scholarly journals Chronic Urinary Retention due to Fowler's Syndrome

2018 ◽  
Vol 06 (01) ◽  
pp. e77-e80
Author(s):  
Jan Trachta ◽  
Johann Wachter ◽  
Jan Kriz
Keyword(s):  
Urinary Retention ◽  
Clinical Symptoms ◽  
Clean Intermittent Catheterization ◽  
Urethral Pressure ◽  
Polycystic Ovaries ◽  
Acute Cystitis ◽  
Teenage Girls ◽  
Chronic Urinary Retention ◽  
Tract Infections ◽  
Fowler’S Syndrome

AbstractFowler's syndrome (FS) is a rare cause of chronic urinary retention in teenage girls and young women. We present a case of a 14-year-old girl who presented at our hospital 2 weeks after uncomplicated laparoscopic appendectomy. The girl complained of reduced urinary frequency and prolonged micturition time. Following an acute cystitis 2 months later, she completely lost her ability to void. A comprehensive set of investigations to assess the cause of her urinary retention including a cerebral and spinal magnetic resonance imaging (MRI), and videourodynamics were performed. The diagnostic workup revealed polycystic ovaries and an asensitive and hypotonic bladder with capacity up to 1200 mL and high maximum urethral pressure of 120 cm of water. She did not tolerate clean intermittent catheterization; therefore, a suprapubic catheter was placed. Under this treatment, she suffered recurrent urinary tract infections. Two years later, she was diagnosed with FS on the basis of the medical history, clinical symptoms, and urodynamic findings. Finally, the implantation of a S3 neurostimulator restored her ability to void.

scholarly journals An Unusual Case of Syringohydromyelia Presenting with Neurogenic Bladder

2019 ◽  
Vol 07 (01) ◽  
pp. e79-e82
Author(s):  
Antonella Geljic ◽  
Slaven Abdovic ◽  
Fran Stampalija ◽  
Lana Loncar ◽  
Batos A. Tripalo ◽  
...  
Keyword(s):  
Urinary Retention ◽  
Urinary Catheter ◽  
Outlet Obstruction ◽  
Conus Medullaris ◽  
Sensory Loss ◽  
Clean Intermittent Catheterization ◽  
Neurological Sequelae ◽  
Hinman Syndrome ◽  
Tract Infections

AbstractWe report the case of a 4-year-old boy who first presented with acute pyelonephritis at the age of 6 months. Diagnostic workup revealed high-grade bilateral vesicourethral reflux (VUR). At the age of 18 months, a bulking agent was used to treat bilateral VUR. Since the VUR persisted, an open bilateral Lich-Gregoir procedure was done at the age of 3 years. Immediately after surgery, he developed acute urinary retention with hydronephrosis that resolved with the placement of dwelling urinary catheter. After removal of the catheter urinary retention relapsed so placement of suprapubic urinary catheter was indicated since he did not have sensory loss. He was started with tamsulosin (α − 1-blocker) and prophylactic antibiotics. Urodynamics were performed and suggested bladder outlet obstruction. On the basis of previous urethroscopy and the absence of neurological sequelae, the differential diagnosis of Hinman syndrome was made. After removal of the suprapubic catheter, clean intermittent catheterization was started and α-blocker continued. However, magnetic resonance imaging of the brain and the spinal cord revealed syringohydromyelia extending from thoracic spine (Th5) to conus medullaris with 6 to 7 mm in diameter. Electromyoneurogram was normal. After a follow-up of 3 years, the hydronephrosis has resolved. The patient is on clean intermittent catherization and has no urinary tract infections.

scholarly journals 1479. Clinical Efficacy and Safety Analysis Evaluating Oral Gepotidacin (GSK2140944) from a Phase IIa Study in the Treatment of Uncomplicated Urinary Tract Infections

