Treatment Of Urinary Tract Disease Research Articles

Reproductive health promotion in working individuals. Guidelines

The methodological recommendations have been developed with the aim of grading, systematizing and identifying key areas for the implementation of individual measures or a comprehensive corporate program for reproductive health promotion in working individuals at the employer level, including taking into account international experience.The guidelines describe seven key subprograms aimed at early diagnosis and timely treatment of urinary tract diseases, assessment of reproductive health, improving literacy in sex education and behavior, reducing the negative impact of industrial and external environmental factors on reproductive health, increasing commitment to measures to combat risk factors for noncommunicable diseases, providing support during menopause in women and andropause in men, and creating conditions in the workplace conducive to maintaining a strong family. The guidelines are intended for healthcare and public health organization specialists, heads of state authorities of constituent entities of the Russian Federation in the field of health protection, specialists of regional centers for public health and medical prevention, as well as for heads of organizations in various economic sectors. The materials presented in the guidelines can also be used by medical workers of various specialties (paramedics, general practitioners (family doctors), obstetrics and gynecology doctors, dermatology and venereology specialists, medical prevention doctors, occupational pathology physicians and urologists).

New Light on Plants and Their Chemical Compounds Used in Polish Folk Medicine to Treat Urinary Diseases.

This review contains the results of Polish (Central Europe) ethnomedical studies that describe the treatment of urinary tract diseases with wild and cultivated plants. The study includes only the plants that are used to treat the urinary tract, excluding prostate diseases. A review of the literature was carried out to verify the pharmacological use of the plants mentioned in the interviews. Based on this, the study reviews the pharmacological activities of all the recorded species and indicates their most important chemical compounds. Fifty-three species (belonging to 30 families) were selected for the study. The Compositae (eight species), Rosaceae (six species), and Apiaceae (six species) are the most common families used in the treatment of urinary diseases in Polish folk medicine. Both in vitro and in vivo studies have confirmed that many of these plant species have beneficial properties, such as diuretic, antihyperuricemic, antimicrobial, and anti-inflammatory activity, or the prevention of urinary stone formation. These effects are exerted through different mechanisms, for example, through the activation of bradykinin B2 receptors, inhibition of xanthine oxidase, or inhibition of Na+-K+ pump. Many plants used in folk medicine are rich in phytochemicals with proven effectiveness against urinary tract diseases, such as rutin, arbutin, or triterpene saponins.

Chromatographic Techniques and Pharmacological Analysis as a Quality Control Strategy for Serjania triquetra a Traditional Medicinal Plant.

Serjania triquetra is a medicinal plant widely used in traditional medicine for the treatment of urinary tract diseases, renal affections, and its complications. The population can buy this plant in folk markets as a raw material mixed with several herbal remedies or as a health supplement. On the market, two commercial presentations were found for the vegetal material; one had a bulk appearance and the other was marketed wrapped in cellophane bags (HESt-2, HESt-3). Nevertheless, the plant has not been exhaustively investigated and quality control techniques have not been developed. This research aimed to realize a phytochemical study using an authentic, freshly collected sample as a reference for S. triquetra (HESt-1), using the compounds identified. A method for the determination of preliminary chromatographic fingerprinting was developed. Additionally, the vasorelaxant effect from three samples was evaluated with ex vivo rat models. Thus, three hydroalcoholic extracts (HESt-1, HESt-2, and HESt-3) were prepared by maceration. A total of nine compounds were fully identified from HESt-1 after the extract was subjected to open-column chromatography. Seven metabolites were detected by gas chromatography, while ursolic acid (UA) and allantoin were isolated and identified using UPLC-MS and NMR, respectively. Three extracts were analyzed for their chromatographic fingerprint by UPLC-MS. Biological activity was explored by ex vivo rat aorta ring model to evaluate vasorelaxant activity. All extracts showed a vasorelaxant effect in a concentration-dependent and endothelium-dependent manner. S. triquetra vascular activity may be attributed to UA and allantoin compounds previously described in the literature for this activity.

Isolation of Individual Compounds from the Terrestrial Parts of Ononis Arvensis L. and Solidago Canadensis L.

