Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0034186 (pyelonephritis)
 6,144 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Thirty-nine cases of functional reconstruction of exstrophied bladder are reviewed. There were 20 females and 19 males. In a first group of 31 staging was planned and carried out in 26 while 3 are awaiting a second stage. In a second group of 8 a single operation was performed. Out of the 31 early cases there were 2 deaths and 10 failures, 16 show good or very good functional result. All 16 show moderate renal scarring from reflux pyelonephritis which occurred between I and II stage. Single operation consisted of innominate osteotomy, bladder and bladder neck and urethral reconstruction and anti-reflux procedure (osteotomy was omitted in a 3 days old baby). Three, operated upon when aged 8 mths., 1 year and 4 years, were breakdowns of previous closure. They are incontinent and will need further surgery at the bladder outlet. Four are dry in the morning and suffer from occasional stress incontinence and enuresis. One, now aged 4 years, still wears pads. These last 5 are awaiting final assessment of and eventually further surgery to improve continence. In all 8 cases pyelo-calyceal cavities are normal except for a moderate right dilatation in one because of kinking of the reimplanted ureter. Delay in bladder closure (mean age 5 mths.) and severe changes to the bladder wall and possibly staging seems to be responsible for most of the failures and for renal damage occurring, after closure, in bladders showing moderate compliance. Single operation allows full protection of upper tract and kidney and should be preferred in patients aged over 2 months. Better functional results may be obtained if operation is performed soon after birth.
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PMID:Functional reconstruction of exstrophied bladder. Timing and technique. Follow-up of 39 cases. 307 Oct 25

The results of urethrocystography in 193 patients with urodynamically and clinically confirmed recurrent incontinence were analyzed. Severe displacement of the vesical cervix and the proximal section of the urethra predisposes the patient to recurrent stress incontinence. The roentgenological findings (difference of over 30 mm in the distance between the vesical cervix and the ischium, outflow of contrast medium next to the catheter under stress with differential values between 20 and 40 mm, angle of inclination of the proximal urethra of over 45 degrees) are significantly more frequent in cases of recurrent stress incontinence than in cases of first occurrence (132 patients). Of the 193 patients 164 (84%) had previously undergone a vaginal operation. In 60% of these 164 patients the difference in the distance between the vesical cervix and the ischium was 30 mm or more under "resting" stress, and in a further 19% it was between 26 and 30 mm, often with outflow of contrast medium during "pressing". Stress incontinence has a damaging effect on the supporting apparatus of the urethra and the bladder, and also on the ureter and the kidneys. Ureteral drainage disorders and chronic pyelonephritis are the changes most commonly diagnosed in roentgenograms. No statistically significant differences between recurrent and first-time stress incontinence were found. Urethrocystographic findings facilitate selection of the surgical procedure. It appears possible to reduce the frequency of recurrence if preoperative roentgenological findings are taken into account.
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PMID:[Recurrent stress incontinence]. 405 46

The many anatomical and physiological changes occurring during pregnancy affect the entire urinary tract. These changes can induce various urological diseases, alter renalfunction and can be life-threatening to the foetus and the mother Some changes can persist post partum. Asymptomatic bacteriuria must be investigated and treated to prevent about 40% of pyelonephritis and a twofold higher premature delivery rate. Duplex ultrasound is the reference examination to diagnose renal colic due to stones and a low-dose IVU can be proposed whenever there is a doubt about the diagnosis. Treatment is conservative. Lower urinary tract symptoms are very frequent and some disorders, such as stress incontinence, can persist after delivery. This review article describes the anatomical and physiological changes observed during pregnancy and their pathological consequences on the urinary tract in order to detect, prevent and treat these disorders.
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PMID:[Urological problems encountered during pregnancy]. 1582 83

Urinary tract infection (UTI) may predominantly involve the lower urinary tract, i.e. acute cystitis, or upper urinary tract consisting of the renal pelvis and kidney,, i.e. acute pyelonephritis The incidence of acute pyelonephritis is higher in young women than in men but the incidence in men over 65 is similar to that in older women. Women have up to a 10% risk of recurrent acute pyelonephritis in the year following a first acute episode. The equivalent risk in men is 6%. Acute pyelonephritis may be uncomplicated and resolve without serious sequelae. A minority of episodes may be complicated by acute kidney injury, papillary necrosis, renal or perinephric abscess or the development of emphysematous pyelonephritis. Acute pyelonephritis is generally caused by microorganisms ascending from the urethra via the bladder into the upper urinary tract. Rarely the kidney may be seeded by blood-borne infection. Ecoli is the most common uropathogen causing pyelonephritis accounting for 70-90% of infections. Species of Enterococci, Klebsiella, Pseudomonas, Proteus and Staphylococci are responsible for the remaining infections. There is a rising incidence in the community of UTI with bacteria that produce extended spectrum beta-lactamase (ESBL) enzymes. These ESBL bacteria have developed resistance to antibiotics such as penicillin, cephalosporins and increasingly to quinolones. Risk factors for uncomplicated acute pyelonephritis include recent sexual intercourse, acute cystitis, stress incontinence and diabetes and for complicated acute pyelonephritis include pregnancy, diabetes, anatomical abnormalities of the urinary tract and renal calculi.
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PMID:Acute pyelonephritis can have serious complications. 2048 80

We report a case of enterococcus lumbar osteomyelitis that developed after post-operative pyelonephritis. A 78-year-old G2P2 with Stage III uterovaginal prolapse and genuine stress urinary incontinence who underwent laparoscopic-assisted vaginal hysterectomy, high uterosacral ligament suspension, tension-free vaginal tape-obturator approach, and cystoscopy presented with post-operative back pain. Work-up of her back pain revealed enterococcus pyelonephritis. She continued to have back pain despite outpatient antibiotic treatment and further work-up revealed enterococcus lumbar osteomyelitis at the level of L1-L2. Enterococcus vertebral osteomyelitis is a rare infection that can occur by hematogenous spread from an infection of the urinary tract.
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PMID:Enterococcus osteomyelitis secondary to pyelonephritis. 2277 80