS In all, 2627 men and 1393 women presented with microscopic (53.2%) or macroscopic haematuria (46.8%). The overall prevalence of malignant disease was 12.1%, but for macroscopic haematuria it was 18.9% and for microscopic haematuria 4.8%. Age and sex also influenced the observed rates of disease. Of the upper tract tumours, 70 were identified after abnormal US, with three cases of transitional cell carcinoma identified on IVU after a normal US. CONCLUSIONS The study provides a rationale for the appropriate investigation of all patients, moderated by the age, sex and degree of haematuria, and the ubiquitous use of US with selective IVU based on age, sex and degree of (and persistence of) haematuria. [ABSTRACT FROM AUTHOR] more...

To describe a new technique of virtual cystoscopy (VC, used previously but with catheterization to drain residual urine and insufflation with air or carbon dioxide) with no invasive catheterization, used in parallel with intravenous urography (IVU), as conventional cystoscopy is an invasive but essential examination, and VC with multislice computed tomography (CT) was introduced to make preliminary examinations noninvasive.Using multislice CT and a device with 16 rows of detectors, we examined five patients using VC that previously involved catheterization, termed‘air VC’ and 16 using VC with the new technique, termed‘IVU VC’. We assessed the new technique by evaluating the tumour detection rate, and merits and demerits of both types of VC.The detection rate of bladder tumours by IVU VC was similar to that from air VC; moreover, IVU VC overcame two significant disadvantages of air VC, i.e. the appearance of the water surface and the need for catheterization.Conventional cystoscopy is still an essential examination but this new method of IVU VC may be ideal for preliminary examination of the bladder. [ABSTRACT FROM AUTHOR] more...

Abstract Objectives: The purpose of this study was to determine the value of unenhanced helical computed tomography (UHCT) in the diagnosis of acute flank pain at our institution. Methods: Two hundred and thirty-three consecutive UHCT examinations, performed for suspected renal/ureteral colic between July 2000 and August 2001 were reviewed, along with pertinent medical records. Results: Ureteral calculi were identified in 148 (64%) examinations, evidence of recent passage of calculi was found in 10 (4%) and no calculi were found in 75 (32%). Thirty-two of the conservatively managed patients were excluded for inadequate follow-up. In the remaining 201 patients, sensitivity of UHCT in diagnosing calculi was 99% and specificity was 98%, while the positive predictive value was 99% and negative positive predictive value was 98%. Overall, an alternative or additional diagnosis was established in 28 (12%) patients. Upon diagnosis of ureterolithiasis on UHCT, none of the patients required additional imaging studies for confirmation. Conclusion: UHCT is a highly sensitive imaging modality for the detection of urinary tract calculi and obstruction. [ABSTRACT FROM AUTHOR] more...

Objective: To briefly describe basic conventional imaging in paediatric uroradiology.Method: The state of the art performance of standard imaging techniques (intravenous urography (IVU), voiding cystourethrography (VCU), and ultrasound (US)) is described, with emphasis on technical aspects, indications, and patient preparation such as adequate hydration. Only basic applications as used in routine clinical work are included.Result and Conclusion: Conventional imaging methods are irreplaceable. They cover the majority of daily clinical routine queries, with consecutive indication of more sophisticated modalities in those patients who need additional imaging for establishing the final diagnosis or outlining therapeutic options. [ABSTRACT FROM AUTHOR] more...

Objective To compare the ability of magnetic resonance urography (MRU), enhanced using gadolinium and frusemide diuresis, and conventional intravenous urography (IVU) to diagnose the cause of ureteric obstruction. Patients and methods The study included 82 patients in whom IVU showed or suggested obstruction and who also underwent MRU. The images from both methods were interpreted by various investigators independently; two evaluated the IVU and two others the MRU, the latter being unaware of the diagnosis after IVU. If the diagnosis remained unclear, further investigations (e.g. computed tomography, retrograde pyelography or ureteroscopy) were conducted. Results The diagnoses were ureteric calculi in 72 patients, ureteric tumours in eight and extra-ureteric tumours in two. In those with urolithiasis, the diagnosis was correct with IVU in 49 patients and with MRU in 64. The diagnosis in this group was incorrect with MRU in only two patients. The main reason for the failure of IVU was absent contrast medium excretion. Three of eight patients with ureteric tumours were correctly diagnosed by IVU but in three patients the diagnosis was incorrect. MRU correctly diagnosed seven of the eight patients in this group, with no false diagnosis. Conclusion IVU is currently likely to remain the standard procedure for imaging the upper urinary tract, but this study shows the potential of MRU when enhanced with gadolinium and frusemide. MRU may be helpful if there is a dilated system with no excretory function, in pregnant women, in children and in those with contrast medium allergy. [ABSTRACT FROM AUTHOR] more...

Objectives: Sodium-glucose cotransporter-2 (SGLT2) inhibitor-induced glycosuria is hypothesized to increase the risk of urinary tract infections (UTIs). We assessed the risk of UTIs associated with SGLT2 inhibitor initiation in type 2 diabetes., Methods: We conducted a population-based cohort study using primary care data from the United Kingdom's Clinical Practice Research Datalink (CPRD) and administrative health-care data from Alberta, Canada. From a base cohort of new metformin users, we constructed 5 comparative cohorts, wherein the exposure contrast was defined as new use of SGLT2 inhibitors or 1 of 5 active comparators: dipeptidylpeptidase-4 (DPP-4) inhibitors, sulfonylureas (SU), glucagon-like peptide-1 receptor agonists (GLP-1 RA), thiazolidinediones (TZD) and insulin. We defined a composite UTI outcome based on hospitalizations or physician visit records. For each comparative cohort, we used high-dimensional propensity score matching to adjust for confounding and Cox proportional hazards regression to estimate the hazard ratios (HRs) in each database. We meta-analyzed estimates using a random-effects model., Results: SGLT2 inhibitor use was not associated with a higher risk of UTI compared with DPP-4 inhibitors (pooled HR, 1.08; 95% confidence interval [CI], 0.89 to 1.30), SU (pooled HR, 1.08; 95% CI, 0.90 to 1.30), GLP-1 RA (pooled HR, 0.81; 95% CI, 0.61 to 1.09) or TZD (pooled HR, 0.81; 95% CI, 0.55 to 1.19). The risk of UTI was lower compared with insulin (pooled HR, 0.74; 95% CI, 0.63 to 0.87). The risk of UTI did not differ based on the SGLT2 inhibitor agent or dose. Last, SGLT2 inhibitor initiation was not associated with an increased risk of UTI recurrence., Conclusion: SGLT2 inhibitor use is not associated with an increased risk of UTIs, compared with other antidiabetic agents., (Copyright © 2022 The Author(s). Published by Elsevier Inc. All rights reserved.) more...

Calyceal diverticula are outpouchings of a renal calyx. Often found incidentally on radiological imaging, they are generally benign and usually asymptomatic, although complications include infection and stone formation. More importantly, calyceal diverticula may mimic other potentially more serious pathology on imaging, such as renal tumour or abscess on ultrasound or computed tomography and even rib metastasis on bone scintigraphy. We present a case of a patient with a calyceal diverticulum found incidentally on imaging, in which the diverticulum is demonstrated on ultrasound, computed tomography, intravenous urogram and bone scintigraphy, and discuss the potential differential diagnoses that need to be excluded in this condition. more...