Incidence Of Cystitis Research Articles

MRI-guided brachytherapy for cervical cancer treatment: The significance of bladder morphology in dose distribution planning.

This retrospective study aimed to investigate the influence of bladder filling type (BFT) on the relationship between bladder volume (BV) and maximum absorbed dose (D2cc) in intra-cavitary brachytherapy (ICBT) for cervical cancer. The study enrolled 269 patients who underwent 3D-optimized ICBT guided by MRI scans between 2016 and 2022. Bladder shape (categorized as tilted, curved, or E) was determined based on specific applicators used. D2cc values were recorded for critical organs, such as bladder, rectum, sigmoid colon, and small bowel. The tilted group exhibited lower D2cc values for the small bowel when BV was less than 400 cc, while still ensuring minimal doses to the rectum and sigmoid colon. In the curved group (BV ≤ 100 cc), significant variations in D2cc for organs at risk were observed. However, in the E group, no substantial correlation between BV and D2cc was identified (p = -0.035). Additionally, the mean mid-sagittal line differences in the tilted group were 8.47 mm (pre-ICBT) and 7.11 mm (during ICBT simulation), surpassing measurements in the other two groups. This study underscores the substantial impact of bladder shape on both the optimal bladder filling volume and maximum absorbed dose in cervical cancer ICBT. The implementation of BFT based on pre-ICBT MRI scans is both practical and beneficial. It accentuates the necessity of accounting for bladder shape when determining appropriate bladder filling volume, thus facilitating effective management of bladder and small bowel doses. Further prospective studies are warranted to assess the effect of BFT on the incidence of cystitis and proctitis following ICBT, all while maintaining consistent bladder distension.

A joint program of antimicrobial stewardship and hospital-acquired infection control to reduce healthcare-associated infections after kidney transplantation: The Hipomenes study

Infection is a common complication in kidney transplant recipients (KTRs). The usefulness of antimicrobial stewardship programs (ASP) and hospital-acquired infection control (HAIC) initiatives in the general inpatient population is well established. We performed a quasi-experimental study to evaluate a joint ASP/HAIC initiative focused on KTRs. A dedicated ASP team optimized antimicrobial prescriptions in consecutive KTRs during the intervention period (June 2015-March 2016). A multifaceted, evidence-based HAIC program was concurrently implemented. Results were compared with the preceding period (June 2014-March 2015). We included 96 and 100 KTRs in the intervention and preintervention periods, respectively. There was a reduction in the consumption of meropenem (rate ratio [RR]: 0.63; 95% confidence interval [CI]: 0.53-0.75; P <.0001), ceftazidime (RR: 0.31; 95% CI: 0.21-0.45; P <.0001), vancomycin (RR: 0.65; 95% CI: 0.53-0.8; P <.0001), and ciprofloxacin (RR: 0.66; 95% CI: 0.55-0.81; P <.0001) and an increase of fosfomycin (RR: 1.80; 95% CI: 1.17-2.76; P =.008) during the intervention period. The incidence of cystitis (RR: 0.30; 95% CI: 0.28-0.33; P <.001) and upper urinary tract infection (RR: 0.56; 95% CI: 0.33-0.95; P =.04) decreased. A specific ASP/HAIC initiative was effective in optimizing antimicrobial use and reducing the incidence of common bacterial infections among KTRs.

Urinary tract infections decreased in Finnish children during the COVID-19 pandemic

