Presence Of Urinary Symptoms Research Articles

Preoperative urine culture with contaminants is not associated with increased risk for urinary tract infection after ureteroscopic stone treatment.

We aimed to assess whether the presence of contaminants in the pre-operative urine culture (preop-UC) predicts postoperative urinary tract infection (postop-UTI) in patients undergoing elective ureteroscopy with laser lithotripsy. A retrospective chart review was performed from 01/2019 to 12/2021 examining patients with unilateral stone burden ≤ 2cm who underwent ureteroscopy with laser lithotripsy and had a preop-UC within 3months. Positive, negative, contaminated, and polymicrobial definitions for UCs were established in accordance with current guidelines. Patients with positive and polymicrobial cultures were excluded. Postop-UTI was defined as the presence of urinary symptoms and a positive UC within 30days of the procedure. Multivariable logistic regression models were utilized to evaluate risk factors for contamination in the preop-UC and the risk of postop-UTI. A total of 201 patients met the inclusion-exclusion criteria. Preop-UC was negative in 153 patients and contaminated in 48 patients. Significant contaminant-related factors included female gender and increased BMI. Postop-UTI was diagnosed in 3.2% of patients with negative preop-UCs and 4.2% of patients with contaminants, with no difference between groups (p = 0.67). The regression model determined that the presence of contaminants in preop-UC failed to predict postop-UTI (OR 0.69, p = 0.64). The presence of contaminants in preop-UCs is not associated with an increased risk of postop-UTIs after ureteroscopy. Our study supports that contaminants in the preop-UC can be interpreted as a negative UC in terms of postop-UTI risk stratification. Preoperative antibiotics should not be prescribed for patients undergoing uncomplicated ureteroscopy for stone surgery in the setting of a contaminated preop-UC.

146. Review of Urine Culture Screening Practices Prior to Urologic Procedures

Abstract Background Screening for UTIs prior to urologic procedures is a well-established practice. However, screening for asymptomatic bacteriuria remains more controversial, especially for procedures considered to be low-risk for complications. The aim of this study was to characterize current screening practices at our facility. Methods This retrospective study reviewed outpatient urologic procedures performed between 10/01/2022 and 12/31/2022. Procedures were stratified by risk based on current American Urological Association guidance. Charts were reviewed for the following information: urinary symptoms, ucx results, antibiotic prescriptions, post-op complications. The primary outcome was the incidence of urinary (GU) infection or infection related hospitalization (IRH) within 30 days post-procedure. Secondary outcomes include ucx screening rates and risk of infection based on presence of urinary symptoms. Results: 210 procedures were reviewed. Risk of GU infection ranged from 8.2% to 12.9%, with the highest rates seen in intermediate- and high-risk procedures. Risk of IRH increased by increasing level of risk (Table 1). Pre-op ucx were ordered in 35% of procedures, however frequency of ordering varied based on level of risk, with intermediate-risk (96%) much more likely to have been screened and no screening was done prior to high-risk procedures (Table 2). Symptomatic patients were more likely to have a pre-op ucx (60.4% vs 28.2% if asymptomatic). Ucx positivity was 3-fold higher if patient was symptomatic. Rates of GU infection and IRH varied based on presence of symptoms and whether preop ucx was ordered. (Table 3)Table 1:Risk of GU infection or IRH by ucx ordering, stratified by risk*no data since no ucx were ordered in high-risk groupTable 2:Preoperative ucx ordering by risk stratificationTable 3:Ucx screening by symptom status Conclusion In this study sample, risk of infectious complications (especially IRH) increased with increasing level of procedural risk. However, screening trends were inconsistent limiting conclusions about the impact of ucx on the incidence of infectious complications prior to intermediate and high-risk procedures. The rate of ucx screening was higher when urinary symptoms were present, but clear trends did not appear. This study highlights the need for consistent screening practices, primarily based on risk of procedure. Larger numbers may help answer the question of whether or not screening should be based on presence of symptoms. Disclosures All Authors: No reported disclosures

The Influence of Oral Health Care on Prevalence of Urinary Symptoms and mean plasma Prostatic Surface Antigen (PSA) concentration in a Population of Nigerian Adult Males

Background/Aims and Objectives: Inflammatory mediators from ongoing oral infection induce intense immune response that could lead to the carcinogenesis as well as progression of pathogenesis of systemic diseases. Development of prostatic carcinoma and presence of urinary symptoms may be linked to the presence of oral problems.

