Symptoms Of Urinary Tract Dysfunction Research Articles

Case Report of Xanthogranulomatous Pyelonephritis: A Rare Diagnostic in Pediatric Aged Patients

Xanthogranulomatous pyelonephritis is an unusual variant of chronic pyelonephritis in which there is massive destruction of the renal parenchyma by granulomatous tissue. The pathophysiological mechanism is not yet fully understood, and the diagnosis is challenging. This is a rare and sporadic diagnosis in the pediatric population. Here, we report a case of a 2-year-old girl with a one-year history of urinary tract infections and recurrent cloudy urine with traces of sand. Several urinalyses demonstrated pyuria without bacteria growth, and she was admitted to the pediatric nephrology unit. Imaging tests were performed and a xanthogranulomatous pyelonephritis was diagnosed. After confirmation of functional exclusion of the right kidney, a successful right nephrectomy was performed, and the histology confirmed the diagnosis. This case highlights the importance of complementary tests, in a child with signs and symptoms of urinary tract dysfunction, to exclude any pathology requiring therapeutic intervention.

A system for the treatment of nocturnal enuresis in children.

This paper presents our findings related to the treatment of children with nocturnal enuresis using our own rehabilitation system. The basic three elements of the therapeutic process include: 1st stage: assessment of the way in which a child urinates; 2nd stage: treatment of bladder dysfunctions; 3rd stage: learning to wake up in order to urinate. Medical records of 198 children were used in the study. Group 1: children with monosymptomatic nocturnal enuresis. Group 2: children with polisymptomatic nocturnal enuresis. Group 1 was treated with the use of alarm device (AD). The treatment in group 2 started with the urotherapy and pharamacotherapy of bladder dysfunctions, if the treatment was effective a therapy with the use of alarm device was recommended. A therapy with an AD was carried out in 122 children, 6 started to wake up without episodes of NE that would trigger the alarm, in 31 the ability to wake up in order to urinate developed in the first month of the therapy, 35 were cured after 2 months, in another 5 children the therapy was continued and was successfully completed in the 3rd month of using the AD. In total, 77 children (63.1%) treated using AD were considered as cured. The system for the treatment based on the functional division is effective both in children with normal bladder function and in patients with symptoms of urinary tract dysfunction. The treatment with AD is more effective in children with monosymptomatic than with polisymptomatic nocturnal enuresis.

Architectural differences in the bony pelvis of women with and without pelvic floor disorders

Objective To investigate the hypothesis that the architecture of the bony pelvis differs between women with and without pelvic floor disorders. Methods We designed a case-control study of women who had undergone magnetic resonance imaging (MRI) of the pelvis at our institution. Records were reviewed to identify women with and without pelvic floor disorders (urinary or anal incontinence, other symptoms of urinary tract dysfunction, or pelvic organ prolapse). Pelvimetry techniques were standardized. Relevant measures included transverse diameter of the inlet, angle of the pubic arch, intertuberous diameter, interspinous diameter, sacrococcygeal length, depth of sacral curvature, anteroposterior conjugate, obstetrical conjugate, and anteroposterior outlet. Multiple logistic regression analysis was used to identify women with pelvic floor disorders as a function of their pelvic dimensions, controlling for potentially confounding variables. Results Subjects included 59 women with pelvic floor disorders and 39 women without pelvic floor disorders. Women with pelvic floor disorders had a wider transverse inlet, wider intertuberous diameter, wider interspinous diameter, greater sacrococcygeal length, deeper sacral curvature, and narrower anteroposterior outlet. When controlling for the confounding effects of age, race, and parity, we found that a wider transverse inlet (odds ratio 3.425) and a shorter obstetrical conjugate (odds ratio 0.233) were significantly associated with pelvic floor disorders. Conclusion A wide transverse inlet and narrow obstetrical conjugate are associated with pelvic floor disorders. We speculate that these features of bony pelvic architecture may predispose the patient to neuromuscular and connective tissue injuries, leading to the development of pelvic floor disorders.