Social restrictions reduced the rates of respiratory infections in 2020, but studies on the rates of urinary tract infections (UTIs) during lockdown have had conflicting results. This study aimed to report UTI incidence during the first and second waves of COVID-19 pandemic in Finland. We conducted a retrospective register-based cohort study. The whole Finnish pediatric population (children under the age of 15 years, N = 860,000) was included. The yearly and monthly incidences of UTIs per 100,000 children in 2020 were compared to that of three previous years (2017–2019) by incidence rate ratios (IRRs) with 95% confidence intervals (CIs). A total of 10,757 cystitis and 4873 pyelonephritis cases were included. The yearly incidence of cystitis was 12% lower (IRR 0.88, CI 0.83–0.94) among children aged 1–6 in 2020 and 11% (IRR 0.89, CI 0.83–0.95) lower among children aged 7–14 in 2020 compared with previous years. The yearly incidence of pyelonephritis was 16% lower (IRR 0.84, CI 0.76–0.94) among children aged 1–6. No significant decrease were observed among children aged < 1 and 7–14.Conclusion: The incidence of cystitis and pyelonephritis during a period of social restrictions was lower than during 2017–2019, especially in children aged 1–6 years. These results raise the possibility of reducing the occurrence of urinary tract infections in children by improving hygiene measures.What is known:• Social restrictions have reduced the rate of common respiratory infections globally.• Previous studies have presented a decreased or unchanged incidence of urinary tract infections during the COVID-19 pandemic.What is new:• During the pandemic, there was a decrease in the incidence of urinary tract infections in Finnish children and the most prominent decrease was in daycare-aged children.• Improved hygiene measures and social restrictions may have influenced the transmission of uropathogens.

Эпидемиологическое исследование распространенности цистита у женщин Воронежской области

Introduction. The article is devoted to an epidemiological study of the prevalence of cystitis and risk factors for recurrence this disease. Materials and methods. The study is based on the data obtained during the screening survey of 1014 women in the age group of 18-80 years old, permanently residing in the Bobrovsky district of the Voronezh region. Based on the age of the subjects, 3 groups were formed: Group 1 (general group) - 1014 women, Group 2 (fertile age) - 551 women, Group 3 (postmenopausal age) - 463 women. To study the influence of risk factors on the development of cystitis, the following criteria were used: antibiotic therapy, sex life, urinary disorders, gastrointestinal tract (GIT) dysfunction, etc. The obtained material was processed using the computer program Statistics 10.0. 𝛘2 was used as a statistical tool. Results. Of the total number of women surveyed, 15.3% had risk factors according to the ORENUC classification system based on the clinical picture of UTI, anatomical level of UTI, the severity of infection, classification of risk factors and the availability of appropriate antimicrobial therapy. The largest number of risk factors was found in postmenopausal patients (p &lt;0.05). It was found that despite the fact that most of the subjects were sexually active, the absence of sexual activity and the presence of one sexual partner did not affect the presence of a history of cystitis episode (p&gt; 0.05), however, it was revealed that the history of cystitis was significantly associated with functions of the gastrointestinal tract (p&lt;0.05). The use of tactics aimed at active detection of cystitis, by means of questionnaires, can increase the detection rate of cystitis by 10 times. Discussions. In our study, we did not find a large number of cases of recurrent cystitis, in contrast to previously published works, which cited figures from 10 to 30% of the number of women, however, by means of questionnaires, we managed to deduce the prevalence of cystitis in the studied region in women over 18 years old. which amounted to 17.4%. The figure obtained is consistent with data published in previously papers. Conclusions. TThis study has confirmed the previously published works indicating the relationship of cystitis with gastrointestinal diseases. In addition, we found that the prevalence of cystitis (having one or more episodes during a lifetime) in the study group was 17.4%. The annual incidence of cystitis in the study group was 3.2%, while according to official statistics in the region it does not exceed 0.4%. The latter fact indicates the need for further research and strengthening of sanitary and edu- cational work among the population (Internet, TV, radio, newspapers, etc.).