Retrospective Analysis of Complications from Prostate Cancer among Nigerians

Background: Prostate cancer (PCa) may be asymptomatic at an early stage and may run an indolent course that requires minimal or no treatment. Early diagnosis through screening reduces the rate of advanced diseases. Whereas, in the western countries where screening is more prevalent, many presents early with a chance for curative treatment. In Africa, late presentation is often the case with palliative treatment sadly the only choice. Objective: To evaluate the associated complications in patients with prostate cancer and assess the Gleason’s grade as a risk factor for complications observed in patients with prostate cancer, in Port Harcourt, Rivers, Nigeria. Method and Methodology: This was a retrospective study carried out over ten years, between January 2011 and December 2020. All patients with histologically confirmed prostate cancer who presented to the University of Port Harcourt Teaching Hospital, Sophia clinic, and Rosivylle clinic were evaluated. The folders were retrieved and their age, presenting complaints, skeletal survey, and biopsy reports were evaluated. Patients with incomplete records were excluded from the study. These data were collated using Microsoft Excel 2016 version and they were analyzed using SPSS version 20. Results: There were 335 patients with PCa with a mean age of 68.71year. The commonest complication was urinary symptoms observed in 192 with urine retention 119(35.5%) and nephropathy 73(21.8%). The spine was the commonest site of bone spread observed in 160(47.8%) followed by the femur 62(18.5%). Anaemia was the next common. There was an association between age, presence of urinary symptoms, and bone involvement with the Gleason’s Grade. However, there was a strong association of the overall presence of complications with Gleason’s score. Conclusion: Men with prostate cancer tend to present with advanced disease in Port Harcourt. The most common presentation was lower urinary tract symptoms followed by low back pain. Complications are associated with high Gleason’s grade cancers. Screening may aid in early diagnosis and cure of the disease especially for men of African descent.

The Relationship Between Urinary Symptom Severity And Functional Status İn Patients With Stroke.

Lower Urinary Tract Dysfunction (LUTD) is a condition that is common in stroke patients and affects their quality of life and psychological state. To determine the factors affecting LUTD severity in stroke patients and to evaluate its relationship with functional status. 77 stroke patients were included in our study. Demographic and stroke characteristics of all patients were recorded. Functional Ambulation Scale (FAS), Functional Independence Measure (FIM), the Core Lower Urinary Tract Symptom Score (CLSS) Questionnaire, Beck Depression Scale were administered to the patient. 33 of 77 patients had urodynamic study and these patients constituted the subgroup of the study. Patients were grouped according to type of disorder, type of detrusor and detrusor sphincter dyssynergia (DSD) using urodynamic study findings. The mean CLSS of men was significantly higher than women (P = 0.017). A significant positive correlation was found between age and CLSS (P = 0.035 r = 0.24) and negative correlation was found between total FIM and all sub-parameter scores and mean of CLSS (P = 0.001 r = -0.467). LUTD is common in stroke patients and the presence of urinary symptoms is associated with poor functional status. No significant relationship was observed between urodynamic data except maximum flow rate and CLSS.

