Search

BACKGROUND: Recurrent bacterial cystitis, often referred to as recurrent urinary tract infection (UTI), can be difficult to manage and alternative treatments are needed. HYPOTHESIS/OBJECTIVE: Intravesicular administration of asymptomatic bacteriuria (ASB) E. coli 212 will not be inferior to antimicrobial treatment for the management of recurrent UTI in dogs. ANIMALS: Thirty-four dogs with >1 UTI in the 12 months before presentation. METHODS: All dogs were deemed normal otherwise based on absence of abnormalities on physical examination, CBC, serum biochemical panel, and abdominal ultrasonography. Dogs were randomized to 1 of 2 treatment groups: Group 1 antimicrobials for 7 days or group 2 intravesicular administration of ASB E. coli 212. Owners were provided a voiding questionnaire regarding their dogs clinical signs, which was completed daily for 14 days to assess clinical cure. Dogs were examined on days 7 and 14 to assess clinical cure, and urine specimens were submitted for urinalysis and bacterial culture. RESULTS: Clinical cure rates for ASB E. coli 212-treated dogs were not inferior to 7 days of antimicrobial treatment with a 12% margin of difference to determine non-inferiority. No significant difference was found between the treatment groups on days 7 and 14 in the proportion of dogs achieving ≥50% or ≥75% reduction in their clinical score compared with baseline. CONCLUSIONS AND CLINICAL IMPORTANCE: These data suggest that intravesicular administration of ASB E. coli 212 is not inferior to antimicrobials for the treatment of recurrent UTI in dogs. This biotherapeutic agent could help alleviate the need for antimicrobials for some dogs with recurrent UTI, improving antimicrobial stewardship.

BACKGROUND: Urethral diverticulum (UD) is a poorly defined anomaly consisting of an outpouching of the urethra. Management without surgical resection is not previously reported in dogs. HYPOTHESIS/OBJECTIVES: Report the outcome of male dogs presented for urinary incontinence with UD treated with an artificial urethral sphincter (AUS). ANIMALS: Eight client-owned dogs with UD treated with an AUS. METHODS: Multicenter retrospective study. Medical records from male dogs with urinary incontinence were reviewed. INCLUSION CRITERIA:  diagnosis of a UD by retrograde cystourethrography, cystoscopy, abdominal ultrasonography or contrast computed tomodensitometry (CT) or a combination of these modalities, AUS placement, and at least 1 follow-up. Urinary continence score (UCS) was attributed retrospectively. RESULTS: Median UCS at presentation was 1/5. A contrast cystourethrogram was diagnostic in 8/8 dogs. All diverticula were saccular, and 7/8 were within the prostatic urethra and 1/8 extended up to the membranous urethra. A congenital origin was suspected in 7 dogs and acquired in 1. Concurrent anomalies included renal dysplasia or chronic pyelonephritis (n = 4), bilateral cryptorchidism (n = 3), and pelvic urinary bladder (n = 3). All dogs were poorly/moderately responsive to phenylpropanolamine. Artificial urethral sphincter placement resulted in improvement in continence in all dogs with a median UCS of 4/5 (5/5 in 2/8 dogs, 4/5 in 5/8 dogs, 3/5 in 1/8 dogs). CONCLUSION: Urethral diverticulum should be considered in male dogs with persistent urinary incontinence not responding to medical management. Artificial urethral sphincter placement is an effective therapeutic option that improved continence scores in all dogs.

Copyright of Die Pathologie is the property of Springer Nature and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Introduction: Uroflowmetry is often used to assess lower urinary tract symptoms (LUTS). Criteria for characterization of flow patterns are not well established, and subjective interpretation is the most common approach for flow curve classification. We assessed the reliability of uroflowmetry curve interpretation in adult women. Materials and Methods: Uroflowmetry studies were obtained in 296 women who participated in an observational cohort study. Four investigators with expertise in female LUTS and urodynamics reviewed and categorized each tracing for interrater reliability. A random subset of 50 tracings was re‐reviewed by each investigator for intrarater reliability. The uroflowmetry tracings were rated using categories of continuous, continuous fluctuating, interrupted, and prolonged. Other parameters included flow rate, voided volume, time to maximum flow, and voiding time. Agreement between raters is summarized with kappa (k) statistics and percentage where at least three raters agreed. Results: The mean age of participants was 44.8 ± 18.3 years. Participant age categories were 18–24 years: 20%; 25–34 years: 17%; 35–64 years: 42%; 65+ years: 18%. Nine percent described their race as Asian, 31% Black, 62% White, and 89% were of non‐Hispanic ethnicity. The interrater reliability was highest for the continuous flow category (k = 0.65), 0.47 for prolonged, 0.41 for continuous fluctuating, and 0.39 for interrupted flow curves. Agreement among at least three raters occurred in 74.3% of uroflow curves (69% for continuous, 33% for continuous fluctuating, 23% for interrupted, and 25% for prolonged). For intrarater reliability, the mean k was 0.72 with a range of 0.57–0.85. Conclusions: Currently accepted uroflowmetry pattern categories have fair to moderate interrater reliability, which is lower for flow curves that do not meet "continuous" criteria. Given the subjective nature of interpreting uroflowmetry data, more consistent and clear parameters may enhance reliability for use in research and as a screening tool for LUTS and voiding dysfunction. Trial Registration: Parent trial: Validation of Bladder Health Instrument for Evaluation in Women (VIEW); ClinicalTrials.gov ID: NCT04016298. [ABSTRACT FROM AUTHOR]

OBJECTIVES This single-centre prospective observational study aimed to investigate reasons for prolonged hospitalization [over the median length of stay (LOS)] after enhanced recovery thoracoscopic [ERAS 3-port video-assisted thoracoscopic surgery (VATS)] wedge resection. METHODS All patients were evaluated twice-daily by an investigator for reasons of hospitalization. Each reason was analysed individually. Predictors for prolonged hospitalization were identified using a multivariable backward stepwise logistic regression model. RESULTS A total of 150 consecutive patients (lymphadenectomy 8.7%) were included from November 2022 to December 2023, with a median LOS of 1 (interquartile range 1–2) day. Of these, 55 patients (36.7%) experienced prolonged hospitalization. The main reasons included postoperative pain (16.0%), air leak (14.7%) and social factors (14.7%), followed by oxygen dependency (7.3%), gastrointestinal factors (5.3%), urinary factors (4.7%), pneumonia (1.3%), pleural effusion (1.3%), chylothorax (0.7%), atrial fibrillation (0.7%), confusion (0.7%) and fatigue (0.7%). Multivariable analysis revealed that an increase in the percentage of predicted forced expiratory volume in 1 s (FEV1%pre) by 1% [odds ratio (OR) 0.41, P = 0.023) and percentage of predicted diffusing capacity for carbon monoxide (DLCO%pre) by 1% (OR 0.95, P = 0.002) decreased likelihood of prolonged hospitalization. Conversely, each additional pack-year (OR 1.01, P = 0.028) and living alone (OR 3.55, P = 0.005) increased the risk of prolonged hospitalization. CONCLUSIONS Prolonged hospitalization (LOS > 1 day) after ERAS 3-port VATS wedge resection, with 8.7% lymphadenectomy, was mainly due to pain, air leak and social factors. Smokers with decreased FEV1%pre or DLCO%pre and patient living alone were at increased risk. Clinical trial registration number ClinicalTrials.gov: NCT06118593 (https://clinicaltrials.gov/study/NCT06118593?cond=why%20in%20hospital&rank=2). [ABSTRACT FROM AUTHOR]