Study on various affections of lower urinary tract in dogs

A total of 55 cases were selected with the different affections of lower urinary tract from year September-2017 to July-2019. The age and sex wise distribution of different disorders of lower urinary tract revealed the age of dogs ranged from one and half year to eighteen years. The age and sex wise distribution of different disorders of lower urinary tract revealed the age of dogs ranged from one and half year to eighteen years. Urolithiasis (52.73 %, n=29) was higher in 7 to 9 years aged dogs (18.18 %), in male dogs (38.18 Vs. 14.55 %). The dogs having non-urolithiasis conditions (n=26, 47.27 %), comprised percent cystitis (n=17), mass in bladder (n=8) (30.91 and 15.54, respectively) and a case of lodged catheter in bladder. The incidence of cystitis and mass in bladder were higher in the age of up to 3 (14.54 %) and 7 to 9 years (9.10 %), respectively. The male dogs were found to be suffering more from cystitis (25.45 %) and mass in bladder (36.36 %) than female dogs (5.45 % and 9.09%, each affection). Labrador and Pug dogs had higher urolithiasis and cystitis up to 14.54 and 7.23 %, each, respectively, whereas German Shepherd had a mass in bladder up to 5.45 %. The dogs given commercial food had higher (31.03 %) urolithiasis. The morbidity period of 24 to 48 hours was observed in dogs having urolithiasis (41.38 %) and cystitis (52.94 %) whereas for dogs having mass in the bladder (52.50 %) had the morbidity lasting for more than a week. The most pronounced clinical signs in dogs having urolithiasis and cystitis were distended bladder in 48.28 % (14) and 70.59 % (12), respectively, whereas haematuria in all cases of mass in bladder. A dog with a lodged catheter in bladder was morbid for more than 72 hrs with a dribbling of urine.

Peculiarities of the regional dynamics of the prevalence and incidence of cystitis in children.

In a child, cystitis (non-specific microbial inflammation of the mucous membrane of the bladder) is considered to be a dangerous disease; the prolongation of the process is usually associated with a delayed diagnosis. The aim of this work was to analyze the health status of the child population of the Chernivtsi region, especially the dynamics of the prevalence and incidence of cystitis. The official statistical data have been studied (reports on the state of medical care for children in the Chernivtsi region and data from the Center of Medical Statistics of the Ministry of Healthcare from 2006 to 2017); information-analytical and statistical methods have been used for the purpose of this study. Attention should be drawn to the significantly high prevalence of cystitis among children aged 15–17 years, especially in the Chernivtsi region as during period I (8.7±0.6 vs. 4.3±0.3 in Ukraine) and II (11.7±1.0 and 5.7±0.4, respectively, per 1000 people). Moreover, over the years, the growth of indicators acquires intensity, while this process is more than twice as pronounced in Chernivtsi. Thus, the growth rate was 65.0% in 2006–2011 and 90.3% in 2012–2017 vs. 27.2% and 32.8% in Ukraine, respectively. The identified data indicate the need to provide specialized care to children with infectious and inflammatory diseases of the urinary system of the Chernivtsi region and the need to improve regional clinical routes of patients with infectious and inflammatory diseases of the urinary system.

Retrospective Analysis of Lower Urinary Tract Disorders in Dogs: Study of Five Years

Background: The data pertaining to the lower urinary tract disorders in dogs in India is very merge. This retrospective analysis presents a retrospective analysis of incidence of affections of lower urinary tract in dogs. Methods: The cases of different affections of lower urinary tract presented at the Veterinary Clinical Complex, Veterinary College, Anand Agricultural University, Anand during April-2012 to March-2017 were screened and detailed information regarding age, sex and breed were collected and analysed to calculate percentage of incidence of different affections of lower urinary tract viz., surgical affections and non-surgical affection. Conclusions: Total 24319 cases of lower urinary tract affections in dogs were registered. Among them 5854 (24.07 %) surgical cases comprising urolithiasis (81, 76.42 %), bladder neoplasia (25, 23.58 %) and 18465 (75.93 %) non-surgical affections with cystitis (176, 0.95 %) cases. The highest incidence of urolithiasis was 25.93 per cent in the year 2014-15 and in 7 to 9 years aged dogs (35.80 %). The sex wise per cent incidence was higher in male (72.84) than female (27.16). The urinary bladder calculi was the highest (72.84 %) followed by the urethra (16.05 %) and both the locations (11.11 %). The year wise highest per cent incidence of cystitis was recorded for the year 2015-16 (52.27). The age wise per cent incidence of cystitis was equally higher 28.98 in the age groups of 7 to 9 and 10 to 12 years, each. The year wise the highest per cent incidence of neoplasia of urinary bladder (TCC) in dogs was 52.00 for the year 2015-2016. The age wise percent incidence of neoplasia of urinary bladder was the highest in 7 to 9 years age groups (36.00). The sex wise per cent incidence for neoplasia in urinary bladder was higher in male (64.00) than female (36.00). The breed wise highest per cent incidence of urolithiasis was in Pomeranian (25.93), cystitis in Pug (28.41) and neoplasia of bladder (TCC) Labrador and Pug (20.00, each).

