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Query: UMLS:C0034186 (pyelonephritis)
 6,144 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Urodynamic studies were carried out in a 14-year-old boy with Prune Belly Syndrome and terminal renal failure prior and after successful renal transplantation. Increased bladder capacity, nonprovocative detrusor instability and a high compliance were the most characteristic findings during the filling phase of the bladder. During the voiding phase an increased detrusor pressure was demonstrated. Outflow resistance and maximum urinary flow rate were within normal range before and after transplantation. In contrast to the findings before renal transplantation, however, micturition was imbalanced after transplantation (residual urine 100 ml). Urodynamics revealed that the bulging of the posterior urethra, observed in the early voiding phase, was due to a congenital insufficiency of the posterior urethral musculature (megalourethra) and not caused by mechanical obstruction leading to urethral dilatation. It is suggested that detrusor-bladder-neck-dyssynergia is the primary cause of the imbalanced micturition and its consequences (bladder distention, reflux, urinary tract infection, hydronephrosis, pyelonephritis) in patients with Prune Belly Syndrome. The findings of a normal, respectively increased detrusor activity are in contrast to the observations of some authors, describing attenutation and absence of detrusor muscle fibres. The indications and effects of transurethral resection and internal urethrotomy, proposed by some authors, are discussed.
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PMID:Urodynamic studies in prune belly syndrome. A case report. 3 48

Trigonal-colonic anastomosis for diversion of urine into the colon was performed in 12 clinically normal dogs and in 10 incontinent dogs with diseases of the urinary bladder or urethra. Dogs were studied from 1 to 30 months after surgery. The surgical procedure was technically satisfactory. Fifteen of 22 dogs were studied with intravenous urography, and only 1 case of hydronephrosis was found. Pyelitis was a common histopathologic finding in both groups of dogs. Pyelonephritis developed in 30% of dogs, regardless of duration of anastomosis. Glomerular filtration rate was reduced in all dogs studied, but renal failure was infrequent. Values for blood urea nitrogen and serum inorganic phosphorus were elevated due to intestinal recycling of nitrogenous products and phosphate. Electrolyte imbalances were not a problem, but gastrointestinal disturbances developed in 3 of the 10 diseased dogs. Six of 10 diseased dogs survived from 9 months to more than 3 years. Trigonal-colonic anastomosis appears to be a satisfactory salvage procedure for incontinent dogs with diseases of the urinary bladder or urethra that do not respond to other forms of therapy.
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PMID:Trigonal-colonic anastomosis: a urinary diversion procedure in dogs. 44 50

The clinical symptoms of urinary tract infections (UTI) are only rarely an indication of the presence of the disease in childhood. Of decisive importance for the detection of UTI is an appropriate investigation to determine whether there is significant bacteriuria. Since in a significant proportion of cases of UTI in children there is underlying congenital anomaly or functional change in the urinary tract with stasis, and since surgical means of treatment are available today, diagnosis, i.e. at least radiological exploration, is essential. Approximately half the children with UTI are younger than one year at the time of diagnosis. In neonates, boys are more frequently affected than girls, whereas in older age-groups the incidence of significant bacteriuria (approximately 1.5%) and clinically relevant UTI or pyelonephritis is higher in females than in males. "Idiopathic" ("non-urologically induced") UTI is very seldom found in boys after infancy, and "asymptomatic bacteriuria" is largely confined to females. The "urethral syndrome" is probably caused by minor obstruction of the urethra and "bladder-sphincter dyssynergy". The fact that approximately nine of ten cases of UTI relapse in children are due to reinfection with a different pathogen has certain consequences for therapy. Prophylactic long-term medication is recommended during the phase after surgical correction of anomalies of the urinary tract.
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PMID:[Urinary tract infections in childhood (author's transl)]. 55 Oct 80