Purpose: Patients with lower urinary tract malformations (LUTM) were suspended from kidney transplantation (KT) programs in the past due to various concerns. Consequently, only a limited number of studies have explored this topic at hand. In this study, our objective was to perform a systematic review (SR) to evaluate the current evidence regarding KT outcomes as well as patient survival (PS), postoperative complications and urinary tract infections (UTI) in individuals with childhood LUTM. Methods: The search encompassed databases of Web of Science, Medline (via PubMed), and Embase (via Scopus) to identify all studies reporting outcomes on KT for patients with LUTM. The research included articles published in English from January 1995 till September 2023. Results: Of the 2634 yielded articles, 15 met the inclusion criteria, enrolling a total of 284,866 KT patients. There was significantly better 5-year graft survival (GS) in recipients with LUTM compared to the control group (RR, 1.04; 95% CI 1.02–1.06); while GS at 1-year and 10-year, and PS at 1-year, 5-year and 10-year were similar between groups. On the other hand, the postoperative UTI rate was significantly higher in the LUTM group (RR: 4.46; 95% CI 1.89–10.51). However, data on serum creatinine and estimated glomerular filtration rate on follow-up were insufficient. Conclusion: GS and PS rates appear to be similar in patients with childhood LUTM and those with normal lower urinary tract functions. Despite a higher postoperative UTI rate within this patient group, it appears that this has no effect on GS rates. [ABSTRACT FROM AUTHOR]

Obstructive uropathy (OU) is a complication of urinary tract diseases, characterized by the presence of an obstacle in the urine outflow. This condition in pregnant women usually leads to urological and/or obstetric complications and requires timely diagnosis to optimize the treatment. A description of the ultrasound findings and a review of two cases of OU in pregnant women are presented. The indication for an ultrasound examination of the kidneys was clinical and laboratory findings. The identified signs and features of the OU became the basis for appropriate treatment and prevention of severe obstetric complications, which were avoided in our cases. However, the outcomes of the described clinical cases indicate the need for a more thorough urological and obstetric approach to women with obstruction uropathy. The ultrasound examination to detect obstructive uropathy in pregnant women, as well as the details and determination of possible etiological factors, were a reliable means of preventing severe obstetric and perinatal complications.

Abstract Background Recurrent bacterial cystitis, often referred to as recurrent urinary tract infection (UTI), can be difficult to manage and alternative treatments are needed. Hypothesis/Objective Intravesicular administration of asymptomatic bacteriuria (ASB) E. coli 212 will not be inferior to antimicrobial treatment for the management of recurrent UTI in dogs. Animals Thirty‐four dogs with >1 UTI in the 12 months before presentation. Methods All dogs were deemed normal otherwise based on absence of abnormalities on physical examination, CBC, serum biochemical panel, and abdominal ultrasonography. Dogs were randomized to 1 of 2 treatment groups: Group 1 antimicrobials for 7 days or group 2 intravesicular administration of ASB E. coli 212. Owners were provided a voiding questionnaire regarding their dogs' clinical signs, which was completed daily for 14 days to assess clinical cure. Dogs were examined on days 7 and 14 to assess clinical cure, and urine specimens were submitted for urinalysis and bacterial culture. Results Clinical cure rates for ASB E. coli 212–treated dogs were not inferior to 7 days of antimicrobial treatment with a 12% margin of difference to determine non‐inferiority. No significant difference was found between the treatment groups on days 7 and 14 in the proportion of dogs achieving ≥50% or ≥75% reduction in their clinical score compared with baseline. Conclusions and Clinical Importance These data suggest that intravesicular administration of ASB E. coli 212 is not inferior to antimicrobials for the treatment of recurrent UTI in dogs. This biotherapeutic agent could help alleviate the need for antimicrobials for some dogs with recurrent UTI, improving antimicrobial stewardship.

Introduction Fungal balls in the urinary tract are rare but dangerous complications of candiduria. Here, we report a case of a urinary tract fungal ball in a single kidney after total nephroureterocystectomy. Case presentation The patient was an 80‐year‐old male. He had a history of pyelonephritis, and his ureteral stent was regularly replaced. He was admitted to the hospital with a chief complaint of urinary tract obstruction, and a 50‐mm‐sized mass was found within the renal pelvis. Because the ureteral stent frequently became obstructed, the mass was removed percutaneously. Candida albicans was detected on the tissue culture results, and the mass was diagnosed as a fungal ball. Conclusion Appropriate urinary drainage methods for fungal balls vary among patients, and it is important to select an appropriate method based on the accumulated number of cases.

Abstract Background Urethral diverticulum (UD) is a poorly defined anomaly consisting of an outpouching of the urethra. Management without surgical resection is not previously reported in dogs. Hypothesis/Objectives Report the outcome of male dogs presented for urinary incontinence with UD treated with an artificial urethral sphincter (AUS). Animals Eight client‐owned dogs with UD treated with an AUS. Methods Multicenter retrospective study. Medical records from male dogs with urinary incontinence were reviewed. Inclusion criteria: diagnosis of a UD by retrograde cystourethrography, cystoscopy, abdominal ultrasonography or contrast computed tomodensitometry (CT) or a combination of these modalities, AUS placement, and at least 1 follow‐up. Urinary continence score (UCS) was attributed retrospectively. Results Median UCS at presentation was 1/5. A contrast cystourethrogram was diagnostic in 8/8 dogs. All diverticula were saccular, and 7/8 were within the prostatic urethra and 1/8 extended up to the membranous urethra. A congenital origin was suspected in 7 dogs and acquired in 1. Concurrent anomalies included renal dysplasia or chronic pyelonephritis (n = 4), bilateral cryptorchidism (n = 3), and pelvic urinary bladder (n = 3). All dogs were poorly/moderately responsive to phenylpropanolamine. Artificial urethral sphincter placement resulted in improvement in continence in all dogs with a median UCS of 4/5 (5/5 in 2/8 dogs, 4/5 in 5/8 dogs, 3/5 in 1/8 dogs). Conclusion Urethral diverticulum should be considered in male dogs with persistent urinary incontinence not responding to medical management. Artificial urethral sphincter placement is an effective therapeutic option that improved continence scores in all dogs.

PURPOSE: To evaluate the efficacy of interventional radiological (IR) procedures in iatrogenic urinary tract injury and investigate the factors affecting the outcome. METHODS: Fifty-eight patients (21 male) with a mean age of 50.3 ± 15.8 years referred for iatrogenic urinary tract injury were enrolled in this study. Technical success was defined as (i) successful placement of a nephrostomy catheter within the renal pelvis and/or (ii) successful antegrade ureteral stent placement (double J stent) between the renal pelvis and bladder lumen. Complete resolution was defined as maintained ureteral patency without an external drain and ureteral stent. The factors that may affect complete resolution [ureteral avulsion, ureterovaginal fistula (UVF), history of malignancy/radiotherapy, and time to IR management] were also investigated. The receiver operating characteristic analysis was performed to estimate the cut-off time point for the IR management timing affecting complete resolution. RESULTS: The technical success rate for nephrostomy and ureteral stent placement was 100% (n = 58/58) and 78% (n = 28/36), respectively. In 14 patients, non-dilated pelvicalyceal systems were evident. In 18 patients, no further intervention after percutaneous nephrostomy was performed due to (i) poor performance status (n = 6) and (ii) reconstruction surgery upon clinicians’ and/or patients’ request (n = 12). Reconstruction surgery was required in 11 of the remaining 40 patients due to failure of percutaneous treatment (n = 11/40, 27.5%). In six of the patients, ureteral stents could not be removed due to the development of benign ureteral strictures (n = 6/40, 15%). Our complete resolution rate was 57.5% (n = 23/40). Age, gender, type of surgery (endoscopic or open), side and location of the injury did not statistically affect the complete resolution rate. The presence of ureteral avulsion, history of malignancy and radiotherapy individually or in combination significantly affected the complete resolution rate negatively. The presence of UVF also had a negative effect on the complete resolution rate; however, it did not reach statistical significance. Delayed intervention was also a significant factor related to lower complete resolution. The optimal cut-off point of the time interval for favorable clinical outcome was found to be 0–19th day following the surgery. CONCLUSION: IR procedures are safe and effective in the management of iatrogenic urinary tract injuries. Antegrade ureteral stenting should be performed as soon as possible to establish ureteral integrity without the development of stricture.