Introduction.Among the different groups of drugs, diuretics are one the most popular classes that have been used for treatment of cardiovascular system and kidney diseases. At the same time, synthetic diuretics which are widely used, cause large amounts of side effects, such as violation of electrolyte, acid-base and water balances, carbohydrate and lipid metabolism. Therefore, it is important to search for individual compounds of plant origin – potential pharmaceutical substances for the treatment of urinary tract diseases. In this study individual compounds were isolated from the terrestrial parts of Ononis arvensis L. and Solidago canadensis L. The diuretic activity of the summary extracts of Ononis arvensis and Solidago canadensis has previously been proven.Aim.Method development for the isolation of individual compounds, using modern physicochemical methods of analysis, from the terrestrial parts of Ononis arvensis and Solidago canadensis and the elucidation of their structure.Materials and methods.Aerial parts of Ononis arvensis and Solidago canadensis were collected in the Saint Petersburg State Chemical-Pharmaceutical University (SPCPU) Nursery Garden of Medicinal Plants (Leningrad region, Vsevolozhsky district, Priozersk highway, 38 km) in August 2019 and identified by Dr. Goncharov Mikhail of the Saint-Petersburg chemical-pharmaceutical university, Saint-Petersburg, Russia. Fraction analysis were preformed with analytical high-performance liquid chromatography using a LC-20 Prominence (Shimadzu corp., Japan) with a SPD-M20A diode-array detector. Isolation of individual compounds was carried out by preparative high-performance liquid chromatography using a Smartline (Knauer, Germany). The structures of the isolated compounds were elucidated using 1D and 2D NMR experiments (Bruker Avance III 400 MHz) along with HR-ESI-MS (Bruker Micromass Q-TOF).Results and discussion.Using the developed methods, from the aerial part of the field restharrow (O. arvensis) we managed to isolate and characterised three individual compounds (1-3). Compounds 1 and 2 are isloflavonoids – pseudobaptigenin-7-О-ß-D-glucopyranoside and formononetin-7-О-ß-D-glucopyranoside, respectively. Compound (3) is a flavonoid – kaempferol-3-O-ß-D-glucopyranoside (astragalin). All compounds were isolated for O. arvansis for the first time. Along with this, four individual compounds (4-7) were isolated from the aerial part of the canadian goldenrod (S. canadensis), namely, quercetin-3-O-ß-D-6''-acetylglucopyranoside, isoramnetin-3-О-ß-D-rutinoside (narcissin), quercetin-3-О-rutinoside (rutin) and quercetin, respectively.Conclusion.As a result of the research, methods have been developed for the isolation of 7 individual compounds, using modern physicochemical methods of analysis, from the aerial parts of Ononis arvensis and Solidago canadensis, the structures of all the isolated compounds were elucidated. Future assessment of the isolated compounds biological activity is presumed.

The antibacterial and antihemolytic activities assessment of zinc oxide nanoparticles synthesized using plant extracts and gamma irradiation against the uro-pathogenic multidrug resistant Proteus vulgaris.

In the case of Proteus vulgaris infection, the increased occurrence of multidrug-resistance strains has become a critical challenge in the treatment of urinary tract diseases. Therefore, using plant extracts as eco-friendly antibacterial provides an attractive solution to battle bacterial infection. The current study investigates the antibacterial and antihemolytic activity of nine medicinal plant extracts against P. vulgaris. Citrus limon extract at 150µg/ml exhibited the highest antimicrobial action against P. vulgaris (the inhibition zone diameter; 22.7mm). Zinc oxide nanoparticles (ZnO NPs) are synthesized using the plant extracts of C. limon, Allium sativum, Sonchus bulbosus, Allium cepa, and Asparagus racemosus. The antibacterial activity of ZnO NPs synthesized using C. limon extract at 150µg/ml is significantly increased (33.8mm). ZnO NPs synthesized using A. cepa, A. racemosus, and C. limon plant extracts are effectively protective for human red blood cells. The ZnO NPs synthesized using C. limon extract are characterized using UV-Visible spectroscopy, FTIR, XRD, and TEM. FTIR revealed that the plant extracts may serve as reducing and capping agents of ZnO NPs. XRD spectra confirmed the crystallinity of ZnO NPs. TEM image demonstrated the formation of spherical shapes of ZnO NPs with an average size of 37.05nm. SEM of P. vulgaris cells treated with ZnO NPs showed cellular morphological damage compared to the untreated cells. ZnO NPs are synthesized by gamma irradiation as a clean and novel method. This study recommended the promising uses of the biosynthesized ZnO NPs using plant extracts as a natural, unique approach, to control the pathogenicity of P. vulgaris.