2019 ◽  
Vol 6 (Supplement_2) ◽  
pp. S539-S539
Author(s):  
J Scott Overcash ◽  
Etienne Dumont ◽  
Caroline R Perry ◽  
Courtney Tiffany ◽  
Nicole Scangarella-Oman ◽  
...  
Keyword(s):  
Urinary Tract ◽  
Urinary Tract Infections ◽  
Clinical Efficacy ◽  
Clinical Symptoms ◽  
Oral Treatment ◽  
Safety Data ◽  
Lower Abdominal Pain ◽  
Efficacy And Safety ◽  
Acute Cystitis ◽  
Tract Infections

Abstract Background Urinary tract infections (UTIs) are very common, with approximately 11% of women >18 years of age experiencing at least 1 episode of acute cystitis per year. Multidrug resistance, typically associated with nosocomial infections, has now emerged at the community level making treatment options for UTIs more difficult. Gepotidacin (GEP), a first-in-class, novel triazaacenaphthylene antibacterial has demonstrated in vitro activity against uropathogens including E. coli and provides high and sustained urine concentrations. It selectively inhibits bacterial DNA replication through a unique mechanism not utilized by any currently approved antibacterial. GEP presents an opportunity to address an unmet medical need and warrants study as a potential new and effective oral treatment for acute cystitis. Methods This Phase IIa single-center study was designed primarily to evaluate plasma and urine pharmacokinetics (PK) of gepotidacin in female participants with acute cystitis. Safety data and clinical and microbiological efficacy of gepotidacin were also assessed as secondary and exploratory endpoints. All participants received oral gepotidacin 1,500 mg BID for 5 days (total of 10 doses) during clinic confinement. Pretreatment and posttreatment PK collections were performed together with safety, efficacy, microbiological, and exploratory assessments throughout the study. Results Summary of Exploratory Endpoints (ITT Population). Clinical Efficacy: All subjects had significant improvement of clinical symptoms (dysuria, frequency, urgency, lower abdominal pain) within 24 to 48 hours of treatment. Most subjects, (20/22; 90.9%) achieved symptom resolution at test of cure (ToC) and follow-up (F/U). Microbiological eradication was achieved independent of baseline CFU’s (see microbiology abstract). Safety Endpoint: Most common AEs involved the GI tract (diarrhea (18/22 [82%] and nausea 17/22 [77%]). Per investigator observation, tolerance to nausea was observed with repeat dosing. No withdrawal due to AE. There were no clinically relevant trends in safety laboratories, ECG, or vital signs. Conclusion This first report of efficacy and safety in the treatment of acute cystitis supports further study of the clinical use of GEP in this indication. Disclosures All authors: No reported disclosures.

scholarly journals General principles of uncomplicated cystitis therapy during pregnancy

2021 ◽  
pp. 121-126
Author(s):  
V. L. Tyutyunnik ◽  
N. E. Kan ◽  
L. V. Khachatryan
Keyword(s):  
Pregnant Women ◽  
Clinical Symptoms ◽  
Acute Cystitis ◽  
Microbiological Test ◽  
Fosfomycin Trometamol ◽  
Acute Uncomplicated Cystitis ◽  
Tract Infections ◽  
Uncomplicated Cystitis ◽  
Total Elimination

Urinary tract infections during pregnancy are associated with severe complications. Earlier initiation of antibiotic treatment for acute uncomplicated cystitis, reduces the various complications.Objective. To assess the effectiveness of fosfomycin in the treatment of acute uncomplicated cystitis during II and III trimester of pregnancy.Material and methods. The study included 74 pregnant women who had acute uncomplicated cystitis in II or III trimesters. All patients received fosfomycin trometamol 3.754 g (equivalent to 3 g fosfomycin) as antimicrobial therapy for acute uncomplicated cystitis. The drug was prescribed to 24 pregnant women in the II, and 50 in the III trimester of pregnancy.Results. After treatment with fosfomycin signs of acute cystitis gone in all patients. At the same time, regression of clinical symptoms was noted during the next days after therapy in 95.9% (n = 71) of cases. Repeated microbiological test of the middle portion of urine was performed 7 days after the end of antibiotic therapy. In 94.6% (n = 70) cases, total elimination of the pathogen was achieved. In 5.4% (n = 4) cases, there was a significant decrease of colonization Follow-up for three months showed the absence of recurrence of acute cystitis in all pregnant women who were included in the study.Conclusion. Fosfomycin is a highly effective drug in the treatment of uncomplicated cystitis during pregnancy.