Blood Transfusion Rate in Patients Undergoing Benign Prostatic Hyperplasia

Background and Objective: Benign Prostatic Hyperplasia (BPH) is defined as the enlargement of the prostate gland in the presence of urinary symptoms without any evidence of malignancy. For patients who have failed medical treatment as the first line of therapy, surgical intervention will be administered as the treatment. Hemorrhage is one of the most dreadful and serious complications of prostate surgery. Bleeding can often be significant and lead to increased morbidity and occasionally mortality. If it persists, it may necessitate blood transfusion and can lead to clot retention in the postoperative period. Materials and Methods: This study was conducted on 87 patients with benign prostatic hyperplasia, who underwent surgical intervention (open prostatectomy and transurethral resection of the prostate) for a year. The volume of packed cell transfusion in these patients was determined and compared based on the surgical method and other variables. The collected data were analyzed in SPSS (version 24). Results: The mean age of the patients was 71.3±9.56 years, and 26.4% of the subjects were under 65 years old. Among the cases, 93.1% of patients underwent transurethral resection of prostate surgery and 7.7% received a blood transfusion. It was found that 41.4%, 12.6%, 10.3%, 3.4%, and 1.1% of the participants had high blood pressure, diabetes, ischemic heart disease, hypothyroidism, and dyslipidemia, respectively. The means of pre- and post-operative hemoglobin were obtained at 13.16±1.83 and 12.33±2.17, respectively, and those of pre- and post-operative hematocrit were estimated at 38.64±4.84 and 36.72±5.72, respectively. Conclusion: Transurethral resection of prostate surgery had a lower rate of blood transfusion, compared to open surgery. The age of the patients and a history of underlying diseases were not significantly related to blood transfusion percentage in these patients. However, the frequency of blood transfusion was higher in patients with hypertension than in those with other diseases; nevertheless, it was not significant.

Urinary incontinence associated with pharmacological treatment of Chronic Obstructive Lung Disease: An integrative review

Chronic Obstructive Pulmonary Disease (COPD) is a lung disease, often associated with smoking. COPD patients have persistent, including urinary incontinence. Therefore, a research has the general objective of knowing the physiological mechanism of urinary incontinence associated with the pharmacological treatment of COPD. As a methodological process, this study is an integrative review that included randomized clinical trials, quasi-experimental intervention studies, cohort and case-control. The selection of studies was carried out in the databases PubMed, SciELO, Science Direct and BVS (Virtual Health Library), published between 2010 and July 2020, in Portuguese and English. Pharmacological classes SABA, LABA, SAMA, LAMA, ICS and iPDE4 were considered to investigate adverse effects and check for the presence of urinary symptoms caused by these drugs. In the results and discussion, 113 articles were identified with the investigated descriptors. After the article selection process, 14 studies resulted: PubMED (13); and Science Direct (1). The pharmacological class related to urinary incontinence identified in this study was that of anticholinergics / antimuscarinics. From this perspective, it can be considered that Urinary Incontinence has a low relationship with the adverse effects of drugs for the treatment of Chronic Obstructive Pulmonary Disease (COPD). However, as urinary incontinence is not considered a life-threatening problem, it is possible that it has not been included among the adverse events to be explored.

Urinary symptoms in women with faecal incontinence.

Faecal incontinence (FI) is estimated to affect 8.9% of women in the United States, with a significant impact on quality of life. Our aim was to compare urinary symptoms in patients with and without FI with different degrees of severity. This prospective cohort of women presented for care at a pelvic floor disorder centre between May 2007 and January 2019. We excluded women with a history of bowel resection, prior history of pelvic organ prolapse surgery or existing prolapse symptoms reported by the patient during intake. The primary outcome was the presence of urinary symptoms in women with and without FI by validated questionnaires. A logistic regression model for association of urinary symptoms with FI was performed, adjusting for age, smoking, diabetes, prior hysterectomy and irritable bowel syndrome. A total of 2932 met inclusion criteria, and of these 1404 (47.89%) reported FI. In the univariate analysis, patients with FI were more likely to have urgency urinary incontinence (P=0.01) or mixed urinary incontinence (P<0.001), report nocturnal enuresis (P<0.001) or have leakage of urine during sex (P<0.001). In an adjusted model, FI was associated with concurrent stress (adjusted OR 1.28, P=0.034), urgency (adjusted OR 1.52, P<0.001) and mixed incontinence (adjusted OR 1.94, P<0.001). In women with pelvic floor disorders, the presence of FI is associated with a higher prevalence of urinary incontinence. Pelvic floor specialists should assess urinary incontinence symptoms along with the presence and severity of FI to provide comprehensive care and guide appropriate therapy.