Viburnum opulus L.-A Review of Phytochemistry and Biological Effects.

Viburnum opulus (VO) is a valuable decorative, medicinal, and food plant. This deciduous shrub is found in natural habitats in Europe, Russia, and some regions in North Africa and North Asia. The VO is traditionally used to treat aliments such as cough, colds, tuberculosis, rheumatic aches, ulcers, stomach, and kidney problems, among others. Many of the health-promoting properties of VO are associated with antioxidant activity, which has been demonstrated in both in vitro and in vivo studies. The results of in vitro studies show the antimicrobial potential of VO, especially against Gram-positive bacteria. In cell-based studies, VO demonstrated anti-inflammatory, anti-obesity, anti-diabetic, osteogenic, cardio-protective, and cytoprotective properties. The applicability of VO in the treatment of urinary tract diseases, endometriosis, and some cancers has been confirmed in in vivo studies. The health benefits of VO result from the presence of bioactive components such as phenolic compounds, vitamin C, carotenoids, iridoids, and essential oils. The aim of this review is to present an overview of the botanical characteristics, chemical compositions, including bioactive compounds, and pro-health properties of VO different morphological parts.

第16回 Clean, Intermittent Self-catheterization in the Treatment of Urinary Tract Diseases

第16回 Clean, Intermittent Self-catheterization in the Treatment of Urinary Tract Diseases

International Society for Companion Animal Infectious Diseases (ISCAID) guidelines for the diagnosis and management of bacterial urinary tract infections in dogs and cats

Urinary tract disease is a common clinical presentation in dogs and cats, and a common reason for antimicrobial prescription. This document is a revision and expansion on the 2011 Antimicrobial Use Guidelines for Treatment of Urinary Tract Disease in Dogs and Cats, providing recommendations for diagnosis and management of sporadic bacterial cystitis, recurrent bacterial cystitis, pyelonephritis, bacterial prostatitis, and subclinical bacteriuria. Issues pertaining to urinary catheters, medical dissolution of uroliths and prophylaxis for urological procedures are also addressed.

Intermittent self-catheterisation: patient perceptions and experience.