Introduction: While the efficacy of flexible ureterorenoscopy (URS) in managing solitary kidney stones (KSs) is widely acknowledged, its effectiveness in treating multiple stones has scarcely been investigated. This study aims to assess the effectiveness and safety of retrograde intrarenal surgery (RIRS) utilizing flexible URS and laser lithotripsy in the management of multiple KSs. Methods: This study was a single-group cohort study conducted on patients with multiple KSs who underwent treatment with RIRS using flexible URS and laser lithotripsy. Stone-free status was considered as the lack of residual stone fragments or any residual stone of any size. The first follow-up appointment was arranged 3-4 weeks following the procedure. If significant residual stones were present, patients underwent reintervention within 2-4 weeks. Results: A total of 110 patients with multiple KSs were included. The mean stone burden was 27.5 ± 7.9 mm, and the mean duration of the operation was 54.9 ± 19.7 minutes. Seven cases (6.3%) experienced intraoperative complications, while postoperative complications were found in eight cases (7.3%). After four weeks, a stone-free rate (SFR) was documented in 80.9% of the cases, and this rate increased to 93.6% after three months. The SFR after three months was significant with Guy's stone score (p < 0.001); however, it did not reach a significant level with any other parameters. Conclusions: The RIRS with flexible URS may be an effective and potentially safe procedure for treating multiple KSs. It may yield a favorable SFR with an acceptable complication rate. [ABSTRACT FROM AUTHOR]

Background: Recurrent bacterial cystitis, often referred to as recurrent urinary tract infection (UTI), can be difficult to manage and alternative treatments are needed. Hypothesis/Objective: Intravesicular administration of asymptomatic bacteriuria (ASB) E. coli 212 will not be inferior to antimicrobial treatment for the management of recurrent UTI in dogs. Animals: Thirty‐four dogs with >1 UTI in the 12 months before presentation. Methods: All dogs were deemed normal otherwise based on absence of abnormalities on physical examination, CBC, serum biochemical panel, and abdominal ultrasonography. Dogs were randomized to 1 of 2 treatment groups: Group 1 antimicrobials for 7 days or group 2 intravesicular administration of ASB E. coli 212. Owners were provided a voiding questionnaire regarding their dogs' clinical signs, which was completed daily for 14 days to assess clinical cure. Dogs were examined on days 7 and 14 to assess clinical cure, and urine specimens were submitted for urinalysis and bacterial culture. Results: Clinical cure rates for ASB E. coli 212–treated dogs were not inferior to 7 days of antimicrobial treatment with a 12% margin of difference to determine non‐inferiority. No significant difference was found between the treatment groups on days 7 and 14 in the proportion of dogs achieving ≥50% or ≥75% reduction in their clinical score compared with baseline. Conclusions and Clinical Importance: These data suggest that intravesicular administration of ASB E. coli 212 is not inferior to antimicrobials for the treatment of recurrent UTI in dogs. This biotherapeutic agent could help alleviate the need for antimicrobials for some dogs with recurrent UTI, improving antimicrobial stewardship. [ABSTRACT FROM AUTHOR]

Lupus nephritis (LN) is one of the most severe clinical manifestations of systemic lupus erythematosus (SLE). Notably, the clinical manifestations of LN are not always consistent with the histopathological findings. Therefore, the diagnosis and activity monitoring of this disease are challenging and largely depend on invasive renal biopsy. Renal biopsy has side effects and is associated with the risk of bleeding and infection. There is a growing interest in the development of novel noninvasive biomarkers for LN. In this review, we summarize most of the LN biomarkers discovered so far by correlating current knowledge with future perspectives. These biomarkers fundamentally reflect the biological processes of kidney damage and repair during disease. Furthermore, this review highlights the role of urinary cell phenotype detection in the diagnosis, monitoring, and treatment of LN and summarizes the limitations and countermeasures of this test. [ABSTRACT FROM AUTHOR]

Background One major barrier to HIV cure is the persistence of virus, possibly linked to an insufficient antiretroviral drug (ARV) distribution into tissues. Objectives To draw the whole-body distribution of three antiretroviral drugs—tenofovir disoproxil fumarate, emtricitabine and dolutegravir—in non-human primates (NHPs). Methods Eight uninfected NHPs received a single injection of a solution containing the three ARVs. Forty-five different tissues were sampled 24 h after injection. Results Median tissue penetration factors (TPFs) were 45.4, 5.8 and 0.5 for tenofovir, emtricitabine and dolutegravir, respectively, and were statistically different between the three ARVs. Tissues were grouped by system, because TPFs were consistent according to these groups, and ranked in order of decreasing TPFs. The digestive system was the system with the highest tissue concentrations. Next came the two main sites of elimination, the liver and the kidney, as well as the tissues of the cardiopulmonary and urinary systems. Then, it was the whole lymphatic system. The next group included the reproductive system, the adipose tissue and the skin. The last two systems were the muscle and the CNS. The intra-tissue variability was rather low with a median coefficient of variation of the concentrations around 15% and no value greater than 80%. Conclusions Overall, this study determines the first whole-body distribution in a validated NHP model. These data have important implications for future preclinical and clinical studies for the development of novel HIV therapies towards an HIV cure. [ABSTRACT FROM AUTHOR]

Objectives Escherichia coli can cause infections in the urinary tract and in normally sterile body sites leading to invasive E. coli disease (IED), including bacteraemia and sepsis, with older populations at increased risk. We aimed to estimate the theoretical coverage rate by the ExPEC4V and 9V vaccine candidates. In addition, we aimed at better understanding the diversity of E. coli isolates, including their genetic and phenotypic antimicrobial resistance (AMR), sequence types (STs), O-serotypes and the bacterial population structure. Methods Blood and urine culture E. coli isolates (n  = 304) were collected from hospitalized patients ≥60 years (n = 238) with IED during a multicentric, observational study across three continents. All isolates were tested for antimicrobial susceptibility, O-serotyped, whole-genome sequenced and bioinformatically analysed. Results A large diversity of STs and of O-serotypes were identified across all centres, with O25b-ST131, O6-ST73 and O1-ST95 being the most prevalent types. A total of 45.4% and 64.7% of all isolates were found to have an O-serotype covered by the ExPEC4V and ExPEC9V vaccine candidates, respectively. The overall frequency of MDR was 37.4% and ST131 was predominant among MDR isolates. Low in-patient genetic variability was observed in cases where multiple isolates were collected from the same patient. Conclusions Our results highlight the predominance of MDR O25b-ST131 E. coli isolates across diverse geographic areas. These findings provide further baseline data on the theoretical coverage of novel vaccines targeting E. coli associated with IED in older adults and their associated AMR levels. [ABSTRACT FROM AUTHOR]

Endometriosis is a chronic inflammatory gynecological condition affecting 10–15% of women in the reproductive age group. The urinary tract is the second most common extragenital organ system affected by endometriosis, and the urinary bladder and ureter are the two most common sites involved. Involvement of the urinary bladder can cause chronic debilitating symptoms, whereas ureteral involvement may lead to asymptomatic loss of renal function. Both conditions are frequently unsuspected, leading to a delay in diagnosis. Therefore, it is important to recognize this entity early, for which knowledge of imaging appearances and techniques is helpful. In this review article, we describe (a) endometriosis background, pathogenesis, definitions and clinical symptoms, (b) imaging appearance, with emphasis on ultrasound and MRI findings of urinary bladder and ureteric endometriosis, (c) ultrasound technique and MRI sequences useful for making the correct diagnosis, (d) overview of the treatment options and key imaging findings that are important to the surgeon for surgical planning, and (e) a structured reporting template useful for multidisciplinary patient management. [ABSTRACT FROM AUTHOR]