Presence of urinary symptoms in bacteremic urinary tract infection: a retrospective cohort study of Escherichia coli bacteremia

BackgroundIt is important to understand clinical features of bacteremic urinary tract infection (bUTI), because bUTI is a serious infection that requires prompt diagnosis and antibiotic therapy. Escherichia coli is the most common and important uropathogen. The objective of our study was to characterize the clinical presentation of E coli bUTI.MethodsRetrospective cohort study of consecutive adult patients admitted for community acquired E. coli bacteremia from January 1, 2015 to December 31, 2016 was conducted at 4 acute care academic and community hospitals in Toronto, Ontario, Canada. Logistic regression models were developed to identify E coli bUTI cases without urinary symptoms.ResultsOf 462 patients with E. coli bacteremia, 284 (61.5%) patients had a urinary source. Of these 284 patients, 161 (56.7%) had urinary symptoms. In a multivariable model, bUTI without urinary symptoms were associated with older age (age < 65 years as reference, age 65–74 years had OR of 2.13 95% CI 0.99–4.59 p = 0.0523; age 75–84 years had OR of 1.80 95% CI 0.91–3.57 p = 0.0914; age > =85 years had OR of 2.95 95% CI 1.44–6.18 p = 0.0036) and delirium (OR of 2.12 95% CI 1.13–4.03 p = 0.0207). Sepsis by SIRS criteria was present in 274 (96.5%) of all bUTI cases and 119 (96.8%) of bUTI cases without urinary symptoms.ConclusionThe majority of patients with E. coli bacteremia had a urinary source. A significant proportion of bUTI cases had no urinary symptoms elicited on history. Elderly and delirious patients were more likely to have bUTI without urinary symptoms. In elderly and delirious patients with sepsis by SIRS criteria but without a clear infectious source, clinicians should suspect, investigate, and treat for bUTI.

Urinary tract infection in patients with multiple sclerosis: An overview

IntroductionMultiple sclerosis (MS) is a demyelinating, chronic, inflammatory, and autoimmune disease of the central nervous system (CNS) with axonal degeneration, presenting a progressive and variable course. MS patients usually have complications, such as bladder dysfunction, presence of urinary symptoms, and Urinary Tract infection (UTI), which is one of the three most common non-neurological complications in MS patients. ObjectiveAnalyze the most diverse aspects of UTI in MS patients, focusing on risk factors, prevalence, hospitalization, mortality rates, diagnosis, and treatment of UTIs in this group. MethodsA non-systematic review of articles published on PubMed in the last 10 years with the search terms "Urinary Tract Infection" AND "Multiple Sclerosis". DiscussionMS patients have a high UTI prevalence, mainly due to the occurrence of urinary disorders in these patients. The most common symptoms of UTI in MS patients are urinary urgency, polyuria, nocturia, urinary retention, and incontinence. Escherichia coli, Pseudomonas aeruginosa, and Klebsiella pneumoniae were the most found organisms and treatment is based on antibiotic therapy. Moreover, UTIs can precipitate outbreaks, worsen the disease, causing more damage and a severe neurological condition deterioration. In addition, UTIs in this group are associated with a high hospitalizations rate and a high mortality rate. Therefore, patients in MS outbreaks with urinary symptoms or positive urinalysis must keep corticosteroid therapy and Disease-Modifying Treatments (DMTs). Whether clinically stable or MS relapse patients, the urinalysis and the presence of symptoms must guide the treatment in each group. Moreover, the pharmacological treatment of asymptomatic bacteriuria has no evidence of clinical efficacy. As the treatment of asymptomatic bacteriuria induces a significant increase in more resistant bacterial strains, it is recommended exceptionally in cases of recurrent acute UTIs, prior to handling of the UTI, pregnancy or patients in need of immunosuppression. ConclusionUTI represents a great risk and concern in MS patients. The high prevalence, hospitalization rate, and mortality rate of UTI in MS is worrying, such as the cause-consequence relationship between UTIs and the use of corticosteroids in outbreaks. Therefore, it is important to be aware of a UTI in this group to make early diagnoses, adequate management, and new infections prevention. Thus, further studies are needed to thoroughly analyze each nuance of this important comorbidity for MS patients.