British Journal of NursingVol. 27, No. 18 CommentIntermittent self-catheterisation: patient perceptions and experienceHelen LakeHelen LakeSearch for more papers by this authorHelen LakePublished Online:3 Oct 2018https://doi.org/10.12968/bjon.2018.27.18.S4AboutSectionsView articleView Full TextPDF/EPUB ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareShare onFacebookTwitterLinked InEmail View article References Bakke A, Digranes A, Høisœter PÅ. Physical predictors of infection in patients treated with clean intermittent self catheterisation: a prospective 7-year study, Br J Urol. 1997; 79 (1): 85-90. https://doi.org/https://doi.org/10.1046/j.1464-410X.1997.30018.x Crossref, Medline, Google ScholarCorbussen-Boekhorst H, Hermeling E, Heesakkers J, Van Gaal B. Patients' experience with intermittent catheterisation in everyday life. J Clin Nurs. 2016; 25(9-10): 1253-1261. https://doi.org/https://doi.org/10.1111/jocn.13146 Crossref, Medline, Google ScholarFry JP, Neff RA. Periodic prompts and reminders in health promotion and health behavior interventions: systematic review. J Med Internet Res. 2009;11(2):e16. https://doi.org/https://doi.org/10.2196/jmir.1138 Crossref, Medline, Google ScholarIgawa Y, Wyndaele J, Nishizawa O. Catherisation: Possible complications and their prevention and treatment. Int J Urol. 2008; 15(6):481-485. https://doi.org/https://doi.org/10.1111/j.1442-2042.2008.02075.x Crossref, Medline, Google ScholarKessler TM, Ryu G, Burkhard FC. Clean intermittent self-catheterization: a burden for the patient? Neurourol Urodyn. 2008; 28(1):18-21. https://doi.org/https://doi.org/1002/nau.20610 Crossref, Google ScholarLapides J, Diokno AC, Silber SJ, Lowe BS. Clean, intermittent self-catheterization in the treatment of urinary tract disease. J Urol. 1972;107(3):458–461 Crossref, Medline, Google ScholarMcClurg D, Walker K, Pickard R et al.. Participant experiences of clean intermittent self catherisation, urinary tract infections and antibiotic use on the ANTIC trial—a qualitative study. Int J Nurs Stud. 2018; 81:1-7. https://doi.org/https://doi.org/10.1016/j.ijnurstu.2018.01.012 Crossref, Medline, Google ScholarNational Institute for Health and Care Excellence. Healthcare-associated infections: prevention and control in primary and community care. Clinical guideline 139. 2017 (updated version of guideline first published in 2012). https://www.nice.org.uk/guidance/cg139 (accessed 25 September 2018) Google ScholarRamm D, Kane R. A qualitative study exploring the emotional responses of female patients learning to perform clean intermittent self-catheterisation. J Clin Nurs. 2011; 20(21-2): 3152-62. https://doi.org/https://doi.org/10.1111/j.1365-2702.2011.03779.x Crossref, Medline, Google ScholarRew M. The use of intermittent self catheterisation in managing neurogenic bladder problems. British Journal of Neuroscience Nursing. 2007; 3(2): 54-60. https://doi.org/https://doi.org/10.12968/bjnn.2007.3.2.23139 Link, Google ScholarRew M, Lake H. A survey of short-and long-term pre-lubricated intermittent catheters. Br J Nurs. 2013; 22(18 Suppl): S12–S18. https://doi.org/https://doi.org/10.12968/bjon.2013.22.Sup18.S12 Link, Google ScholarShekelle PG, Morton SC, Clark KA, Pathak M, Vickrey BG. Systematic review of risk factors for urinary tract infection in adults with spinal cord dysfunction. J Spinal Cord Med. 1999; 22(4):258-272. https://doi.org/https://doi.org/10.1080/10790268.1999.11719579 Crossref, Medline, Google ScholarWoodward S. Dos and don'ts of intermittent self-catheterisation. Br J Nurs. 2013; 22(18 Suppl):S10. https://doi.org/https://doi.org/10.12968/bjon.2013.22.Sup18.S10 Link, Google ScholarVan Achterberg T, Holleman G, Cobussen-Boekhorst H, Arts R, Heesakkers J. Adherence to clean intermittent self-catheterization procedures: determinants explored. J Clin Nurs. 2008;17(3):394-402. https://doi.org/https://doi.org/10.1111/j.1365-2702.2006.01893.x Medline, Google Scholar FiguresReferencesRelatedDetails 4 October 2018Volume 27Issue 18ISSN (print): 0966-0461ISSN (online): 2052-2819 Metrics History Published online 3 October 2018 Published in print 4 October 2018 Information© MA Healthcare LimitedPDF download

Ethnopharmacological survey of medicinal plants practiced by traditional healers and herbalists for treatment of some urological diseases in the West Bank/Palestine