Recurrent cystitis and bacterial vaginosis: how to avoid polypharmacy

Background. The structure of lower urinary tract infections has clear sex-based differences. The vaginal microbiota is a key factor in the pathogenesis of lower urinary tract infections: aerobic vaginitis predisposes to infection and increases the incidence of cystitis by 2.9 times.&#x0D; Aim. To determine the effectiveness of Nifuratel as monotherapy in patients with chronic cystitis and concomitant bacterial vaginosis (BV).&#x0D; Materials and methods. Study design: an open-label, non-comparative, pilot, single-center, prospective study, which included 23 patients with recurrent cystitis and BV. All women received monotherapy with Nifuratel (Macmiror manufactured by Doppel Farmaceutici S.r.l., Italy) in tablets of 200 mg 3 times a day for 7 days. Control visits were performed in 7.90 and 180 days.&#x0D; Results. BV was diagnosed in all patients; 19 (82.6%) women also had vaginal candidiasis. At the end of therapy, 17 (73.9%) patients showed an excellent outcome, 4 (17.4%) a significant improvement, 2 (8.7%) no effect. After the end of three-month therapy, 18 (81.8%) out of 22 patients who left in the study had no complaints of urinary disorders or vaginal discharge. Their urinalyses were normal. Molecular genetic analysis of the vaginal biocenosis showed moderate dysbiosis; Candida spp. was revealed only in 3 (13.6%) cases. 18 patients came for the 4th visit. Within six months after the end of monotherapy with Nifuratel, the patients had no complaints. They all achieved the recovery of vaginal normocenosis with a sufficient amount of Lactobacillus spp.&#x0D; Conclusion. Monotherapy in patients with recurrent cystitis and BV is highly effective for both diseases: 73.9% of women achieved stable normalization of urine and vaginal microbiota analyzes, removal of bacteriuria. The bi-directional action of Nifuratel allows to avoid polypharmacy in this category of patients.

Bladder calculi and cystitis in Hanwoo steers without clinical symptoms: a case report

Two Hanwoo steers were emergency-slaughtered due to symptoms of urethral obstruction. The steers were of the same age and were raised using the same feed management. The remaining 22 cattle in the finishing period showed no symptoms of urinary calculi until 30 months of age and were examined for the presence of bladder calculi when slaughtered. Bladder calculi were observed in 11 of 22 steers at slaughter (50%) and cystitis occurred in 13 of 22 steers (59.1%). There was a significant relationship between the presence of bladder calculi and the incidence of cystitis (P &amp;lt; 0.05).