Prospective observational study of the impact of vaginal surgery (pelvic organ prolapse with or without urinary incontinence) on female sexual function.

There is a difference of opinion in the literature as to whether pelvic organ prolapse (POP) is a direct cause of female sexual dysfunction (FSD). Sexual function in women is negatively impacted by the presence of urinary symptoms. Thus, sexual dysfunction (SD) might be improved, unchanged, or worsened by pelvic floor surgery. In this study, we observed SD and impact of surgical intervention on female sexual function (FSF) using a validated Prolapse/Urinary Incontinence Sexual Questionnaire Short Form (PISQ-12) in women undergoing surgery for POP with or without urinary incontinence. Two hundred women were recruited and followed up at 6 and 12months postoperatively. Sexual function (SF) as measured by the PISQ-12 improved after surgery irrespective of the nature of surgery or the patient's past gynaecology history. Improvement in SF was seen by 6months (97 patients) postsurgery (P<0.05), after which (at 12months; 80 patients) no further change was observed. Improved SF was associated with better patient satisfaction postoperatively. Sexual function improved in women following surgery for POP with or withour urinary incontinence, irrespective of the nature of surgery and the patient's past gynecologic history. Results of this study will assist when counselling women with POP with or without urinary incontinence regarding treatment options.

Discrepancies between urinary symptoms assessment and objective bladder dysfunctions in multiple sclerosis

ObjectiveTo assess the association between objective bladder function parameters in relation to urinary symptoms, and to analyze the sensitivity and specificity of subjective urinary symptom-assessment in predicting objective bladder dysfunction in a multiple sclerosis (MS) population.MethodsConsecutive MS patients with Expanded Disability Status Score (EDSS) ≤7.0 were included in this prospective study. In a single visit, patients were evaluated for the presence of urinary symptoms, then assessed for the following urological parameters: maximum urinary flow rate (Qmax), postvoid residual urine volume (PVR), and detrusor sphincter dyssinergia (DSD).ResultsOne hundred nine subjects were included with a mean disease duration of 12.5 ± 8.7 years, 90.8% had a relapsing-remitting course; the mean EDSS score was 2.6 ± 1.7. Overall, 53.5% complained of at least one urinary symptom, and the most reported one was urgency (40.7%), followed by frequency (15.7%) and incomplete emptying (12.0%). Abnormal values were found for Qmax in 34.9%, for PVR in 40.4% of participants; DSD was diagnosed in 33.9% of the cases. Only Qmax was found negatively associated with the EDSS score (p = 0.007), but no other association was observed. The presence of urinary symptoms was poor predictor of bladder dysfunction, urgency among the others showed relatively higher predicting value.ConclusionsSubjective urinary symptoms assessment failed in predicting bladder function. Our results confirmed the value of objective urological assessment in patients with MS, irrespective of the presence of urinary symptoms.

