Устранение инфравезикальной обструкции, полученной в результате этапного хирургического лечения высокого урогенитального синуса. Клинический случай

The migration of neutrophils through infected tissues is mediated by the CXC chemokines and its receptors (CXCR1 and CXCR2). It has been proposed that a CXCR1 deficiency could confer susceptibility to acute pyelonephritis in children. The objective of the study is to assess the surface expression of CXCR1 and CXCR2 and the existence of polymorphisms in the CXCR1 gene in premenopausal women with recurrent urinary tract infections. The study included 20 premenopausal women with recurrent urinary infections, with normal urinary tracts, and without diseases potentially associated with relapsing urinary infections and 30 controls without previous urinary infections. The levels of CXCR1 and CXCR2 expression on neutrophils were measured and analyzed by flow cytometry by measuring the mean fluorescence intensity (MFI) channel. The promoter and coding regions of the CXCR1 gene were analyzed for the presence of polymorphisms by a sequence-based typing method. Patients with recurrent urinary tract infections exhibited median levels of CXCR1 expression, determined from MFI values, similar to those of the controls. The analysis of CXCR2 showed that patients with recurrent urinary infections had lower median levels of expression, determined from the MFI values, than the controls (P = 0.002, Mann-Whitney U test). No polymorphisms were detected at the promoter or at the exon 1 region of the CXCR1 gene either in the patients or in the controls. Polymorphisms were detected at the exon 2 of CXCR1, but their frequencies did not differ between patients and controls. We have found a low level of CXCR2 expression in patients with recurrent urinary tract infections. These results suggest that a low level of CXCR2 expression may increase the susceptibilities of premenopausal women to urinary tract infections.

The aim of the study was to assess the preoperative and intraoperative potential risk factors for infectious complications after percutaneous nephrolithotomy (PCNL). A total of 303 patients who underwent PCNL for renal stones were included in the recent study. A detailed history including past renal surgery, nephrostomy insertion and recurrent urinary infection were obtained from all patients. Preoperative urine culture, renal pelvic urine culture and stone culture were obtained from all patients. The intraoperative data were prospectively noted. All patients were followed up postoperatively for signs of systemic inflammatory response syndrome (SIRS) and sepsis. In 83 (27.4%) of the patients, SIRS was observed and of these patients 23 (7.6%) were diagnosed as sepsis. Escherichia coli was the most common organism detected in cultures, followed by Pseudomonas aeruginosa, Enterococcus and Klebsiella spp. in all patients. By multivariate logistic regression analysis, presence of infection stone, stone burden and recurrent urinary tract infection were associated with both SIRS and sepsis development. Presence of infection stone, stone burden ≥800 mm(2) and recurrent urinary tract infection can be identified as independent predictors for the development of SIRS and sepsis.

The influence of smoking on bacterial resistance after vaccine or antibiotic prophylaxis against recurrent urinary tract infections

153 female patients with recurrent urinary infection were seen between July 1971 and December 1971 at the Urology clinic of the Hokkaido University Hospital. The age distribution was from 2 year-to 76 year-old. 25 cases harbored well explicable underlying conditions for recurrent infection. Other 128 cases required more detailed functional studies to explain its pathogeneses and to outline the proper treatment. Distal urethral stenosis, the majority of which was found in women over 50 year old, was thought to be etiologically significant in only 12% of the cases. Faulty voiding habit either by infrequent voiding or by frequent holding of the urge to void, was the primary cause of recurrence in 48%. Latent uninhibited ngB was found in 10%. Success rate in the prevention of recurrence was increased by the regimen of frequent voiding among infrequent voiders and by the concommitant administration of anticholinergic in patients with uninhibited ngB. The role of hydrostatic pressure must be a significant factor in patients with recurrent urinary infection.