1508. Urinary Tract Infections (UTIs) in the First Year Post-Renal Transplant: Risks and Opportunities

BackgroundUTIs are the most common infection after renal transplant (RTx) with an incidence of 6–86%. Post-RTx UTI has been associated with risk for graft loss and mortality, and RTx recipients are at risk for multidrug-resistant (MDR) UTI given immunosuppression (IS) and instrumentation. We sought to evaluate the incidence, timing, microbiology, and MDR risk of post-RTx UTI, as well as to characterize asymptomatic bacteriuria (ASB) practices at our center.MethodsThis was a retrospective cohort of subjects with ≥1 positive culture (≥105 CFU/mL) during the first year post-RTx that were transplanted from September 1, 2012 to October 1, 2016. Each bacteriuria episode was adjudicated as cystitis, pyelonephritis, or ASB (Figure 1). Subjects without bacteriuria were excluded from primary analysis but used to calculate UTI incidence. The primary outcome was 1-year symptomatic UTI incidence. Secondary outcomes: incidence of cystitis, pyelonephritis, and ASB; time-to-first UTI; microbiologic trends; and presence of MDR risk factors.ResultsBaseline characteristics: 52% male, median age 57 years, 65% stented, 34% antithymocyte globulin induction, 94% standard IS regimen (tacrolimus/mycophenolate/prednisone), 93% trimethoprim/sulfamethoxazole prophylaxis, and 21% receipt of IV antibiotics for ≥48 hours within 90 days of first positive culture (IV Abx); Of 527 RTx subjects, 100 had ≥1 positive culture. The 100 subjects had 234 cultures representing 359 isolates. Primary outcome: 12.1% symptomatic UTI incidence. Secondary outcomes (1-year incidences): 18.6% positive culture, 4.3% cystitis, 8.6% pyelonephritis, 11.9% ASB. Time to the first symptomatic UTI was a median of 50 days. A summary of microbiologic results can be found in Figure 2. ASB occurred 130 times and was treated 74.6% of the time (Figure 3). Significant risk factors for MDR UTI included female gender (P = 0.005), IV abx (P = 0.001), and recurrent UTI (P = 0.017).ConclusionIncidence of symptomatic UTI at our center was lower than previous reports. E. coli and E. faecalis were the most common urinary pathogens identified. MDR risk factors identified were biologically plausible and consistent with prior literature. ASB treatment occurred frequently and is an area to target stewardship interventions. Disclosures All authors: No reported disclosures.

The effect of Rosa (L. Rosa canina) on the incidence of urinary tract infection in the puerperium: A randomized placebo-controlled trial.

Urinary tract infection (UTI) is an infection that can occur in any area of the urinary tract which is characterized by a positive urine culture (U/C). The risk of UTI following cesarean section (CS) increases due to procedures such as catheterization. In vitro studies have demonstrated the effect of Rosa canina fruit in preventing Escherichia coli growth. This study was conducted to determine the effect of R.canina fruit in preventing the incidence of UTI in women following CS. This triple-blind randomized clinical trial was conducted in 2016 on 400 women following CS with negative U/C in Alzahra and Taleghani educational hospitals in the city of Tabriz-Iran. Participants were assigned into two groups of 200 women using block randomization. Each group received a twice daily dose of 500mg capsules containing R.canina or placebo from the second day after CS for 20days. Women were assessed by U/C on the 7th-10th and 20th days following CS. UTI was significantly lower in the intervention group compared with the control in the follow-ups conducted on the 7th-10th days (odds ratio=0.22; confidence interval 95% [0.07, 0.67]; p=.006) and 20th day (odds ratio=0.32; confidence interval 95% [0.14, 0.75]; p=.008). But the incidence of cystitis in the two groups was not statistically significant (p>.05). R.canina fruit capsules were able to reduce the incidence of UTI after CS. Thus, it is likely that administration of this medication can promote maternal health following CS.