In 321 women with the symptoms of a stress-incontinence we tried to find out if specific methods can reform the diagnostic. By clinical tests an urinary incontinence could be shown only in 71.1%. The results from urethrocystography (169 patients) and simultane measuring of pressure in urethra and urinary bladder (222 patients) are compared with the results of the clinical examination of urine incontinence. According to the method used, the urethrocystography was corresponding with the positive clinical test between 75.9 and 93.5%, the measuring of the pressure in 87.4%. In negative clinical tests a stress-incontinence could be diagnosed or be excluded by combined radiological, tonometrical and endoscopical examinations. Urethrocystography and simultane measuring of pressure complement one another, they are no competitive methods. Our investigations further showed that the upper urogenital tract is cooperating in stress-incontinence. In the infusion-urogram 19.7% of the patients showed signs of chronic pyelonephritis, 15.3% had no urinary insufficience. 22.6% were suspect to have a chronic pyelonephritis. Finally the worth of diagnostic methods on therapeutic actions is discussed.
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PMID:[A contribution to the diagnostic of stress-in-continence (author's transl)]. 56 67

Report is given of clinical experiences gained with the new developed semi-syntheticpenicillin "Spectacillin" on 75 patients suffering from an urological disease. The drug has been applied for therapy of acute and chronic forms of inflammations of the bladder and the urethra, additionally the prostatitis, the epididymitis, but first of all the pyelonephritis (caused bacterially). Within the germ spectrum of these diseases, germs of the coli-type, streptococcus faecalis (enterococcus), staphylococcus aureus, Neisseria gonorrhoeae, proteus, pseudomonas and aerobacter were found. Patients with acute/subacute diseases have been treated 8 to 9 days (3-4 grams per day) on an average; in case of chronic diseases, the patients received initially 1 gram a day and thereupon during 3 to 4 weeks 3 to 4 grams per day. The well-succeeded results have been documentated by means of the clinical course, the germ-elimination and the laboratory findings. The exanthematous quote may be demonstrated as remarkably low, considering the good universal compatibility of the substance. For this reason "Spectacillin" not finally is suitable for treatment of acute and chronic infections of the urogenital systems.
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PMID:[Clinical study with Spectacillin on patients with infections of the urogenital system (author's transl)]. 80 72

Two groups of patients, each consisting of 40, were investigated for the occurrence of mycoplasmas in the urethra, bladder and upper urinary tract. Mycoplasmas were isolated significantly more frequently from the bladder urine of patients with chronic pyelonephritis than from patients with non-infectious urinary tract diseases. Furthermore, mycoplasmas were isolated from the upper urinary tract of 5 patients with chronic pyelonephritis, while mycoplasmas could not be cultivated from the upper urinary tract of patients with non-infectious urinary tract diseases.
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PMID:The occurrence of mycoplasmas in the urinary tract of patients with chronic pyelonephritis. 113 Jan 97

Urinary tract infections in pregnant women develop owing to the short urethra in women, mechanical pressure of the uterus onto atonic urethra during pregnancy, atony of the urinary bladder caused by the level of progesterone, iatrogenic factors (catheterization), some metabolic disorders, anemia, obstipation etc. These are frequent reasons why pregnant women over the pregnancy period develop infections of urinary tract, where a significant number of them have bacteriuria showing no symptoms of acute infection whatsoever. The research covered unselectively 4,850 urine samples of pregnant women. The results obtained by classical methods--taking urinoculture and doing antibiogramme--have shown that in this sample there is a large number of asymptomatic bacteria (13%), which is complicated by an increased incidence of pyelonephritis gestoses in the second half of the pregnancy. In our sample, the commonest cause of urinary infections has been E. Coli, then the second trimester of risk gestation period; the risk group with regard to parity are primiparas, while the risk age is between 20 and 29.
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PMID:[Urinary infections during pregnancy and methods of prevention]. 136 37