Background: Bacteria are present on all surfaces, to which they were carried by many direct and indirect methods of transmission. A toilet is simply a receptacle into which both solid and liquid waste of human origin, in the form of urine and excreta are discharged. In public toilets, complete strangers mix and use the same sanitary facilities, with all the related risks of bodily fluid exchange, contamination and organism transmission. Unhygienic use of the toilet's facilities may cause urine and fecal residues after use to serve as a major reservoir or source of human pathogen, which may in turn bring about disease outbreak. Aim: This study aimed at Identification of Bacteria from Public Toilets of Modern Market (Goico) In Musanze Town, Rwanda Method: This cross-sectional study was conducted to identify bacteria from GOICO market toilets. About 40 samples; 20 from male and 20 from female toilets were collected and transported to INES-clinical microbiology laboratory for microbiological analysis. Laboratory techniques including culture, gram stain, biochemical tests and antibiogram were performed. Results: The most predominant bacteria isolated was S. aureus (31.43%), followed by S. typhi (20%), Streptococcus(15.71%), E. coli(12.86%), P. aeuriginosa(10%), P. mirabilis(7.14%), C. freundi(1.43%), S. epidermidis (1.43%). It was noted that female toilets were more contaminated (51.43%) than male toilets (48.57%). All gram positive and gram-negative bacteria were sensitive to Gentamicin. Almost all bacteria except P. mirabilis were sensitive to Norfloxacin, gram negative showed a resistance to Vancomycin and Novobiocin. Conclusion: These results should alert public toilets users that extreme caution must be executed while using these toilets, as they may be a source of pathogenic bacteria. The best way to keep a toilet and its seat free of bacteria is to clean it with bleach. Otherwise, keep the bacteria at bay by washing your hands, and if you just don't trust that toilet seat, wipe it down with a disinfectant or antibacterial wipe before you sit. [ABSTRACT FROM AUTHOR]

The emergence of carbapenem-resistant hypervirulent Klebsiella pneumoniae (CR-hvKp) is a growing concern due to its high mortality and limited treatment options. Although hypermucoviscosity is crucial for CR-hvKp infection, the role of changes in bacterial mucoviscosity in the host colonization and persistence of CR-hvKp is not clearly defined. Herein, we observed a phenotypic switch of CR-hvKp from a hypermucoviscous to a hypomucoviscous state in a patient with scrotal abscess and urinary tract infection (UTI). This switch was attributed to decreased expression of rmpADC, the regulator of mucoid phenotype, caused by deletion of the upstream insertion sequence ISKpn26. Postswitching, the hypomucoid variant showed a 9.0-fold decrease in mice sepsis mortality, a >170.0-fold reduction in the ability to evade macrophage phagocytosis in vitro, and an 11.2-to 40.9-fold drop in growth rate in normal mouse serum. Conversely, it exhibited an increased residence time in the mouse urinary tract (21 vs. 6 d), as well as a 216.4-fold boost in adhesion to bladder epithelial cells and a 48.7% enhancement in biofilm production. Notably, the CR-hvKp mucoid switch was reproduced in an antibiotic-free mouse UTI model. The in vivo generation of hypomucoid variants was primarily associated with defective or low expression of rmpADC or capsule synthesis gene wcaJ, mediated by ISKpn26 insertion/deletion or base-pair insertion. The spontaneous hypomucoid variants also outcompeted hypermucoid bacteria in the mouse urinary tract. Collectively, the ISKpn26-associated mucoid switch in CR-hvKp signifies the antibiotic-independent host adaptive evolution, providing insights into the role of mucoid switch in the persistence of CR-hvKp. [ABSTRACT FROM AUTHOR]

Background: Accurate measurement of ureteral diameters plays a pivotal role in diagnosing and monitoring urinary tract obstruction (UTO). While three‐dimensional magnetic resonance urography (3D MRU) represents a significant advancement in imaging, the traditional manual methods for assessing ureteral diameters are characterized by labor‐intensive procedures and inherent variability. In the realm of medical image analysis, deep learning has led to a paradigm shift, yet the development of a comprehensive automated tool for the precise segmentation and measurement of ureters in MR images is an unaddressed challenge. Purpose: The ureter was quantitatively measured on 3D MRU images using a deep learning model. Methods: A retrospective cohort of 445 3D MRU scans (443 patients, 52 ± 18 years; 217 female patients) was collected and split into training, validation, and internal testing cohorts. A 3D V‐Net model was trained for urinary tract segmentation, and a post‐processing algorithm was developed for ureteral measurements. The accuracy of the segmentation was evaluated using the Dice similarity coefficient (DSC) and volume intraclass correlation coefficient (ICC), with ground truth segmentations provided by experienced radiologists. The external cohort comprised 50 scans (50 patients, 55 ± 21 years; 30 female patients), and the model‐predicted ureteral diameter measurements were compared with manual measurements to assess system performance. The various diameter parameters of ureter among the different measurement methods (ground truth, auto‐segmentation with automatic diameter extraction, and manual segmentation with automatic diameter extraction) were assessed with Friedman tests and post hoc Dunn test. The effectiveness of the UTO diagnosis was assessed by receiver operating characteristic (ROC) curves and their respective areas under the curve (AUC) between different methods. Results: In both the internal test and external cohorts, the mean DSC values for bilateral ureters exceeded 0.70. The ICCs for the bilateral ureter volume obtained by comparing the model and manual segmentation were all greater than 0.96 (p < 0.05), except for the right ureter in the internal test cohort, for which the ICC was 0.773 (p < 0.05). The mean DSCs for interobserver and intraobserver reliability were all above 0.97. The maximum diameter of the ureter exhibited no statistically significant differences either in the dilated (p = 0.08) or in the non‐dilated (p = 0.32) ureters across the three measurement methods. The AUCs of ground truth, auto‐segmentation with automatic diameter extraction, and manual segmentation with automatic diameter extraction in diagnosing UTO were 0.988 (95% CI: 0.934, 1.000), 0.961 (95% CI: 0.893, 0.991), and 0.979 (95% CI: 0.919, 0.998), respectively. There was no statistical difference between AUCs of the different methods (p > 0.05). Conclusion: The proposed deep learning model and post‐processing algorithm provide an effective means for the quantitative evaluation of urinary diseases using 3D MRU images. [ABSTRACT FROM AUTHOR]

The migration or translocation of an intrauterine device (IUD) in the urinary tract is a rare event. Here, we present the case of a 55-year-old woman who accidentally discovered the ectopic presence of an IUD following a radiological examination for pelvic pain caused by a lumbar discopathy. Over the years, the patient had several IUDs inserted without being able to specify which one had migrated. The removal of the IUD was performed laparoscopically with the minimum resection of the bladder wall and the subsequent cystorrhaphy. The evolution of the patient was favorable. To better analyze these events, we conducted an all-time extensive electronic search of the PubMed database and identified 94 eligible articles, with a total of 115 cases. The literature analysis on the IUD migrations shows either the simultaneous existence of the second IUD or of a maximum number of up to two IUD insertions during the life of patients. Thus, in the presented case, we identified five IUD insertions over time, which explained the chronic inflammatory process by forming an important mass of adherents that included the urinary bladder, uterus, omentum, sigmoid colon, and abdominal wall. Therapeutic management must be adapted to each case depending on the intra/extravesical location of the migrated IUD evaluated by imaging. [ABSTRACT FROM AUTHOR]