Instructing females to wipe their vulva after bowel movements is unnecessary to prevent cystitis: a short research report

ABSTRACTIn Japan, females are often taught to wipe their vulva from front to back (FTB) after bowel movements in order to prevent cystitis. In this report, we studied whether vulva care after bowel movements in females is a risk factor for simple cystitis. Moreover, we evaluated factors affecting the method of vulva care after bowel movements in females. We recruited 274 females for this study. We analysed the correlations between the style of vulva care, restroom habits and patient characteristics. In addition, we evaluated the correlation between the incidence of cystitis and the style of vulva care after bowel movements. There were no significant differences in the presence of coexisting diseases (P = 0·766), activities of daily living (ADL's) (P = 0·203), body mass index (BMI) (P = 0·174) or restroom style (P = 0·512). However, a significantly greater number of elderly subjects reported wiping from back to front (P = 0·023). In the cystitis group, 48 females (28%) reported wiping the vulva from back to front after bowel movements. In the control group, 29 females (28%) reported wiping the vulva from FTB after bowel movements. There were no significant differences between these two groups (P = 0·988). Our data demonstrated that instructing females to wipe their vulva from FTB after bowel movements is unnecessary for the purpose of preventing cystitis.

Safety of same-day pegfilgrastim administration and incidence of cystitis and ureteritis in mCRPC treated with cabazitaxel ± carboplatin.

e16513Background: Cabazitaxel (CBZ) is a novel taxane approved after docetaxel in patients (pts) with metastatic castration resistant prostate cancer (mCRPC). Though myeloid growth factors are comm...

Standardized cranberry capsules for radiation cystitis in prostate cancer patients in New Zealand: a randomized double blinded, placebo controlled pilot study.

Acute radiation cystitis, inflammation of the bladder, is a common side effect in men receiving external beam radiation for prostate cancer. Although several treatments provide symptomatic relief, there is no effective treatment to prevent or treat radiation cystitis. Cranberry products have been associated with urinary tract health. This study aimed to determine the effect of highly standardized cranberry capsules (containing 72 mg proanthocyanidins [PACS]) compared with that of placebo capsules on the incidence and severity of radiation cystitis. Forty-one men with prostate cancer participated in a double blinded randomized placebo controlled study. Men took one capsule a day at breakfast during treatment and for 2 weeks after treatment completion. Severity of urinary symptoms and the bother these caused were measured using the individual items of the urinary domain of the Modified Expanded Prostate Index Composite (EPIC). The incidence of cystitis was lower in men taking cranberry capsules (65%) compared with those that took placebo capsules (90%) (p = 0.058); severe cystitis was seen in 30% of men in the cranberry arm and 45% in the placebo arm (p = 0.30). Overall, the incidence of pain/burning was significantly lower in the cranberry cohort (p = 0.045). Men on the low hydration regimen who took cranberry had less pain/burning (p = 0.038), stronger urine steam (p = 0.030) and used significantly fewer pads/liners (p = 0.042), which was significantly different from those on the high hydration regimen (p = 0.028). Men receiving radiation therapy for prostate cancer may benefit from using cranberry capsules, particularly those on low hydration regimens or with baseline urinary symptoms.

Preventive Effects ofLactobacillusMixture on ExperimentalE. coliUrinary Tract Infection in Infant Rats

PurposeUrinary tract infection (UTI) is an ascending infection of fecal uropathogens, urogenital lactobacilli are suggested to play a role in the prevention of UTI. This study was to investigate whether lactobacillus mixture (LM) could prevent the experimental infantile UTI.Materials and MethodsThe LM were composed of three lactobacillus strains (L. gasseri, L. rhamnosus, and L. reuteri). Mother rats were grouped as lactobacillus (LB) group I (LB I, n=22), II (LB II, n=24) and control (n=20). LB I and LB II were fed with LM (1 mL/day) and control with phosphate-buffered saline (PBS) from late pregnancy through lactation. All newborn rats were breast-fed and their urine and stool were collected at the end of the 3rd week to compare lactobacillus colony. Then, infant rats from LB II were treated with intravesical instillation of LM. Infant rats from LB I and control were instilled with PBS. Twenty-four hours later, experimental UTI was introduced by intravesical instillation of standard E. coli strain. After 72 hours later, the infant rats were sacrificed for histologic examination.ResultsLactobacilli colonies in urine and stool were not statistically different among the three groups. The incidence of pyelonephritis in the LB II was 16.7% (4/24), LB I 72.7% (16.22) and control 75.0% (15/20) (p=0.015). The incidence of cystitis was not significantly different among the three groups.ConclusionThe intravesically instilled LM significantly prevented experimental pyelonephritis in infant rats, however, LM administered orally to the pregnant and lactating mother rats did not.