The membranous part of the urethra has anatomic specificity influencing its trauma mechanism and allowed for in the trauma treatment policy. In 239 patients with an injured membranous part of the urethra described in the paper, the rupture was mainly due to the hip fracture. 85% of the patients developed a complete rupture with subsequent obliteration, 15% had strictures. Cicatrization involved the whole membranous part in 74% of the cases. In relevant traumas common are severe rectourethral and peritoneal fistulas surgical treatment of which as well as obliterations involves great technical difficulties. There is a variety of operative approaches and techniques (perineal, original anteropubic and anorectal). Urethral reconstruction should not be followed by bougienage. Typical are also frequent renal and genital complications (phlegmons, nephroliths, ureteroliths, epididymitis, orchitis, prostatitis, pyelonephritis). The number of complications depends on the choice of the adequate operative technique and due consideration of anatomical characteristics of the membranous part of the urethra.
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PMID:[The characteristics of the membranous part of the urethra]. 141 40

Urethral strictures resultant from hip fractures were examined and treated in 140 patients admitted to hospital with multiple attendant traumas: rupture of the bladder and abdominal organs, rib and limb fractures, renal injuries. All of them underwent epicystostomy followed in 3--4 months by urethroplasty. Drainage of the bladder and paracystic fat was passive in 38 and active in 102 patients. Passive drainage, common in urological practice, failed to yield satisfactory results because of deficient urine outflow from the bladder and gave rise to various complications: phlegmons, femoral osteomyelitis, pyelonephritis, urosepsis. Fourteen patients developed urinary fistulas, four subjects had a large postoperative hernia involving the bladder. The adverse effects made urethroplasty problematic. With active drainage, the bladder and paracystic fat were continuously irrigated with drug solutions siphoned off from a jar into a dropper obtained from a disposable hemotransfusion system. Patients on active drainage avoided complications, 47 of them were successfully operated on the urethra, in 55 urethral competence recovered without surgical interventions.
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PMID:[The prevention and treatment of posttraumatic strictures of the posterior urethra in patients with pelvic bone fractures]. 175 28

Spheroidal bladder substitutes made from double-folded ileal segments, similar to Goodwin's cup-patch technique, are devoid of major coordinated wall contractions. This, together with the reservoir's direct anastomosis to the membranous urethra, prevents major intraluminal pressure peaks and assures a residue-free voiding of sterile urine. In order to determine whether, under these conditions, an afferent tubular isoperistaltic ileal segment of 20-cm length protects the upper urinary tract as efficiently as an antireflux nipple, 60 male patients who were subjected to radical cystectomy were prospectively randomised to groups in which a bladder substitute was formed together with either of these 2 antireflux devices. An analysis of the results obtained in 20 patients from each group who could be followed for more than 1 year (median observation time 30 and 36 months) showed no differences between the groups in metabolic disturbances, kidney size, reservoir capacity, diurnal and nocturnal urinary continence, the incidence of urinary tract infection or episodes of acute pyelonephritis. Later than 1 year postoperatively, intravenous urograms of the renoureteral units of 25% of the patients with antireflux nipples showed persistent but generally slight dilatation of the upper urinary tracts. This observation was significantly more frequent than it was in patients with afferent tubular segments. Urodynamic and radiographic studies showed that the competence of the antireflux nipples was secured by the raised surrounding intravesical pressure. This, however, also resulted in a transient functional obstruction, and a gradual rise of the basal pressure in the upper urinary tracts was recorded. In patients with afferent ileal tubular segments, contrast medium could be forced upwards into the renal pelvis when the bladder substitutes were overfilled. However, despite raised intravesical pressures, peristalsis in the isoperistaltic afferent tubular segment gradually returned contrast medium back to the reservoir. Our results suggest that the combination of an ileal low-pressure reservoir together with an afferent tubular isoperistaltic limb is at least as good as an antireflux nipple valve. Moreover, the use of the afferent ileal limb makes it possible to resect the distal and often diseased ureters together with the paraureteric lymphatics at a safe distance from the bladder tumor. This avoids also distal ischemic ureteric stenosis and makes possible a simple end-to-side ureterointestinal anastomosis with a small complication rate.
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PMID:Ileal bladder substitute: antireflux nipple or afferent tubular segment? 181 49


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