BackgroundThroughout history, every civilization in the world used plants or their derivatives for treatment or prevention of diseases. In Palestine as in many other countries, herbal medicines are broadly used in the treatment of wide range of diseases including urological diseases. The main objective of this research is to study the use of herbal remedies by herbalists and traditional healers for treatment of various urological diseases in the West Bank regions of Palestine and to assess their efficacy and safety through the literature review of the most cited plants.MethodThe study included a survey part, plant identification and a review study. The first part was a cross-sectional descriptive study. Face to face questionnaires were distributed to 150 traditional healers and herbalist in all regions of the West Bank of Palestine. The literature review part was to assess the most cited plants for their efficacy and toxicity.ResultsOne hundred forty four herbalists and traditional healers accepted to participate in this study which was conducted between March and April, 2016. The results showed that 57 plant species belonging to 30 families were used by herbalists and traditional healers for treatment of various urinary tract diseases in Palestine. Of these, Apiaceae family was the most prevalent. Paronychia argentea, Plantago ovata, Punica granatum, Taraxacum syriacum, Morus alba and Foeniculum vulgare were the most commonly used plant species in the treatment of kidney stones, while Capsella bursa-pastoris, Ammi visnaga and Ammi majus were the most recommended species for treatment of urinary tract infections and Portulaca oleracea used for renal failure. In addition Curcuma longa and Crocus sativus were used for enuresis while Juglans regia, Quercus infectoria, Sambucus ebulus and Zea mays were used for treatment symptoms of benign prostate hyperplasia. Fruits were the most common parts used, and a decoction was the most commonly used method of preparation. Through literature review, it was found that Paronychia argentea has a low hemolytic effect and contains oxalic acid and nitrate. Therefore, it could be harmful to renal failure patients, also Juglans regia, Quercus infectoria and, Sambucus ebulus are harmful plants and cannot be used for treatment of any disease.ConclusionsOur data provided that ethnopharmacological flora in the West Bank regions of Palestine can be quite wealthy and diverse in the treatments of urinary tract diseases. Clinical trials and pharmacological tests are required evaluate safety and efficacy of these herbal remedies.

Clean, Intermittent Self-Catheterization in the Treatment of Urinary Tract Disease.

No AccessJournal of UrologyCatheterization1 Feb 2017Clean, Intermittent Self-Catheterization in the Treatment of Urinary Tract Disease Jack Lapides, Ananias C. Diokno, Sherman J. Silber, and Bette S. Lowe Jack LapidesJack Lapides More articles by this author , Ananias C. DioknoAnanias C. Diokno More articles by this author , Sherman J. SilberSherman J. Silber More articles by this author , and Bette S. LoweBette S. Lowe More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2016.10.097AboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail References 1 Lapides, J.: Role of hydrostatic pressure and distention in urinary tract infection. In: Progress in Pyelonephritis. Edited by E. H. Kass. Philadelphia: F. A. Davis Co., p. 578, 1965. Google Scholar 2 Mehrotra, R. M. L.: An experimental study of the vesical circulation during distension and in cystitis. J Path Bact., 66: 79, 1953. Google Scholar 3 Lapides, J., Costello, R. T., Jr., Zierdt, D. K. and Stone, T. E.: Primary cause and treatment of recurrent urinary infection in women: preliminary report. J Urol., 100: 552, 1968. Google Scholar 4 Lapides, J. and Costello, R. T., Jr.: Uninhibited neurogenic bladder: a common cause for recurrent urinary infection in normal women. J Urol., 101: 539, 1969. Google Scholar 5 Lapides, J. and Diokno, A. C.: Persistence of the infant bladder as a cause for urinary infection in girls. J Urol., 103: 243, 1970. Google Scholar 6 Schwarz, H.: Renal invasion by E. coli via a mucosal lesion of the sigmoid colon: a demonstration utilizing methods of autoradiography and group-specific serologic typing. Invest Urol., 6: 98, 1968. Google Scholar 7 Campbell, M. F.: Urologic complications of anorectal and colon surgery. Amer J Proctol., 12: 43, 1961. Google Scholar 8 Lapides, J.: Urinary diversion. Surgery, 69: 142, 1971. Google Scholar 9 Guttmann, L. and Frankel, H.: The value of intermittent catheterization in the early management of traumatic paraplegic and tetraplegia. Paraplegia, 4: 63, 1966. Google Scholar © 2002 by American Urological Association, Inc.®FiguresReferencesRelatedDetails Volume 197Issue 2SFebruary 2017Page: S122-S124 Advertisement Copyright & Permissions© 2002 by American Urological Association, Inc.®MetricsAuthor Information Jack Lapides More articles by this author Ananias C. Diokno More articles by this author Sherman J. Silber More articles by this author Bette S. Lowe More articles by this author Expand All Advertisement PDF downloadLoading ...