Urinary retention in women

2017 ◽  
Author(s):  
Clare J. Fowler ◽  
Jalesh N. Panicker
Keyword(s):  
Urinary Retention ◽  
Young Woman ◽  
Young Women ◽  
Emg Activity ◽  
Urethral Sphincter ◽  
Polycystic Ovaries ◽  
Medical Opinion ◽  
Positive Identification ◽  
Striated Urethral Sphincter ◽  
Fowler’S Syndrome

If a young woman in complete urinary retention is investigated and all urological and neurological investigations are found to be normal, the commonest diagnosis then made is Fowler’s syndrome (FS). Described by Fowler et al. in 1987, the original syndrome comprised of complete urinary retention with the finding of a particular pattern of electromyographic (EMG) activity recorded with a concentric needle electrode from the striated urethral sphincter, in a young woman with clinical features of polycystic ovaries. Prior to that, description medical opinion was that urinary retention in young women was due to ‘hysteria’; more had been written about ‘psychogenic urinary retention in women’ than any other possible causes. Twenty-five years on, the situation now seems to be that if neither the urologist or urologist can discover an underlying abnormality, the woman may be told she has FS without any positive identification of that condition.

Etiology and clinical features of epididymo-orchitis: A single-center study in Tehran, Iran

2020 ◽  
Vol 20 ◽  
Author(s):  
Sara Abolghasemi ◽  
Mohammad Alizadeh ◽  
Ali Hashemi ◽  
Shabnam Tehrani
Keyword(s):  
Chlamydia Trachomatis ◽  
Clinical Symptoms ◽  
Urine Culture ◽  
Clinical Manifestations ◽  
Urinary Frequency ◽  
Serological Tests ◽  
Duration Of Symptoms ◽  
Two Samples ◽  
History Of ◽  
Tract Infections

Introduction: Epididymo-orchitis is a common urological disease among men. Little is known about the clinical and epidemiological aspects of the disease in Iran. Thus, the present study was aimed to investigate the etiology, clinical sequelae and risk factors of patients with epididymo-orchitis in Tehran, Iran. Materials and Methods: Patients presenting with epididymo-orchitis were prospectively analyzed in order to study the etiology and pattern of the disease. Bacteriological, molecular and serological tests were undertaken to look for Chlamydia trachomatis, Neisseria gonorrhoeae, Brucella spp., Mycoplasma spp, and other bacteria. Results: Fifty patients with epididymo-orchitis were evaluated according to their clinical symptoms, duration of symptoms, physical examination, and laboratory studies. The mean age of the patients was 53 years. Fever, dysuria, pain in the flanks, urinary frequency and discharges occurred in 58.0%, 50.0%, 50.0%, 28.0% and 6.0%, respectively. Bacterial pathogen was identified in 26% (13/50) of patients by urine culture. Escherichia coli was the etiological agent in 11/13 patients (84.6%). Two out of 50 patients (4.0%) were also positive for Chlamydia trachomatis. Two samples were serologically positive for Brucella spp. High Mean age, fever, urinary frequency, history of the underlying disease and history of urinary tract infections were found to have a significant association with the positive bacteriologic urine culture (P<0.05). Conclusions: The most common clinical manifestations were fever, dysuria, and abdominal pain. E. coli and C. trachomatis were the major causative agents. Use of a set of diagnostic approaches including clinical symptoms, urine culture and more precise techniques such as PCR should be taken into consideration for the definitive diagnosis.

scholarly journals Respiratory tract infections in children with allergic asthma on allergen immunotherapy during influenza season