Renal calculous disease may be associated with various degrees of renal insufficiency secondary to a combination of obstruction, urinary infection, frequent surgical intervention, and coexisting medical disease. Herein, we present our data on the progression of renal function in patients with stones associated with renal insufficiency and assess the significance of various factors that could predict postoperative renal function deterioration. Data were obtained from 4400 patients undergoing treatment for calculous disease at our institute since 1991. Renal insufficiency, defined as a baseline serum creatinine >1.5 mg/dL, was present in 84 (1.9%). Predictive factors evaluated for renal function deterioration were preoperative (age, duration of symptomatology and nephrolithiasis, urinary tract infection, coexistent medical diseases, baseline serum creatinine, and stone burden), intraoperative (number of percutaneous tracts), and postoperative (recurrent infection, proteinuria, cortical atrophy, residual fragments, and stone recurrence). Over a mean follow-up of 2.2 years (range 6 months-6 years), 33 patients (39.3%) showed improvement, 24 (28.6%) showed stabilization, and 27 (32.1%) showed deterioration in their renal function. Higher baseline serum creatinine, proteinuria >300 mg/day, renal cortical atrophy, stone burden >1500 mm(2), recurrent urinary infection, and age <15 years were significant predictors of subsequent renal function deterioration. Patients with nephrolithiasis and mild to moderate renal insufficiency warrant aggressive treatment aimed at complete stone clearance and prevention of recurrence of stones and urinary infection. A higher baseline preoperative serum creatinine, proteinuria >300 mg/day on follow-up, renal cortical atrophy, stone burden >1500 mm(2), recurrent urinary infection, and age <15 years are associated with a significantly higher likelihood of renal function deterioration after treatment of the calculous disease.

Introduction. Injuries to the ureter occur in 1-2,5% of cases of all lesions of the genitourinary organs. Iatrogenic injuries account for more than 80% of cases. Their number is associated with the active application of minimally invasive treatment methods into practice. The choice of reconstructive surgery in these patients depends on the functional state of the kidneys and ureters, the extent and level of stricture. Of particular importance is theBoari technique, which is associated with the general embryogenesis of the lower urinary tract. If there is tension in the anastomosis ar ea, it is preferable to use the psoas-hitch technique. Materials and methods. The work was based on the results of the treatment of 42 patients undergoing inpatient treatment at the MC «Medassist» clinic from 2019 to 2024. All patients underwent laparoscopic ureteral plastic surgery using the Boari and psoas-hitch techniques. Results. According to MSCT of the urinary system, no relapse was detected in any of the subjects during the follow-up period. With dynamic nephroscintigraphy after surgical treatment, an improvement in the functional parameters of kidney function was recorded in most patients (n=39; 92,9). According to ultrasound data, passive reflux was noted in 15 (35,7%) patients. Pyelonephritis occurred in 3 (7,1%) patients, all of whom had a urological history. According to the cystometric study, there was no reliable relationship between the volume of the flap used and the development of dysfunctional urination; detrusor hyperactivity of the detrusor before surgery was detected in 7,1% of cases (n=3); after surgery – 9,5% of cases (n=4); no clinically significant change in the maximum cystometric capacity after such a benefit was recorded. Conclusions. Reconstructive surgery for iatrogenic injuries of the lower third of the ureter using Boari and psoas-hitch techniques is effective in 92,9% of patients. 35,7% of patients in the postoperative period had clinically insignificant passive vesicoureteral reflux. Patients with a history of infravesical obstruction, bladder surgery or repeated plasty using flap techniques, and external radiation therapy to the pelvic organs have a high risk of recurrent urinary infection due to active and passive reflux. Cystometry revealed no significant relationship between the length of the bladder flap used and the development of dysfunctional urination.

Recurrent urinary infections are a common problem for women of all ages. Risk factors for urinary infection differ for pre- and postmenopausal women. Management strategies are well established, and include treatment of the acute symptomatic episode, and decreasing the frequency of subsequent episodes. This update focuses on the management of acute uncomplicated urinary infection, the most common bacterial infection in women.

Recurrent urinary infections are a common problem for women of all ages. Risk factors for urinary infection differ for pre- and postmenopausal women. Management strategies are well established, and include treatment of the acute symptomatic episode, and decreasing the frequency of subsequent episodes. This update focuses on the management of acute uncomplicated urinary infection, the most common bacterial infection in women.

Isolated Distal Vaginal Agenesis Masquerading as Recurrent Urinary Infections in an Adolescent Female

Recurrent urinary infection consist of repeated attacks of symptoms. It is much more common in females than males. But due to BPH as major predisposing factor in males, recurrent infections is much more common in them, in their elderly age. UTIs are the most common of all bacterial infections and can occur at any time in the life of an individual. The present Research study on Recurrent Urinary Tract Infection (RUTI) was conducted on 40 patients, divided in two groups of 20 each and the two groups was treated with separate group of medicine i.e., Group ‘A’ & ‘B’. The present study explored that dominant humoural incidence of Tadia-e-Majari-e-Bol (urinary tract infection) is more common in Safravi Mizaj and according to Unani text Warm-e-Majari-e-Bol is due to derangement of Safravi Khilt. The investigation data shows most of the patients have pus cells and are bacterial culture positive and some patients have red cells and albumin in urine. After going through their investigation, 20 patients were treated with Group ‘A’ & another 20 patients with Group ‘B’ medicine for the period of 6 weeks with a weekly follow up. This research study ultimately concluded that Group ‘ A’ medicine have response as Cured 70%, Partial Response 15% and No Response 15% and response with Group ‘B’ medicine as Cured 60%, Partial Response 25% and No Response 15%. It can be inferentially started as Group ‘A’ medicine has better response than Group ‘ B’ medicine. After going through all the observation and results of this study, it is concluded that both the group of drugs were effective in the management of Tadia - e- Majaria-e- Bol (Urinary tract infection). Both the drug groups are safe and free from any side effect on other body organs.