Background: Uroperitoneum is a typical disease of the newborn foal, which occurs rarely but regularly. Ultrasonography is considered the most important imaging method for diagnosing this disease. Thus far, only one older case series comprising 31 foals suffering from uroperitoneum has systematically listed results of ultrasound examinations. Objective: This paper presents the findings of an ultrasonographic examination of 34 foals with uroperitoneum in order to inform future interpretation of ultrasonographic data in suspected uroperitoneum cases. Method: Ultrasonographic data of 34 neonatal foals up to the age of 14 days diagnosed with uroperitoneum between 2006 and 2022 were analysed. Results: Most foals demonstrated highly increased levels of free (97%), anechogenic (91%) fluid in the abdomen. Although the urinary bladder was frequently visible (50%), bladder wall discontinuity was only occasionally detectable (18%). Conclusion: Transabdominal ultrasonography has proved to be a very reliable imaging method for diagnosing suspected uroperitoneum. It is recommended that it be used in every case of suspected uroperitoneum in order to exclude differential diagnoses. [ABSTRACT FROM AUTHOR]

PURPOSE To evaluate the efficacy of interventional radiological (IR) procedures in iatrogenic urinary tract injury and investigate the factors affecting the outcome. METHODS Fifty-eight patients (21 male) with a mean age of 50.3 ± 15.8 years referred for iatrogenic urinary tract injury were enrolled in this study. Technical success was defined as (i) successful placement of a nephrostomy catheter within the renal pelvis and/or (ii) successful antegrade ureteral stent placement (double J stent) between the renal pelvis and bladder lumen. Complete resolution was defined as maintained ureteral patency without an external drain and ureteral stent. The factors that may affect complete resolution [ureteral avulsion, ureterovaginal fistula (UVF), history of malignancy/ radiotherapy, and time to IR management] were also investigated. The receiver operating characteristic analysis was performed to estimate the cut-off time point for the IR management timing affecting complete resolution. RESULTS The technical success rate for nephrostomy and ureteral stent placement was 100% (n = 58/58) and 78% (n = 28/36), respectively. In 14 patients, non-dilated pelvicalyceal systems were evident. In 18 patients, no further intervention after percutaneous nephrostomy was performed due to (i) poor performance status (n = 6) and (ii) reconstruction surgery upon clinicians' and/or patients' request (n = 12). Reconstruction surgery was required in 11 of the remaining 40 patients due to failure of percutaneous treatment (n = 11/40, 27.5%). In six of the patients, ureteral stents could not be removed due to the development of benign ureteral strictures (n = 6/40, 15%). Our complete resolution rate was 57.5% (n = 23/40). Age, gender, type of surgery (endoscopic or open), side and location of the injury did not statistically affect the complete resolution rate. The presence of ureteral avulsion, history of malignancy and radiotherapy individually or in combination significantly affected the complete resolution rate negatively. The presence of UVF also had a negative effect on the complete resolution rate; however, it did not reach statistical significance. Delayed intervention was also a significant factor related to lower complete resolution. The optimal cut-off point of the time interval for favorable clinical outcome was found to be 0--19th day following the surgery. CONCLUSION IR procedures are safe and effective in the management of iatrogenic urinary tract injuries. Antegrade ureteral stenting should be performed as soon as possible to establish ureteral integrity without the development of stricture. [ABSTRACT FROM AUTHOR]

ObjectiveNumerous studies have investigated predictors of intravesical recurrence following radical nephrectomy (RNU) in patients with upper urinary tract uroepithelial carcinoma (UTUC). In contrast, extravesical recurrence (EUR) has received less focus. Consequently, this study aims to evaluate the significant predictors of EUR after RNU through a systematic review of the literature and a meta-analysis.MethodologyWe conducted a computerized bibliographic search across PubMed, Embase, and Cochrane databases to identify reports that include detailed results from multivariate analyses of predictors of EUR. Adhering to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines and the AMSTAR (Assessing the Methodological Quality of Systematic Reviews) criteria, we selected thirteen retrospective studies, each with a sample size exceeding 100 cases. Using Review Manager 5.4 software, we performed cumulative analyses of available HR and their corresponding 95% confidence intervals to evaluate potential predictors of EUR.ResultsOur findings indicate that patient-specific predictors include preoperative Ki-67 with a HR of 3.61 (P = 0.003), neutrophil-to-lymphocyte ratio with an HR of 2.20 (P = 0.0005), and glomerular filtration rate with an HR of 3.35 (P = 0.0009). Tumor-specific predictors identified were tumor stage with an HR of 4.67 (P < 0.00001), lymphovascular invasion with an HR of 2.37 (P = 0.004), and lymph node status with an HR of 2.68 (P < 0.0001). Regarding treatment-specific predictors, positive surgical margins were associated with an HR of 3.97 (P = 0.0005), and adjuvant chemotherapy was associated with an HR of 1.65 (P = 0.03).DiscussionOur study identified three significant predictors across patient, tumor, and treatment dimensions for extravesical recurrence following radical nephroureterectomy in patients with upper urinary tract uroepithelial carcinoma. We hypothesize that history of bladder cancer, platelet-to-lymphocyte ratio, and urinary cytology could also be strong predictors of post- RNU extravesical recurrence in patients with upper UTUC, assuming adequate sample size and controlled heterogeneity. This research aims to provide urological clinicians with enhanced guidance for postoperative decision-making.

Introduction: While the efficacy of flexible ureterorenoscopy (URS) in managing solitary kidney stones (KSs) is widely acknowledged, its effectiveness in treating multiple stones has scarcely been investigated. This study aims to assess the effectiveness and safety of retrograde intrarenal surgery (RIRS) utilizing flexible URS and laser lithotripsy in the management of multiple KSs. Methods: This study was a single-group cohort study conducted on patients with multiple KSs who underwent treatment with RIRS using flexible URS and laser lithotripsy. Stone-free status was considered as the lack of residual stone fragments or any residual stone of any size. The first follow-up appointment was arranged 3-4 weeks following the procedure. If significant residual stones were present, patients underwent reintervention within 2-4 weeks. Results: A total of 110 patients with multiple KSs were included. The mean stone burden was 27.5 ± 7.9 mm, and the mean duration of the operation was 54.9 ± 19.7 minutes. Seven cases (6.3%) experienced intraoperative complications, while postoperative complications were found in eight cases (7.3%). After four weeks, a stone-free rate (SFR) was documented in 80.9% of the cases, and this rate increased to 93.6% after three months. The SFR after three months was significant with Guy’s stone score (p < 0.001); however, it did not reach a significant level with any other parameters. Conclusions: The RIRS with flexible URS may be an effective and potentially safe procedure for treating multiple KSs. It may yield a favorable SFR with an acceptable complication rate.

PurposeAlthough congenital anomalies of the kidney and urinary tract (CAKUT) are among the leading causes of end-stage kidney disease (ESKD) in children and young adults, kidney transplantation access for this population has not been well studied in the US. We compared transplantation access in the US based on whether the etiology of kidney disease was secondary to CAKUT, and additionally by CAKUT subgroups (anatomic vs. inherited causes of CAKUT).MethodsUsing the United States Renal Data System, we conducted a retrospective cohort study of 80,531 children and young adults who started dialysis between 1995 and 2015. We used adjusted Cox models to examine the association between etiology of kidney disease (CAKUT vs. non-CAKUT, anatomic vs. inherited) and receipt of kidney transplantation, and secondarily, receipt of a living vs. deceased donor kidney transplant.ResultsOverall, we found an increased likelihood of kidney transplantation access for participants with CAKUT compared to those without CAKUT (HR 1.23; 95% CI 1.20-1.27). Among the subset of individuals with CAKUT as the attributed cause of ESKD, we found a lower likelihood of kidney transplantation in those with anatomic causes of CAKUT compared to those with inherited causes of CAKUT (adjusted HR 0.85; 0.81-0.90).ConclusionThere are notable disparities in kidney transplantation rates among CAKUT subgroups. Those with anatomic causes of CAKUT started on dialysis have significantly reduced access to kidney transplantations compared to individuals with inherited causes of CAKUT who were initiated on dialysis. Further studies are needed to understand barriers to transplantation access in this population.

