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

Bladder wash-out tests were performed in a series of patients after successful antireflux surgery. The majority (65.5%) of infections were localized in the bladder, even if the IVP demonstrated signs of pyelonephritis (renal scarring and calcieal clubbing). 21.3% of the tests demonstrated a participation of the upper urinary tract. The bladder bacteriurias were interpreted as reinfections, and also some of the supravesical bacteriurias. In other cases, this differentiation could not be made.
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PMID:[Localization of urinary infection after antireflux surgery (author's transl)]. 96 48

Escherichia coli with both P and type 1 fimbriae caused vaginal colonization in the female green monkey, while only the P-fimbriated bacteria frequently caused ascending bladder infection. Bladder inoculation caused only short-lived bladder infection from type 1 fimbriated E. coli, but those with P-fimbriae caused acute pyelonephritis even in the absence of vesicoureteral reflux. Thus, type 1 fimbriae of E. coli, while causing vaginal colonization, did not often cause ascending infection in the non-compromised host as did P-fimbriated bacteria.
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PMID:Bacterial adherence in urinary tract infections: preliminary studies in a primate model. 269 59

Bladder washout (BWO) and antibody-coated bacteria (ACB) tests were performed on 25 patients with radiological and/or clinical evidence of chronic upper urinary tract infection (UTI) and 12 patients with asymptomatic bacteriuria. Using a traditional single-washout procedure, the BWO test gave equivocal results in many cases of chronic pyelonephritis; this seemed mainly due to the lack of complete bladder sterilization. A modified procedure, including double sterilization and irrigation, biochemical typing of isolated bacteria, and evaluation of temporal pattern of bacteriuria recurrence, was then introduced. Although preliminary results of the modified BWO test demonstrated a general improvement in the diagnosis of the infection site, it seemed rather difficult, at least in chronic UTI, to establish localizing criteria based on definite numeric changes in bacterial counts after washout.
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PMID:A modified bladder washout test to improve diagnostic results in chronic urinary tract infections. 391 26

Bladder aspirate urine samples (N = 190) were cultured for the presence of fastidious microorganisms. These samples were obtained from patients with urinary tract disease in whom standard bacteriologic investigation had failed to indicate infection. Gardnerella vaginalis was recovered alone, or in association with Ureaplasma urealyticum from the bladder urine of 33% of patients with reflux scarring. G. vaginalis was localized to the upper urinary tract in 75% of these patients with bladder counts greater than 10(3) colony-forming units per milliliter. The results show that two fastidious microbial species, not conventionally associated with urinary tract infection, are recoverable from the upper urinary tracts of patients with so-called sterile pyelonephritis.
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PMID:Unconventional bacteria in urinary tract disease: Gardnerella vaginalis. 660 91

Two female babies aged 8 and 13 mo., affected with bladder exstrophy, were submitted to a single-stage functional reconstruction of the bladder. Innominate osteotomy, bladder closure, anti-reflux procedure and narrowing of the bladder outlet followed by pubic reapproximation and easy closure of the abdominal wall were performed in one session. Bladder enlargment and a steadily improving continence occurred in the first case with no reflux and no urinary infection. Further surgery may not be needed if full urinary control can be achieved through active cooperation by the patient. Postoperative continence was achieved in the second patient with a secondary operation on the bladder outlet and pedicled muscle transplant. The absence of reflux, infection and pyelonephritis dis warrant a safe and definite bladder enlargement, with a very satisfactory functional result. An anti-reflux procedure should always be performed at the time of bladder reconstruction in babies older than 3 or 4 months.
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PMID:One stage functional reconstruction of exstrophied bladder: report of two cases with six-year follow-up. 714 45

Bladder-aspirate urine samples (N = 428) were cultured for the presence of fastidious microorganisms. These samples were obtained from 190 patients with urinary tract disease or symptoms suggesting infection of the urinary tract in whom standard bacteriologic investigation had failed to indicate bacterial infection. Ureaplasma urealyticum was recovered alone or in association with other microorganisms from the bladder urine of 75% of patients with reflux scarring and abnormal renal function. Ureaplasma organisms were localized to the upper urinary tract in 80% of patients with bladder counts greater than 10(3) colony-forming units per ml. The results indicate that microorganisms not conventionally associated with urinary tract infection are recoverable from the bladder urine of a high percentage of patients with so-called "sterile pyelonephritis," in which group of patients these microorganisms may contribute to progressive renal disease.
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PMID:Unconventional bacteria in urinary tract disease: Ureaplasma urealyticum. 721 69

