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)

Symptomatic urinary tract infection is a common complaint in women. A convenient classification of such infection is bacterial pyelonephritis, bacterial cystitis, and "urethral syndrome," on the basis of symptoms and urine culture colony count. Pyelonephritis can be treated in the office if the patient is not toxic, follow-up is possible, and the patient can tolerate oral medication. Treatment commonly is given over a period of two to six weeks. Single-dose therapy is now the preferred treatment for bacterial cystitis, and several agents are effective. When an infectious agent can be identified in urethral syndrome, antibiotic therapy is useful. Patients in whom an agent cannot be identified may be found to have interstitial cystitis. Recurrence can be a matter of relapse but usually results from reinfection. The causes of relapse usually can be approached surgically, while reinfection must be treated with behavior modification and prolonged antibiotic prophylaxis.
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PMID:Urinary tract infection in women. New perspectives on office management. 684 73

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

Bacterial cystitis is the most common bacterial infection occurring in women. Thirty percent of women will experience at least one episode of cystitis during their lifetime. About one third of patients presenting with symptoms of cystitis have upper urinary tract infection. A careful history to identify risk factors for subclinical pyelonephritis is important. Symptoms of chronic cystitis accompanied by sterile urine without pyuria may represent interstitial cystitis. Dysuria may also be the principal complaint of women with vaginitis (infectious, atrophic or chemical) or urethritis. A stepwise diagnostic approach, accompanied by inexpensive office laboratory testing, is usually sufficient to determine the cause of dysuria.
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PMID:The women with dysuria. 960 6

Ten clinical cases of neuromuscular dysplasia of the ureter (NMDU) are reported. Eight patients were young (24-38 years), two--of the middle age (41-58 years). NMDU was bilateral in two patients. Ureteral achalasia of the congenital solitary kidney occured in one case. One 28-year-old female with megaureter of the solitary kidney had interstitial cystitis. Clinical picture of the disease was characterized primarily with acute pyelonephritis, pain and secondary urolithiasis. Surgical treatment consisted in resection of the affected part of the ureter with modeling of the lumen of the latter on the drainage and Boari plastic repair. Bilateral Boari operation was made in 2 patients. In one case of ureteral achalasia and ureterocele direct ureterocystoanastomosis was created with good result. Sigmocystoplasty with transplantation of the solitary kidney ureter into the intestinal transplant was made in the patient with scar contracture of the detrusor and megaureter. Functional result of the operation was good. Complications were registered in 4 patients, 2 of which were reoperated. In nine patients of ten good and satisfactory functional results were obtained.
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PMID:[Surgical treatment of neuromuscular dysplasia of the ureter]. 1609 12

We retrospectively analyzed the clinical relevance of hydrodistention under anesthesia for patients having urgency and/or lower abdominal pain who were clinically diagnosed as having interstitial cystitis (IC) from May 1996 to May 2005. Their symptoms were refractory to anticholinergic or antiinflammatory agents. Hydrodistention was performed under general or spinal anesthesia with direct vision by cystoscopy and irrigation fluid was instilled into the bladder at a pressure of 80 cmH2O. Cystoscopic findings revealed glomerulation in 26 patients (96%), cracking in 10 (37%) and Hunner's ulcer in 3. Twenty-four patients (89%) obtained improvement of the objective symptoms after treatment. However, symptoms soon deteriorated in 16 patients, and the average duration of efficacy was only 4.7 months (SD; +/-3.7). There were two episodes of complication in this treatment. Bladder rupture occurred during hydrodistention, but was successfully managed with simple percutaneous perivesical drainage. One patient with acute pyelonephritis was treated with an antimicrobial agent without any additional treatment. Although bladder specimens were examined by immunohistochemistry, tryptase and c-kit were not linked with the mast cell count, severity of symptoms or treatment efficacy. Hydrodistention of the bladder may be recommended as the first treatment choice for patients with IC because it provides relatively high efficacy. However, the short duration of the efficacy requires a second-line treatment option for better management of patients with IC.
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PMID:[Hydrodistention of the bladder in patients with interstitial cystitis--clinical efficacy and its association with immunohistochemical findings for bladder tissues]. 1713 63

The most common cause of acute dysuria is infection, especially cystitis. Other infectious causes include urethritis, sexually transmitted infections, and vaginitis. Noninfectious inflammatory causes include a foreign body in the urinary tract and dermatologic conditions. Noninflammatory causes of dysuria include medication use, urethral anatomic abnormalities, local trauma, and interstitial cystitis/bladder pain syndrome. An initial targeted history includes features of a local cause (e.g., vaginal or urethral irritation), risk factors for a complicated urinary tract infection (e.g., male sex, pregnancy, presence of urologic obstruction, recent procedure), and symptoms of pyelonephritis. Women with dysuria who have no complicating features can be treated for cystitis without further diagnostic evaluation. Women with vulvovaginal symptoms should be evaluated for vaginitis. Any complicating features or recurrent symptoms warrant a history, physical examination, urinalysis, and urine culture. Findings from the secondary evaluation, selected laboratory tests, and directed imaging studies enable physicians to progress through a logical evaluation and determine the cause of dysuria or make an appropriate referral.
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PMID:Dysuria: Evaluation and Differential Diagnosis in Adults. 2655 71