“Laparoscopic” Cystoscopy Versus Traditional Cystoscopy in Patients Undergoing Laparoscopic Hysterectomy: Preliminary Results from a Pilot Study

Study Objective: To conduct a prospective, randomized pilot study to report procedural time, cost, incidence of cystitis and adverse events associated with laparoscopic cystoscopy as compared to traditional cystoscopy in patients undergoing laparoscopic hysterectomy.

Complications in Women Undergoing Burch Colposuspension Versus Autologous Rectus Fascial Sling for Stress Urinary Incontinence

We determined the clinicodemographic factors associated with complications of continence procedures, the impact of concomitant surgery on the complication rate and the relationship between the incidence of cystitis and the method of postoperative bladder drainage. We reviewed serious adverse events and adverse events in the Stress Incontinence Surgical Efficacy Trial, a randomized trial comparing Burch colposuspension to the autologous rectus fascial sling. Clinicodemographic variables were analyzed to determine those associated with adverse events using logistic regression analysis. Complications were stratified based on the presence or absence of concomitant surgery. Differences in complication rates (controlling for concomitant surgery) and cystitis rates (controlling for the bladder emptying method) were compared using Fisher's exact test. Blood loss (p = 0.0002) and operative time (p <0.0001) were significantly associated with an adverse event. Patients who underwent concomitant surgery had a significantly higher serious adverse event rate (14.2% vs 7.3%, p = 0.01) and adverse event rate (60.5% vs 48%, p <0.01) than patients who underwent continence surgery alone. Cystitis rates were higher in the sling vs the Burch group up to 6 weeks postoperatively regardless of concomitant surgery status (p <0.01). Intermittent self-catheterization increased the cystitis rate by 17% and 23% in the Burch and sling groups, respectively. Concomitant surgery at continence surgery increased the risk of complications. Sling surgery was associated with a higher risk of cystitis within the first 6 weeks postoperatively. Intermittent self-catheterization increased the risk of cystitis in each group. Complications were associated with surgical factors and not with patient related factors.

Urologic Complications of Pelvic Irradiation

We evaluated 964 patients who had undergone radiation therapy for malignant disease of the pelvic viscera during a 5-year period and who had been followed for 5 to 10 years after completion of treatment. Therapy had been given for gynecological tumors in 493 cases, genitourinary tumors in 240 cases, bowel tumors in 172 cases and various other malignant tumors in the pelvis in 59 cases. The incidence of cystitis, hematuria, ureteral obstruction and fistula formation was determined for each group.There were 203 urological complications, an incidence of 21 per cent, but only 25 of these complications (2.5 per cent) could be ascribed to the effects of radiation alone, the remainder being associated with persistent or recurrent tumor. Approximately 20 per cent of the patients had some abnormalities detected in the pre-treatment excretory urogram.The development of urologic complications was related to the radiation dosage and previous bladder operations.

THE BACTERIOLOGY OF THE URINE IN CHILDREN WITH VULVOVAGINITIS

The conception of an ascending route of infection in cystitis of infancy has heretofore largely rested on the unproved assumption of a constantly contaminated urethral tract. Such a hypothesis served to explain the predominance of cystitis in female infants. Helmholz and Beeler 1 in a recent study of the bacteriology of the urine in normal children, and of the urine from children with extra-urinary infections, established conclusively that the organisms of the colon group are not normal inhabitants of the female urethra. They further demonstrated that in those instances of extra-urinary infection in which organisms were found in the urine, these were present in such small numbers that they could not be considered other than accidental contaminations from the urethra. If the incidence of cystitis were subject to local factors, then any condition which increased such local factors should militate against a sterile urinary tract. It therefore seemed important to