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Yuyun Li ◽  
Dongming Wang ◽  
Lili Zhi ◽  
Yunmei Zhu ◽  
Lan Qiao ◽  
...  
Keyword(s):  
Respiratory Tract ◽  
Allergic Asthma ◽  
Respiratory Tract Infections ◽  
Allergen Immunotherapy ◽  
Clinical Symptoms ◽  
Influenza Season ◽  
The Body ◽  
History Of ◽  
Tract Infections ◽  
Stage 1

AbstractTo describle how respiratory tract infections (RTIs) that occurred in children with allergic asthma (AA) on allergen immunotherapy (AIT) during an influenza season. Data including clinical symptoms and treatment history of children (those with AA on AIT and their siblings under 14 years old), who suffered from RTIs during an influenza season (Dec 1st, 2019–Dec 31st, 2019), were collected (by face to face interview and medical records) and analyzed. Children on AIT were divided into 2 groups: stage 1 (dose increasing stage) and stage 2 (dose maintenance stage). Their siblings were enrolled as control. During the study period, 49 children with AA on AIT (33 patients in stage 1 and 16 patients in stage 2) as well as 49 children without AA ( their siblings ) were included. There were no significant differences in occurrences of RTIs among the three groups (p > 0.05). Compared with children in the other two groups, patients with RTIs in stage 2 had less duration of coughing and needed less medicine. Children on AIT with maintenance doses had fewer symptoms and recovered quickly when they were attacked by RTIs, which suggested that AIT with dose maintenance may enhance disease resistance of the body.

scholarly journals Urinary tract infections in children with myelodysplasia in whom clean intermittent catheterization was administered

2017 ◽  
Vol 49 (1) ◽  
pp. 36-41 ◽  
Author(s):  
Zuhal Albayrak Yildiz ◽  
Cengiz Candan ◽  
Mustafa Arga ◽  
Pinar Turhan ◽  
Pinar Isguven ◽  
...  
Keyword(s):  
Urinary Tract ◽  
Urinary Tract Infections ◽  
Intermittent Catheterization ◽  
Clean Intermittent Catheterization ◽  
Tract Infections

scholarly journals The Molecular Epidemiology and Clinical Phylogenetics of Rhinoviruses among Paediatric Cases in Sydney, Australia.

2020 ◽  
Author(s):  
Dillon Adam ◽  
Xin Chen ◽  
Matthew Scotch ◽  
C. Raina MacIntyre ◽  
Dominic Dwyer ◽  
...  
Keyword(s):  
Disease Severity ◽  
Respiratory Tract Infections ◽  
Clinical Symptoms ◽  
Age Groups ◽  
Epidemiological Evidence ◽  
Treatment Practices ◽  
Phylogenetic Methods ◽  
Significant Burden ◽  
Tract Infections ◽  
Sydney Australia

Background Rhinoviruses (RV) represent the most common aetiological agent of all acute respiratory tract infections across all age groups and a significant burden of disease among children. Recent studies have shown that RV-A and RV-C species are associated with varying degrees of disease severity and clinical symptoms. Methods In this study, we uncovered potential associations between RV species and subtypes, and clinical disease severity using a matched dataset of 52 RV isolates sampled from children (<18 years) in Sydney, Australia between 2006 and 2009 using epidemiological and phylogenetic methods. Results We found that RV-C was significantly more likely to be isolated from paediatric cases under two years of age compared to RV-A, although no significant differences in recorded symptoms were observed. Significant phylogenetic-trait associations between age and the VP4/VP2 capsid protein phylogeny suggests age-specific variations in infectivity among subtypes might also be possible. Conclusions This study adds to the growing body of epidemiological evidence concerning RV. Improving surveillance and testing for RV, including routine whole genome sequencing may improve our understanding of the varied diseashe outcomes of RV species and subtypes. Future studies could aim to identify specific genetic markers associated with age-specific infectivity of RV which could inform treatment practices and public health surveillance of RV.

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