Influence of hyperbaric oxygenation and its use in urinary tract diseases

Abstract In this publication, we adduce examples of the use of hyperbaric oxygen therapy in urinary tract diseases. Hyperbaric oxygen therapy has been proved to have a positive influence on the kidneys of animals with diabetes, sepsis or undergoing chemotherapy. In the literature, we can also find many examples of the use of hyperbaric therapy with good clinical outcomes in human patients with prostatic hypertrophy, pyelonephritis, and hemorrhagic cystitis. The first trials of this kind of treatment of urinary tract diseases were started at the end of the twentieth century. In spite of the promising results, and numerous reports on the effectiveness of this non-invasive method of treatment, it is not currently used on a regular basis. Because many factors such as time, multiple applications, the parameters used in the hyperbaric chamber as well as the medications taken by the patient affect the quality of the result, further studies are needed to make hyperbaric therapy more suitable and safer for each patient.

Phytotherapy as the part of the complex treatment of lower urinary tract diseases

The use of phytotherapy in the treatment of urinary tract diseases has been known for a long time. But at present it has become widely used and got scientific justification for urological pathology, particularly in the treatment of prostatitis.Aim. To investigate the best phytotherapeutic medications for the complex treatment of lower urinary tract diseas.Methods and results. Reasonable combinations of various compatible herbs have been investigated. The best phytotherapeutic medications to reduce inflammation in the prostate have been determined.Conclusion. Phytotherapy should be used only after consulting a phytotherapist in strict compliance with relevant regulations. These regulations provide the duration, the alternation of herbal collections, taking patient age and comorbidities into account, etc.

More aggressive intrarenal endoscopic maneuvers are assuring a stone free outcome and safety.

The papers by Alkan et al. [1] and by Drake et al. [2] represent the novel trend in endourology with the expansive use of flexible scopes. The flexible scopes with recent equipment advances, especially Holmium lasers, lead to great development of the RIRS technique (retrograde intrarenal surgery). RIRS combines the minimally invasive procedures of transurethral endoscopic treatment of urinary tract diseases, e.g. kidney and ureteric stones, tumors of the upper urinary tract, strictures as well as other abnormalities of the upper urinary tract [3]. Moreover, one uses the term RIRS when considering non-standarized techniques applied in patients with urinary diversions or in a post-transplant cohort [4]. Both papers are dealing with advanced endourogical methods, in which flexible ureterorenoscopes are used in the treatment of kidney stones. Authors documented high efficacy of the minimally invasive methods in both, bilateral disease [2], and multifocal uretero-renal stones [1] (92.8% and 88,9% stone free rate, respectively). In both papers, the number of patients treated with the RIRS procedure is limited (42 and 45, respectively), however, the conclusion is clear – both presented that the strategies are feasible, effective and safe. Interestingly, the authors provided different stone free rates (SFR): <4 mm [1] and <2 mm [2], respectively. A simple classification of SFR was provided by Somani et al., as presented in table 1, [5]. However different authors [6] report substantial variations in the described stone-free rates (SFR) following flexible URS. Table 1 SFR according to Somani et al. [5]. The suffix U (USS, ultrasound), C (CT, computed tomography), or X (X-ray) determines the method used for the evaluation of urolithiasis existence The issue of special importance is the configuration of the calico-pelvical systems and grade of dilatation or hydronephrosis in patients qualified for RIRS, which may affect the success of the technique [7], while no comments on this are available in the papers. Furthermore, the concomitant pre-/post-operative infections of the urinary tract were not discussed thoroughly by the authors, which according to the literatures occur relatively uncommonly in <2.2% of cases [8], as for individuals undergoing ureterorenoscopic stone removal. However, the infection may cause serious clinical scenarios even though post-URS symptomatic UTI was 0% in a study by Knopf et al. [9]. In the paper by Drake et al. [2] this aspect was omitted, while Alkan et al. [1] described the frequency of 1/45 UTI cases with fever. As a prophylaxis, in the paper by Drake et al. [2] gentamycin was used, which is not a routine antibiotic (trimethoprim+sul-phamethoxazole, cephalosporine group 2 or 3, aminipenicillin or fluoroquinolones as stated in EAU Guidelines on Urological infections 2015) [11]. The aspect of pre-stenting would also be debatable, since some authors [10] argue about the additional benefit of this technique for intraoperative ureteric injury and distal ureteric stricture prevention. The procedure of ureteral and ipsilateral small simultaneous calyceal stones removal increased the use of ureteral stent [1], while in the paper by Drake et al. the access sheath was used in 2/3 of the cases and a stent was left in all cases [2]. Surprisingly, in the paper by Drake et al. only 14% (3/21) of the patient's had the procedure of pre-stenting introduced [2]. In summary, RIRS is a milestone, when considering the progress in endourology, and its potential is well documented in these two valuable publications.