One hundred and twenty-two augmentation cystoplasties performed over an 8-year period were reviewed. Mean age at surgery was 37 years (range 2-82 years). There were 82 female patients. The primary urodynamic diagnosis was reduced compliance in 92 (77%) patients and detrusor hyperreflexia/instability in the remainder. The clinical diagnostic groups were: spinal cord injury/disease in 32 (27%), myelodysplasia in 27 (22%), interstitial cystitis in 21 (17%), idiopathic detrusor instability in 13 (11%), radiation cystitis in 8 (7%), Hinman-Allen syndrome in 5 (4%), and miscellaneous in 11 (9%). A detubularized ileal augmentation was used in 82 (67%) patients. In 36 (30%) a detubularized ileocecocystoplasty was fashioned and in the remainder detubularized sigmoid was used. In 19 patients augmentation accompanied undiversion. Sixteen patients had a simultaneous fascial sling for urethral incompetence. Mean follow-up was 37 months (range 6-96 months). There was no postoperative mortality. During follow-up 4 patients died from unrelated causes, 11 have been lost to follow-up, and 5 patients await planned transplantation. Bladder capacity was increased from a preoperative mean of 108 ml (range 15-500 ml) to 438 ml (200-1,200 ml) postoperatively. Of the 106 assessable patients, 80 (75%) had an excellent result, 21 (20%) were improved, and 5 (5%) had major ongoing problems. During the period of follow-up, 17 (16%) patients underwent revision of their augmentation. Twenty-four (21%) patients developed bladder stones and 30% of these did so more than once. Urinary incontinence became manifest in 15 (13%) patients but required surgical treatment in only half of these. Pyelonephritis occurred in 13 (11%) patients. Five patients developed small bowel obstruction following discharge from hospital. There were 7 instances of reservoir rupture in 5 (4%) patients. Augmentation cystoplasty has a pivotal role in the treatment of a broad range of lower and upper urinary tract problems. Careful patient selection and close follow-up are essential.
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PMID:Long-term results and complications using augmentation cystoplasty in reconstructive urology. 758 66

The medical records of 88 patients followed through our spinal cord injury clinic were reviewed to determine if elevated intravesical pressures result in more urologic complications than are seen with low pressure bladders. Fifty-two of the patients were noted to have a high bladder pressure (sustained detrusor pressure greater than 40 cm water) on cystogram while 36 had low pressures. All patients had routine urine cultures, urodynamics, ultrasonography, radioisotope renal scans, and excretory urograms. Bladder management was directed at maintaining a low bladder pressure and included one or more of the following: intermittent catheterization, anticholinergics, alpha blockers, transurethral sphincterotomy, or indwelling catheters. Average follow-up was 6 years. Mild degrees of hydronephrosis were noted in seven (14 percent) of the patients with a high pressure bladder and in one (3 percent) with a low pressure bladder. Pyelonephritis was noted in two (4 percent) with high bladder pressure and two (5 percent) with low bladder pressure. Preservation of renal function occurred as the result of patient compliance with bladder management and bladder pressure. Sustained high detrusor pressure, when not corrected, leads to upper tract deterioration which was reversed by aggressive lower tract management.
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PMID:The development of urologic complications in relationship to bladder pressure in spinal cord injured patients. 842 79

The authors report their experience with an intraurethral prosthetic stent as an alternative treatment for detrusor-external urethral sphincter dyssynergia (DESD). A sphincter prosthesis was inserted into the membranous urethra of 25 men with spinal cord injuries, DESD, and elevated voiding pressure. Bladder voiding pressure decreased from 87 cm H2O +/- 23 to 27 cm H2O +/- 11 in 12 months (P < .001). There was a significant decrease in residual urine volume 12 months after prosthesis placement, from 122 mL +/- 77 to 33 mL +/- 19 (P < .01); bladder capacity remained relatively unchanged, from 174 mL +/- 84 to 230 mL +/- 92 (P < .57). No deleterious effects were seen in renal or erectile function. Migration of three prostheses occurred 1 day to 6 weeks after insertion. One additional complication, pyelonephritis, occurred in a patient with preexisting vesicoureteral reflux, necessitating reimplantation of bilateral ureters. The intraurethral wire mesh prosthesis, with its simplicity of placement and minimal associated morbidity, offers a potential alternative to external sphincterotomy.
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PMID:Placement of a wire mesh prosthesis in the external urinary sphincter of men with spinal cord injuries. 847 6

The goal of treatment of end-stage renal failure in pediatric patients is a functioning transplant. Due to the serious shortage of cadaver kidneys, we have to consider living related donor transplantation (tpl) more frequently. Certain features are characteristic of pediatric patients before transplantation: underlying disease (over 2/3 are congenital or hereditary), the form of dialysis (automated peritoneal dialysis at home in young children) and the frequent need for tube feeding and treatment with growth hormone. Patients weighing 10 kg or more can be given an adult kidney. Young recipients are at risk for vascular thrombosis and hence the CVP should be kept high to allow good circulation, and continuous heparinization (10 units per kg and hour) is advocated. Minor rejection episodes may be overlooked in the presence of a large graft in a small child. Bladder dysfunction is a problem in many children with obstructive uropathy. Later on, viral infections (CMV, EBV) may pose serious problems since most children have not previously been exposed to them. Further problems are pyelonephritis in the graft and recurrence of the underlying disease. Long-term results are very satisfactory in terms of survival and quality of life including later social integration.
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PMID:[Kidney transplantation in the child]. 928 31


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