Context: Urinary problems are common in females, affecting approximately one-third of adult women. Multiple deliveries Reduced pelvic floor strength affects the bladder function because the bladder does not completely empty, leaving a 'pool' of urine, which can lead to recurrent urinary infection. Kegel exercises are the most widely used method for strengthening muscles in the pelvic floor. Patients can do them at any time, anywhere, while doing other work and without regular visits to hospitals.&#x0D; Aim: The study aims to assess the effects of Kegel Exercises on the recurrence of Lower Urinary Tract Infection in Multiparty.&#x0D; Methods: A convenience sample of 100 patients suffer from recurrent urinary tract infection (UTI) and (Multiparty) had more than three normal deliveries, assigned randomly and alternatively into two equal groups, 50 in each. The first group (control group) received standard hospital nursing care. The second group (study group) taught Kegel exercises. Outcome measurements included the use of UTI Symptoms Assessment Questionnaire, administered pre and two months post regular Kegel exercises, to assess the severity and bothersome of the most frequently reported symptoms of UTI.&#x0D; Results: Regarding the degree of symptoms for urinary tract infection in the first visit, the majority of patients in both groups had a maximum degree of symptoms. Regarding all symptoms, the patient suffering from frequency, urgency of urination, pain or burning when passing urine, inability to empty the bladder completely, pain or uncomfortable pressure in lower abdomen/pelvic area, low back pain, and blood in urine with a non-statistically significant difference between both groups. On the other hand, in the second visit, there was a statistically significant difference between patients who received hospital care and study group who practice Kegel exercise regarding all symptoms. There was a statistically significant difference between both groups regarding the severity of urinary tract infections.&#x0D; Conclusion: Women with recurrent urinary tract infection symptoms exhibit self-reported cure or improvement of urinary tract infection symptoms after the regular performance of Kegel exercises. Applying educational sessions by nurses is recommended for females after normal delivery and caesarian section delivery.

Recurrent Urinary Tract Infection in Adult Women: Diagnosis and Treatment

The faecal, introital, and urinary bacterial flora have been studied in 3 normal women and 5 women with recurrent urinary infection. In the normal women urinary abnormalities were uncommon, but the patients regularly had episodes of bacteriuria and pyuria, only a quarter of which were symptomatic. Symptoms tended to be associated with high white cell excretion rates and with the longer episodes. Introital colonisation was heavier and more frequent in the patients than in the control subjects. Organisms recovered from the urine had previously colonised the introitus in most cases. It appears that symptomatic episodes constitute only a small part of the disease process in patients with recurrent urinary tract infection.

The formation of intracellular bacterial communities (IBC) has been proposed as a new pathogenic model for urinary tract infections. Scarce reports describe this phenomenon in humans. We describe the presence of IBC in uroepithelial cells of a child with recurrent urinary infections. Urine specimen was collected from a child with Escherichia coli UTI and analyzed by light and confocal laser scanning microscopy (CLSM). The capability of this strain to produce intracellular infection in bladder tissue was confirmed in mice models. Escherichia coli phylogenetic group, presence of virulence factors genes, and its multiple locus sequence type were determined. CLSM showed large collections of morphologically coccoid and rod bacteria in eukaryotic cells cytoplasm, even seemingly protruding from the cells. Escherichia coli EC7U, ST3626, harbored type 1, P, and S/F1C fimbriae and K1 capsule genes. In this report, we confirm the presence of IBC in children with UTI, as it has been described before in women.

Recent publications state that development and progression of clubbing and scarring do not occur in children with recurrent urinary tract infections. To test this assertion, we reviewed the excretory urograms of 106 children (208 renal units) with carefully documented recurrent bacterial urinary infections which commenced before the age of 10 years. We followed 93 of these renal units radio-logically for at least two years. In 31 kidneys, scarring and clubbing progressed; 4 previously normal kidneys developed scarring and clubbing. Two factors, infection and reflux, appeared important in the development of these changes. This study demonstrates that clubbing and scarring can develop and that existing lesions can progress in children with recurrent bacterial urinary infections.