BackgroundBacterial urinary tract infections have been associated with comorbidities and increased antimicrobial resistance over time.ObjectiveTo identify bacterial species, antimicrobial susceptibility patterns and risk factors associated with antimicrobial resistance.AnimalsThree hundred sixty-three positive urine cultures from 308 cats.MethodsBacterial species and antimicrobial susceptibility data from positive aerobic bacterial urine cultures from cats with growth of ≥103 colony forming units per milliliter (cfu/ml) were included. Medical records were reviewed, and bacteriuria was classified as sporadic bacterial cystitis, recurrent bacterial cystitis or subclinical bacteriuria (SBU). Multivariable logistic regression analysis was used to evaluate antimicrobial resistance risk factors.ResultsA total of 444 bacterial isolates from 363 bacteriuric episodes were identified. Escherichia coli (52%) and SBU (59%) were the most common organism and classification, respectively. When compared to other classifications of bacteriuria, Enterococcus spp. were more likely to be isolated from SBU episodes (P 90% susceptible designation to all bacteria isolated highlighting the importance of performing urine culture and susceptibility testing, particularly for cats with recurrent bacterial cystitis.

Hematuria is the presence of blood in the urine and is classified as either gross hematuria or microscopic hematuria. There are many causes of hematuria, and the differential diagnosis depends on the presence or absence of comorbidities and whether it is glomerular or non-glomerular. When hematuria in children is symptomatic or persistent, an evaluation of the cause is essential. The causes of hematuria and basic approaches to its diagnosis are discussed in this review.

Abstract Introduction The safety and efficacy of CRS + HIPEC combined with urinary tract resection and reconstruction are controversial. This study aims to summarize the clinicopathological features and to evaluate the safety and survival prognosis of CRS + HIPEC combined with urinary tract resection and reconstruction. Methods The patients who underwent urinary tract resection and reconstruction as part of CRS surgery were retrospectively selected from our disease-specific database for analysis. The clinicopathological characteristics, treatment-related variables, perioperative adverse events (AEs), and survival outcomes were studied using a descriptive approach and the K-M analysis with log-rank comparison. Results Forty-nine patients were enrolled. Perioperative serious AEs (SAEs) were observed in 11 patients (22.4%), with urinary SAEs occurring in 3 patients (6.1%). Additionally, there were 23 cases (46.8%) involving urinary adverse events (UAEs). The median overall survival (OS) in the entire cohort was 59.2 (95%CI: 42.1–76.4) months. The median OS of the UAE group and No-UAE group were 59.2 months (95%CI not reached), and 50.5 (95%CI: 11.5 to 89.6) months, respectively, with no significant difference (P = 0.475). Furthermore, there were no significant differences in OS based on the grade of UAEs or the number of UAEs (P = 0.562 and P = 0.622, respectively). Conclusion The combination of CRS + HIPEC with urinary tract resection and reconstruction is associated with a high incidence of Grade I-II UAEs, which do not have an impact on OS. The safety profile of this combined technique is acceptable. However, this is a retrospective single-center single-arm analysis, with limitations of generalizability and potential selection bias. The findings need high-level validation.

BACKGROUND: Idiopathic functional urinary outflow tract obstruction (iFUOTO) is an uncommon but life-limiting disease whose etiology and clinical course of disease remain poorly understood. OBJECTIVE: Characterize signalment, clinical signs, clinicopathologic findings, treatments, and propose a standardized response score for dogs with iFUOTO. ANIMALS: Thirty-one client-owned dogs diagnosed with iFUOTO. METHODS: Retrospective case series. Medical records from 2010 to 2021 were reviewed and findings recorded. Dogs were categorized based on the presence or absence of overt signs of neurological disease. Response to treatment was scored. RESULTS: Thirty-one dogs were included. All dogs had stranguria and 14 (45%) had overflow urinary incontinence. Mean age of onset for signs was 6.9 years±8 months. Twenty-four dogs (77%) were castrated males, 5 (16%) intact males, and 2 (6%) spayed females. Eight (26%) of dogs had overt neurological deficits. Follow-up data were available for 29 dogs (median 38 days, range: 2-1277). Final outcome scores were not significantly different among dogs with overt signs of neurological disease (median score 2.5; range: 0-3) and those without (median score 1; range; 0-3; P = .35). Treatments included alpha antagonists, skeletal muscle relaxants, parasympathomimetics, anti-inflammatories, castration, temporary placement of a urethral catheter, or a combination of these. CONCLUSIONS AND CLINICAL RELEVANCE: Multimodal treatment was frequently prescribed, but a standard outcome score is needed to evaluate the effectiveness of these therapies. Serial neurological examinations and monitoring of the dogs dysuria are warranted.

Introduction: The safety and efficacy of CRS + HIPEC combined with urinary tract resection and reconstruction are controversial. This study aims to summarize the clinicopathological features and to evaluate the safety and survival prognosis of CRS + HIPEC combined with urinary tract resection and reconstruction. Methods: The patients who underwent urinary tract resection and reconstruction as part of CRS surgery were retrospectively selected from our disease-specific database for analysis. The clinicopathological characteristics, treatment-related variables, perioperative adverse events (AEs), and survival outcomes were studied using a descriptive approach and the K-M analysis with log-rank comparison. Results: Forty-nine patients were enrolled. Perioperative serious AEs (SAEs) were observed in 11 patients (22.4%), with urinary SAEs occurring in 3 patients (6.1%). Additionally, there were 23 cases (46.8%) involving urinary adverse events (UAEs). The median overall survival (OS) in the entire cohort was 59.2 (95%CI: 42.1–76.4) months. The median OS of the UAE group and No-UAE group were 59.2 months (95%CI not reached), and 50.5 (95%CI: 11.5 to 89.6) months, respectively, with no significant difference (P = 0.475). Furthermore, there were no significant differences in OS based on the grade of UAEs or the number of UAEs (P = 0.562 and P = 0.622, respectively). Conclusion: The combination of CRS + HIPEC with urinary tract resection and reconstruction is associated with a high incidence of Grade I-II UAEs, which do not have an impact on OS. The safety profile of this combined technique is acceptable. However, this is a retrospective single-center single-arm analysis, with limitations of generalizability and potential selection bias. The findings need high-level validation. [ABSTRACT FROM AUTHOR]

We assessed the risk of congenital anomalies in children who have a sibling with cancer. We performed a matched cohort study of children born between 2006 and 2022 in Quebec. The exposure was having a sibling with cancer. Exposed children were matched to unexposed children based on sex, number of siblings, birth order, and year. The outcome included heart defects, orofacial clefts, and other anomalies. Using conditional logistic regression, we estimated odds ratios (OR) and 95 % confidence intervals (CI) for the association between having a sibling with cancer and the likelihood of having a congenital anomaly. A total of 2403 children who had a sibling with cancer were matched to 240,257 unexposed children. Congenital anomalies were more frequent in children who had a sibling with cancer compared with unexposed children (10.3 % vs 8.9 %). Overall, having a sibling with cancer was only weakly associated with congenital anomalies (OR 1.18, 95 % CI 1.04–1.35). Exposed children tended to have greater odds of polydactyly/syndactyly (OR 1.89, 95 % CI 1.11–3.21) and urinary defects (OR 1.50, 95 % CI 1.09–2.08) compared with unexposed children. Children who have a sibling with cancer have an only weakly elevated risk of congenital anomalies. [ABSTRACT FROM AUTHOR]

Hematuria is the presence of blood in the urine and is classified as either gross hematuria or microscopic hematuria. There are many causes of hematuria, and the differential diagnosis depends on the presence or absence of comorbidities and whether it is glomerular or non-glomerular. When hematuria in children is symptomatic or persistent, an evaluation of the cause is essential. The causes of hematuria and basic approaches to its diagnosis are discussed in this review. [ABSTRACT FROM AUTHOR]