New techniques on the horizon: interventional radiology and interventional endoscopy of the urinary tract ('endourology').

Interventional radiology and interventional endoscopy (IR/IE) uses contemporary imaging modalities, such as fluoroscopy and endoscopy, to perform diagnostic and therapeutic procedures in various body parts. The majority of IR/IE procedures currently undertaken in veterinary medicine pertain to the urinary tract, and this subspecialty has been termed 'endourology'. This technology treats diseases of the renal pelvis, ureter(s), bladder and urethra. In human medicine, endourology has overtaken traditional open urologic surgery in the past 20-30 years, and in veterinary medicine similar progress is occurring. This article presents a brief overview of some of the more common IR/IE procedures currently being performed for the treatment of urinary tract disease in veterinary patients. These techniques include percutaneous nephrolithotomy for lithotripsy of problematic nephrolithiasis, mesenchymal stem cell therapy for chronic kidney disease, sclerotherapy for the treatment of idiopathic renal hematuria, various diversion techniques for ureteral obstructions, laser lithotripsy for lower urinary tract stone disease, percutaneous cystolithotomy for removal of bladder stones, hydraulic occluder placement for refractory urinary incontinence, percutaneous cystostomy tube placement for bladder diversion, urethral stenting for benign and malignant urethral obstructions, and antegrade urethral catheterization for treatment of urethral tears. The majority of the data presented in this article is solely the experience of the author, and some of this has only been published and/or presented in abstract form or small case series. For information on traditional surgical approaches to these ailments readers are encouraged to evaluate other sources.

UROLITHIASIS Selected examples of complications after minimally invasive treatment for urolithiasis

In recent years urologists have concentrated on the intense introduction of minimally invasive methods for the treatment of urinary tract diseases with major progress noted in the treatment of urolithiasis. Nowadays extracorporeal shockwave lithotripsy (ESWL), percutaneous nephrolithotomy (PCNL), and ureteroscopic lithotripsy (URSL) are widely used in the treatment of urinary tract lithiasis. The aim of this study is to present examples of urinary tract lithiasis as the complication after minimally invasive methods used in the treatment of urolithiasis. One should remember that even minimally invasive medical procedures using the instruments retained in long-term contact with urine may be the cause of incrustation and stone formation.

Long-Term Followup and Time to Event Outcome Analysis of Continent Catheterizable Channels

Creation of a continent catheterizable channel has facilitated the treatment of patients undergoing lower urinary tract reconstruction. We present outcomes and complications of a single center series of continent catheterizable channels followed out to 15 years. We retrospectively reviewed medical records of all children who underwent continent catheterizable channel (Mitrofanoff and Monti) between 1992 and 2007. Collected data included age, underlying diagnosis, associated procedures, stoma site, conduit type (appendix or reconfigured bowel), time to complications and need for subsequent surgical revisions. We identified 71 girls and 98 boys who underwent surgery at a mean age of 7.5 years (range 6 months to 22 years) and were subsequently followed for a mean of 5.8 years (8 months to 15 years). Underlying diagnoses included neurogenic bladder (36% of patients), bladder exstrophy (25%), epispadias (6%) and posterior urethral valves (6%). Concurrent procedures were conducted in 71% of cases, including augmentation (35%) and bladder neck plasty (22%) or closure (8%). Surgical revision was performed in 39% of patients, including stomal revision (18%), redo operation (8%), bulking agent injection (8%) and prolapse correction (4%). Although an initial peak was followed by a relatively stable complication-free period, delayed problems were detected on long-term followup. No statistically significant differences in complication rates were noted when comparing use of appendix and reconfigured bowel or different stoma locations. Despite an initial decrease in complications soon after continent catheterizable channel creation, late problems appeared on long-term evaluation. In our experience no specific factor predicted the likelihood of complications. Nevertheless, despite the need for surgical revision, good functional outcomes were evidenced in this series.