Outcomes of haematuria referrals: two-year data from a single large university hospital in Denmark

Objective: The aim of this study was to review haematuria referrals to a large university hospital in Denmark, based on the previous Danish guidelines for haematuria referral (before January 2016), to evaluate the pattern of referrals and the cancer detection rates and compare these with the current guidelines.Materials and methods: A retrospective study was undertaken of all patients referred from primary care for the evaluation of haematuria from January 2013 to December 2014. All patients underwent cystoscopic examination and upper urinary tract evaluation using computed tomography. Patients' demographics, type of haematuria, presence of urinary symptoms and cancer detection rates were recorded.Results: The study included 1577 patients, with a mean age of 63 years (range 16–96 years). Of these, 56.4% had visible haematuria (VH) and 43.6% were referred for non-visible haematuria (NVH). In total, 228 malignancies were detected (14.5% cancer detection rate). Overall, 11.2% of patients had bladder cancer, 1.8% renal cancer and 0.4% upper tract transitional cell carcinoma. In the VH group, 205 malignancies were detected (23% cancer detection rate). The detection rate was higher for those with asymptomatic VH (24.6%) than for those with symptomatic VH (15.4%). The cancer detection rate for symptomatic NVH was 9.1%, with only three cancers diagnosed in those younger than 60 years of age. For asymptomatic NVH, the cancer detection rate was only 1.5%, with a total of eight urological malignancies diagnosed in patients aged 60 years or older.Conclusions: The new Danish referral pathway has an acceptable capture rate for patients presenting with haematuria of all severities. The overall cancer detection rate of 14.5%, and 23% for patients with VH in this study, is an important validation of previous studies. A cancer detection rate of greater than 30% was shown in patients with VH over 70 years old.

Dutasteride is associated with reduced risk of transrectal prostate biopsy-associated urinary tract infection and related hospitalizations.

To evaluate whether the use of dutasteride is associated with a lower risk of transrectal prostate biopsy-associated urinary tract infection (TPBA-UTI) among men in the Reduction by Dutasteride of Prostate Cancer Events (REDUCE) study. Retrospective analysis of 6045 men undergoing 2-year repeat prostate biopsy in REDUCE. Participants were randomized to receive dutasteride 0.5mg or placebo daily. TPBA-UTI was defined as the presence of urinary symptoms and the prescription of antibiotics by the treating physician within 30days after biopsy. Severe TPBA-UTI was defined as TPBA-UTI requiring hospitalization. Comparison of TPBA-UTI between treatment arms was done using Chi-square test and logistic regression adjusting for participant characteristics. Of the subjects included in the study, 3067 (50.7%) were randomized to the placebo arm and 2978 (49.3%) to the dutasteride arm. A total 51 (0.8%) men had TPBA-UTI, including 38 (1.2%) in the placebo arm and 13 (0.4%) in the dutasteride arm (univariable relative risk [RR]=0.35, P=0.001; multivariable odds ratio [OR]=0.34, P=0.003). The number needed to treat (NNT) to prevent one TPBA-UTI was 125 subjects. Of these, 14 (28%) had severe TPBA-UTI, including 12 (0.4%) in the placebo arm and only 2 (0.07%) in the dutasteride arm (univariable RR=0.17, P=0.021; multivariable OR=0.17, P=0.031). The NNT to prevent one severe TPBA-UTI was 309 subjects. Among men undergoing a 2-year repeat prostate biopsy, the use of dutasteride for 2years was associated with a reduced the risk of overall and severe TBPA-UTI. CLINICALTRIALS. NCT00056407.