A 2‐year‐old, male, neutered labrador retriever with a previous diagnosis of left renal agenesis and left cryptorchidism presented for investigation of mild intermittent urinary incontinence. Abdominal ultrasound, intravenous urography and retrograde positive‐contrast urethrocystography were performed, identifying an unusual fluid‐filled structure, confluent with the left side of the prostate gland. Histopathological diagnosis, following surgical excision, was an ectopic ureterocoele remnant. Urinary incontinence temporarily improved following surgery, but subsequently recurred. A presumptive diagnosis of urethral sphincter mechanism incompetence, in addition to the ectopic ureterocoele remnant was given. Dogs with renal agenesis typically have an absent ipsilateral ureter; however, this report demonstrates an ipsilateral ectopic ureterocoele remnant, a condition rarely reported in veterinary medicine. Multiple ipsilateral genitourinary deformities should be suspected and investigated in animals presenting with any urogenital developmental abnormality. Clinical significance of ectopic ureterocoele remnant in male dogs with urinary incontinence should however be carefully evaluated, and other causes (e.g., urethral sphincter mechanism incompetence) should be considered. [ABSTRACT FROM AUTHOR]

A 5‐year 11‐month‐old, male, neutered, Bengal cross cat was examined for a 5‐week history of tenesmus. Positive contrast urethrocystography and computed tomography scan demonstrated a fluid‐filled structure occupying the pelvic canal. Midline coeliotomy and symphysiotomy revealed a large cystic structure dorsal to the urethra in the area of the prostate. This structure was communicating with the urethra via a duct and both vas deferens were inserting in it. The duct was ligated and partial ablation and omentalisation of the structure was performed. Histopathological examination identified features consistent with a true uterus masculinus. Bacteriology of the cystic fluid cultured Escherichia coli and Bacteroides fragilis. The cat recovered uneventfully and with no ongoing clinical issues. [ABSTRACT FROM AUTHOR]

Background: Bacteria are present on all surfaces, to which they were carried by many direct and indirect methods of transmission. A toilet is simply a receptacle into which both solid and liquid waste of human origin, in the form of urine and excreta are discharged. In public toilets, complete strangers mix and use the same sanitary facilities, with all the related risks of bodily fluid exchange, contamination and organism transmission. Unhygienic use of the toilet's facilities may cause urine and fecal residues after use to serve as a major reservoir or source of human pathogen, which may in turn bring about disease outbreak. Aim: This study aimed at Identification of Bacteria from Public Toilets of Modern Market (Goico) In Musanze Town, Rwanda Method: This cross-sectional study was conducted to identify bacteria from GOICO market toilets. About 40 samples; 20 from male and 20 from female toilets were collected and transported to INES-clinical microbiology laboratory for microbiological analysis. Laboratory techniques including culture, gram stain, biochemical tests and antibiogram were performed. Results: The most predominant bacteria isolated was S. aureus (31.43%), followed by S. typhi (20%), Streptococcus(15.71%), E. coli(12.86%), P. aeuriginosa(10%), P. mirabilis(7.14%), C. freundi(1.43%), S. epidermidis (1.43%). It was noted that female toilets were more contaminated (51.43%) than male toilets (48.57%). All gram positive and gram-negative bacteria were sensitive to Gentamicin. Almost all bacteria except P. mirabilis were sensitive to Norfloxacin, gram negative showed a resistance to Vancomycin and Novobiocin. Conclusion: These results should alert public toilets users that extreme caution must be executed while using these toilets, as they may be a source of pathogenic bacteria. The best way to keep a toilet and its seat free of bacteria is to clean it with bleach. Otherwise, keep the bacteria at bay by washing your hands, and if you just don't trust that toilet seat, wipe it down with a disinfectant or antibacterial wipe before you sit. [ABSTRACT FROM AUTHOR]

Cranberries have a long history of use in the prevention of urinary tract infections. Cranberry products vary in proanthocyanidin content, a compound implicated in preventing the adhesion of uropathogenic Escherichia coli (E. coli) to uroepithelial cells. Testing is routinely done by cranberry product formulators to evaluate in vitro bacterial anti-adhesion bioactivity, shelf-life, and potential efficacy of cranberry products for consumer use to maintain urinary tract health. Hemagglutination assays evaluate the anti-adhesion bioactivity of cranberry products by determining how effectively the products prevent agglutination of specific red blood cells with E. coli expressing P-type and Type 1 fimbriae. The current study sought to improve upon an established anti-adhesion assay method by expanding the number of E. coli strains used to broaden potential in vivo efficacy implications and presenting results using photomicrographic data to improve accuracy and build databases on products that are routinely tested. Different lots of cranberry powder ingredient and two formulated products were tested independently for anti-adhesion activity using the established method and the improved method. Positive harmonization of results on the same samples using rigorous controls was achieved and provides the substantiation needed for the cranberry industry to utilize the improved, rapid in vitro testing method to standardize cranberry products for sufficient anti-adhesion bioactivity and maintain consumer confidence. [ABSTRACT FROM AUTHOR]

Objective For over 60 years there has been conjecture about the identity of an Ehrlich's test positive pyrrole (Mauve Factor) reputed to be a biomarker for psychological disorders, including anxiety. We reviewed studies that attempt to identify Mauve Factor and subjected authentic standards of the 2 main candidates, kryptopyrrole and hydroxypyrrole, to the Ehrlich's reaction. Methods Modified Ehrlich's test for kryptopyrrole and hydroxypyrrole were applied to urine samples from 10 volunteers, anxious and nonanxious. Results Based on the mechanistic chemistry of Ehrlich's reaction and reactions of the 2 compounds, Mauve Factor cannot be hydroxypyrrole. Analyses of urine samples from volunteers, identified by the Generalized Anxiety Disorder - 7 item scale (GAD-7 ≥10; n = 5) and control urine samples (GAD-7 <10; n = 5) using a kryptopyrrole calibration graph, show that concentrations are similar in both groups. Conclusion Kryptopyrrole may be the elusive Mauve Factor. Its possible origin from stercobilin via gut microbiome–mediated metabolism, its link to gut-mediated neurological effects via γ-aminobutyric acid (GABA) receptors, and its predicted interaction with Zn2+ and consequent impact on zinc homeostasis are discussed. The GAD-7 scale does not differentiate between state and trait anxiety and as such, the minimal difference in pyrrole levels between volunteer groups requires further study. [ABSTRACT FROM AUTHOR]

• Women submitted to hysterectomy for cervical cancer increased the percentage of urinary symptoms. • After 4th PO month, the FSFI score has improved in women submitted to surgery for benign conditions. • Non-surgical factors may be associated with higher rates of pelvic dysfunction after hysterectomy. • Cervical cancer patients had higher percentages of urinary and sexual dysfunctions. The estimated worldwide incidence of cervical cancer (CC) is half a million cases per year. Surgical treatment is the mainstay approach for this condition. To assess the effects of hysterectomy due to cervical cancer in urinary symptoms and sexual function and the disorder related impact on the quality of patients life. A cohort study was performed in Fortaleza/CE (Brazil) with 71 patients; of these, 31 were diagnosed with cervical cancer (G-CCU) and 40 with gynecological benign disease (G-PB). Sexual function (FSFI questionnaire), quality of life (SF-36 questionnaire) and urinary symptoms (KHQ instrument) were investigated in both groups at baseline (T0), one month (T1) and four months after surgery (T2). Both groups presented at baseline, similar urinary symptoms (p > 0.05), but this frequency doubled for the G-CCU group at T1 and remained unchanged at T2 (p = 0.012). G-PB's frequency of symptoms remained the same for 4 months after surgery. At baseline G-PB had higher risk for sexual dysfunction than G-CCU (82.5 % versus 54.8 %, p = 0.011). However for G-CCU, an increase of this percentage was perceived at T2.Women from the G-CCU group presented worse general and specific quality of life results. Women underwent to hysterectomy due to cervical cancer presented higher percentages of urinary symptoms, higher risk for sexual dysfunction and worse general and specific quality of life scores. [ABSTRACT FROM AUTHOR]