Antimicrobial Use Guidelines for Treatment of Urinary Tract Disease in Dogs and Cats: Antimicrobial Guidelines Working Group of the International Society for Companion Animal Infectious Diseases

Urinary tract disease is a common reason for use (and likely misuse, improper use, and overuse) of antimicrobials in dogs and cats. There is a lack of comprehensive treatment guidelines such as those that are available for human medicine. Accordingly, guidelines for diagnosis and management of urinary tract infections were created by a Working Group of the International Society for Companion Animal Infectious Diseases. While objective data are currently limited, these guidelines provide information to assist in the diagnosis and management of upper and lower urinary tract infections in dogs and cats.

Clinical effects of 2 days of treatment by fosfomycin calcium for acute uncomplicated cystitis in women

Fosfomycin calcium is a fosfomycin antimicrobial agent with a characteristic structure. After oral administration, the drug is absorbed and excreted via the kidneys in the unchanged form, without being metabolized in the body. It is, therefore, indicated for the treatment of urinary tract diseases, including cystitis and pyelonephritis. In the present study, the clinical usefulness of fosfomycin calcium (FOSMICIN® TABLETS 500) administered orally at the dosage of 1 g (two tablets) three times daily for 2 days was examined in female patients, who were at least 20 years of age, with acute uncomplicated cystitis of bacterial origin. Of the 48 patients enrolled between February 2008 and August 2008, 39 were evaluable for efficacy and safety. Overall evaluation of the cure revealed that microbiological eradication rate (microbiological outcome) and clinical efficacy rate (clinical outcome) at 5-9 days after drug administration (visit 2) were 94.9%. Determination of the microbiological and clinical outcomes for the evaluation of recurrence at 4-6 weeks after drug administration (visit 3) were 75.8 and 85.7%, respectively. Of the 48 patients, 40 (83.3%) returned to the clinic at visit 3. The causative bacterial species for cystitis was Escherichia coli in 31 (79.5%) of the 39 patients evaluable for efficacy and safety. Adverse drug reactions observed during the administration and follow-up periods included mild diarrhea and loose stools in 1 patient each, neither requiring any specific treatment. Evaluation of cure at visit 2 in patients in whom the causative bacterial species for the infection was E. coli revealed a microbiological outcome of 93.5%, and clinical outcome was 96.8%. Furthermore, evaluation for recurrence at visit 3 revealed a microbiological outcome of 74.1% and clinical outcome of 82.1%. When the patients were divided by age into an under 60 years of age group and an over 60 years of age group, the microbiological and clinical outcomes determined for evaluation of cure at visit 2 were 96.4 and 92.9%, respectively, and the corresponding rates determined for the evaluation of recurrence at visit 3 were 87.0 and 96.0%, respectively, in the under 60 years of age group. In the over 60 years of age group, the corresponding microbiological outcome and clinical outcome rates evaluated for cure were 90.9 and 100%, respectively, and those evaluated for recurrence were 50.0 and 60.0%, respectively. These results indicate the usefulness of fosfomycin calcium administered at 1 g three times daily for 2 days for acute uncomplicated cystitis.

Clinical Effect of Laparoscopic in the Urological Surgery

目的 分析腹腔镜手术在治疗肾脏、输尿管、肾上腺疾病中的临床效果.方法 对86例采用腹腔镜技术治疗的泌尿外科疾病患者的临床资料进行回顾性分析.结果 86例中手术成功80例,占93.02%,平均住院时间为5.5d,术中均未输血,术中术后未出现严重并发症.结论 腹腔镜手术治疗泌尿系疾病,具有损伤小,痛苦轻,术后恢复快和住院时间短等优点,有较好的临床应用前景。