Symptom clusters for revising scale membership in the analysis of prostate cancer patient reported outcome measures: a secondary data analysis of the Medical Research Council RT01 trial (ISCRTN47772397)

PurposeTo investigate the role of symptom clusters in the analysis and utilisation of patient reported outcome measures (PROMs) for data modelling and clinical practice. To compare symptom clusters with scales, and to explore their value in PROMs interpretation and symptom management.MethodsA dataset called RT01 (ISCRTN47772397) of 843 prostate cancer patients was used. PROMs were reported with the University of California, Los Angeles Prostate Cancer Index (UCLA-PCI). Symptom clusters were explored with hierarchical cluster analysis (HCA) and average linkage method (correlation > 0.6). The reliability of the Urinary Function Scale was evaluated with Cronbach’s Alpha. The strength of the relationship between the items was investigated with Spearman’s correlation. Predictive accuracy of the clusters was compared to the scales by receiver operating characteristic (ROC) analysis. Presence of urinary symptoms at 3 years measured with the late effects on normal tissue: subjective, objective, management tool (LENT/SOM) was an endpoint.ResultsTwo symptom clusters were identified (urinary cluster and sexual cluster). The grouping of symptom clusters was different than UCLA-PCI Scales. Two items of the urinary function scales (“number of pads” and “urinary leak interfering with sex”) were excluded from the urinary cluster. The correlation with the other items in the scale ranged from 0.20 to 0.21 and 0.31 to 0.39, respectively. Cronbach’s Alpha showed low correlation of those items with the Urinary Function Scale (0.14–0.36 and 0.33–0.44, respectively). All urinary function scale items were subject to a ceiling effect. Clusters had better predictive accuracy, AUC = 0.70 –0.65, while scales AUC = 0.67–0.61.ConclusionThis study adds to the knowledge on how cluster analysis can be applied for the interpretation and utilisation of PROMs. We conclude that multiple-item scales should be evaluated and that symptom clusters provide a study-specific approach for modelling and interpretation of PROMs.

Nocturia and others urinary symptoms in three stages of postpartum according mode of delivery

Introduction: There are risk factors causing urinary symptoms associated with childbirth. The aim was to investigate the presence of urinary symptoms in postpartum. Methods: Prospective cohort study was undertaken. The women were evaluated three times. The first interview was face-to-face at 2 days after the childbirth. At 2 and 8 weeks after delivery, the patients were interviewed by telephone. Results: 132 women were divided into two groups according to the mode of delivery: VG (vaginal delivery group) and CG (cesarean group). The average age of the women was 25.54 (±5.65) years in VG and 25.23 (±5.26) years in CG (p = 0.869). The most frequent symptom in both groups was nocturia. Conclusion: urinary symptoms tend to worsen throughout the postpartum period, regardless of the mode of delivery.

Spontaneous Rupture of the Urinary Bladder - A Case Report and Review of Literature

Introduction: Spontaneous rupture of the urinary bladder [SRUB] is a rare event. Patients usually present with features of peritonitis and diagnosis is usually made at operation. There are several factors that can predispose patients to an event like this, but most commonly it includes a chronic increase in bladder wall pressure and chronic inflammatory states besides malignancy. Case Report: A 42 years old male came in emergency surgery department with pain in abdomen. Ultrasonography of abdomen was suggestive of peritonitis for which he underwent exploratory laparotomy and was found to have perforation of urinary bladder which was repaired. Patient recovered uneventfully. Conclusion: Rupture of urinary bladder must be included in the differential diagnosis of acute abdomen presenting with peritonitis. A high index of suspicion is essential in the presence of urinary symptoms. In the majority of cases, underlying bladder pathology has been identified, although idiopathic SRUB may occur.

Predictors of prostate cancer screening intention among older men in Jordan

ABSTRACTIntention to prostate cancer screening (PCS) is one of the major factors affecting the long‐term success of population‐based PCS programmes. The aim of this study is to explore strong factors linked to intention to PCS among older Jordanian adults using the Health Belief Model (HBM). Data were obtained from Jordanian older adults, aged 40 years and over, who visited a comprehensive health care centre within a ministry of health. A pilot test was conducted to investigate the internal consistency of the Champion Health Belief Model Scale for PCS and the clarity of survey questions. Sample characteristics and rates of participation in PCS were examined using means and frequencies. Important factors associated with intention to PCS were examined using bivariate correlation and standard multiple linear regression analysis. About 13% of the respondents were adherent to PCS over the prior decade. Four out of the seven HBM‐driven factors (perceived susceptibility, benefits and barriers to prostate‐specific antigen (PSA) test, and health motivation) were statistically significant. Those with greater levels of susceptibility, benefits of PSA test and health motivation and lower levels of barriers to PSA testing were having more intention to participate in PCS. Family history, presence of urinary symptoms, age and knowledge about prostate cancer significantly predicted the intention to PCS. Intervention programmes, which lower perceived barriers to PSA testing and increase susceptibility, benefits of PSA testing and health motivation, should be developed and implemented.