Purpose: Lower urinary tract symptoms (LUTS) are a challenge to the healthy nursing workforce. Nurses confront various objective and subjective nursing workloads which contribute to their LUTS, but less is known about how nursing workloads influence their LUTS. This study is designed to test hypotheses that delayed voiding behaviors mediate the relationships between nursing workloads and LUTS in female nurses. Materials and Methods: This study analyzed the baseline data collected from an ongoing cohort study named Nurse Urinary Related Health Study in China. LUTS of nurses in 20 tertiary hospitals were assessed with the International Consultation on Incontinence Questionnaire? Female Lower Urinary Tract Symptoms. Objective nursing workloads including working environment, working hours, and working schedule were collected, and perceived stress, the proxy of the subjective nursing workload, was assessed with the Perceived Stress Scale. Delayed voiding behaviors were assessed with 3 questions adapted from the Taiwan Nurse Bladder Survey. Structural equation modeling was used to run the mediation model. Results: More than half (51%) of 13,191 female nurses had LUTS. Median age was 31 years (IQR 27-37). When delayed voiding behaviors served as a mediator, the direct effects of subjective nursing workload rather than objective nursing workloads on LUTS were significant. Conclusions: Nursing workloads influence nurses' LUTS via delayed voiding behaviors. Strategies tailored to delayed voiding behaviors should be developed, and these may work with stress-reducing strategies as the gatekeepers for nurses' bladder health. [ABSTRACT FROM AUTHOR]

Copyright of Revista Foco (Interdisciplinary Studies Journal) is the property of Revista Foco and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Objectives Expanding the virtual microscopy (VM) slide collection for nongynecological cytology is important to teaching. In a mixed-methods approach, this study evaluated VM's performance and user experience to determine its feasibility and usage in an educational setting. Methods From September through October 2022, the students reviewed 44 whole-slide imaged nongynecological slides. The concordance rate with reference diagnosis was compared with that from light microscopy (LM) from 4 months earlier. In addition to assessing the overall performance from VM, imaged urinary cytology's accuracy was reviewed for both urinary and nonurinary cytology. Finally, the students' weekly feedback logs were analyzed to gain insights for improving the digital screening experience. Results The overall nongynecological diagnostic accuracy was significant between the 2 screening platforms (P <.001), favoring LM over the VM platform. Light microscopy also performed better than VM in urine cytology cases, with 84.2% concordance against reference diagnosis, compared with 61.1% for the VM platform (P =.03). As for the accuracy of nonurinary cases, its glass slide (LM) agreement with the reference diagnosis was also superior at 84.8%, compared with 58.8% for VM (P =.03). Finally, the overarching theme discerned from reviewing the user logs was concern over image quality, which was mentioned 76 times. Conclusions The VM results were poorer compared with LM in our validation. Its use seems promising, but more focus is needed to improve the VM screening platform. [ABSTRACT FROM AUTHOR]

Copyright of Die Urologie is the property of Springer Nature and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Abstract Background Uroperitoneum is a typical disease of the newborn foal, which occurs rarely but regularly. Ultrasonography is considered the most important imaging method for diagnosing this disease. Thus far, only one older case series comprising 31 foals suffering from uroperitoneum has systematically listed results of ultrasound examinations. Objective This paper presents the findings of an ultrasonographic examination of 34 foals with uroperitoneum in order to inform future interpretation of ultrasonographic data in suspected uroperitoneum cases. Method Ultrasonographic data of 34 neonatal foals up to the age of 14 days diagnosed with uroperitoneum between 2006 and 2022 were analysed. Results Most foals demonstrated highly increased levels of free (97%), anechogenic (91%) fluid in the abdomen. Although the urinary bladder was frequently visible (50%), bladder wall discontinuity was only occasionally detectable (18%). Conclusion Transabdominal ultrasonography has proved to be a very reliable imaging method for diagnosing suspected uroperitoneum. It is recommended that it be used in every case of suspected uroperitoneum in order to exclude differential diagnoses.

Antenatally diagnosed urinary tract dilatation (UTD), previously referred to as antenatal hydronephrosis, is the most commonly detected abnormality by prenatal ultrasonography. Several grading systems have been developed for the classification of antenatal UTD using prenatal and postnatal ultrasonography. UTD comprises a wide variety of congenital abnormalities of the kidney and urinary tract ranging from transient UTD to more significant abnormalities such as vesicoureteral reflux, ureteropelvic junction obstruction, ureterocele, ureterovesical junction obstruction, posterior urethral valves, and non-refluxing megaureter. Optimizing the evaluation of antenatally detected UTD is essential to recognize children with important disorders while avoiding excessive investigations. Conservative approach with close follow-up is increasingly accepted as an appropriate treatment option for patients with asymptomatic vesicoureteral reflux and ureteropelvic junction obstruction in recent years. However, predicting permanent kidney damage in an unselected group of children with antenatal UTD is still challenging. The management and follow-up of children with UTD should be individualized based on recommendations from a pediatric nephrologist, a pediatric urologist, or both. Future research directed at predicting long-term outcomes of children diagnosed with UTD from mild findings to severe disease is needed to refine management for those at higher risk of kidney disease progression.

Minimally invasive surgical creation of a peritoneal window for the treatment of lymphoceles post-kidney transplant is an effective procedure that comes with an elevated risk of iatrogenic injury to the urinary tract. Here, we present indocyanine green dye injection through a ureteral stent for intraoperative identification and avoidance of the transplant collecting system during peritoneal window creation. The procedure was successful and allowed for the resolution of the lymphocele without complication. [ABSTRACT FROM AUTHOR]

Extracellular vesicles (EVs) are a population of nanoscale particles surrounded by a phospholipid bilayer, enabling intercellular transfer of bioactive molecules. Once released from the parental cell, EVs can be found in most biological fluids in the human body and can be isolated from them. For this reason, EVs have significant diagnostic potential and can serve as an excellent source of circulating disease biomarkers. Protein glycosylation plays a key role in many biological processes, and aberrant glycosylation is a hallmark of various diseases. EVs have been shown to carry multiple glycoproteins, but little is known about the specific biological roles of these glycoproteins in the context of EVs. Moreover, specific changes in EV glycosylation have been described for several diseases, including cancers and metabolic, cardiovascular, neurological or kidney diseases. Urine is the richest source of EVs, providing almost unlimited (in terms of volume) opportunities for non-invasive EV isolation. Recent studies have also revealed a pathological link between urinary EV glycosylation and urological cancers, as well as other pathologies of the urinary tract. In this review, we discuss recent research advances in this field and the diagnostic/prognostic potential of urinary EV glycosylation. In addition, we summarize common methods for isolating EVs from urine and techniques used to study their glycosylation.

Background Congenital anomalies of the kidney and urinary tract (CAKUT) are a group of structural abnormalities affecting these vital organs, frequently leading to chronic kidney disease in children. This study aims to comprehensively understand the clinical profile of CAKUT in children in Central India, an area with unique socio-demographic characteristics and limited prior research on this topic. Methods A prospective observational study will be conducted over three years in the pediatric department of AVBRH, a tertiary healthcare center in Central India. Data were collected through interviews with parents or guardians of children up to 18 admitted to the hospital. Clinical symptoms, prenatal history, physical examinations, and diagnostic investigations were meticulously documented. Expected outcome The study is expected to reveal the prevalence and clinical profile of CAKUT in Central Indian children. Anticipated outcomes include insights into anomalies, clinical symptoms, and potential correlations with factors like prenatal care and consanguineous marriages. Diagnostic investigations will help assess the severity of renal impairment. The results may also uncover regional variations and have implications for public health initiatives aimed at early intervention and improved patient care. However, these are preliminary expectations that are subject to confirmation through the completion of the study.