Correlative factors of cognitive dysfunction in PD patients: a cross-sectional study from Southwest China

Background: Cognitive dysfunction is common in Parkinson’s disease (PD). A comprehensive understanding of cognitive dysfunction and its correlative factors in Chinese PD patients were not available.Methods: This cross-sectional study included 454 PD patients. Cognitive function was evaluated using the Montreal Cognitive Assessment. Non-motor symptoms were assessed using the Non-Motor Symptoms Scale (NMSS), and depression and anxiety were assessed using the Hamilton Depression Rating Scale and the Hamilton Anxiety Rating Scale, respectively.Results: Cognitive dysfunction was observed in 58.1% of the patients. The mean age, age of onset, scores of rigidity, bradykinesia, axial impairment, tremor, speech and facial expression, total Unified PD Rating Scale part III and H&Y stage, and NMSS scores were significantly higher in PD patients with cognitive dysfunction than in those without cognitive dysfunction. The prevalence of sleep/fatigue domain with the item ‘difficulty falling asleep’, mood/apathy domain with the item ‘feelings of nervousness’, perceptual problems/hallucinations domain with the item ‘delusions’, attention/memory domain with the items ‘concentration’ and ‘forget to do things’, gastrointestinal domain with the items ‘dribbling saliva’ and ‘swallowing’, urinary domain with the item ‘nocturia’, and the item ‘taste or smell’ in the miscellaneous domain were significantly higher in PD patients with cognitive dysfunction. Logistic regression indicated that female sex, older age, lower education level, higher bradykinesia score, and presence of the urinary domain were associated with cognitive dysfunction in PD.Conclusions: Age, sex, education level, bradykinesia score, and presence of urinary symptoms are correlative factors of cognitive dysfunction in Chinese PD patients.

THE CONTRIBUTION OF GENES POLYMORPHISM OF THROMBOPHILIA IN CLINICAL VARIABILITY OF HEMORRHAGIC VASCULITIS

Background: The article is devoted to the study of clinical and laboratory characteristics of the current of hemorrhagic vasculitis in children in the Republic of Buryatia. Patients and methods: The study included 27 patients aged 7,6±4,02 years, who conducted clinical and laboratory tests, immunological study of antiphospholipids of antibodies, genetic testing for thrombophilia markers of candidate genes. Results: The results showed that hemorrhagic vasculitis often affects children of Buryat nationality. In 96% of cases there are mixed clinical forms of the disease. 63% of children of hemorrhagic vasculitis preceded by various factors, a higher percentage of infectious diseases. The first clinical symptom in 63% of patients is a typical purpura hemorrhagic rash. Results of clinical laboratory blood tests revealed no significant deviations. Circulation of lupus anticoagulant was detected in 37% of subjects . The аCL IgM detected in 3 children, aβ2-GP-I IgA — in 4 , aβ2-GP-I IgM — in 1 patient. Carriers of thrombophilia polymorphisms were in 95% of children. Noted that homozygous variants of genes polymorphisms of methylenetetrahydrofolateredreductase and plasminogen activator inhibitor-1 correlate with the presence of urinary symptoms and recurrence of the rash. Conclusion: The study shows the risk of recurrent flow of hemorrhagic vasculitis and nefritis of Henoch–Schonlein in children with thrombophilia gene polymorphism.