Obstructive uropathy from a giant urinary bladder stone: a rare urological emergency

2021 ◽  
Vol 14 (1) ◽  
pp. e234339
Author(s):  
Subhabrata Mukherjee ◽  
Rajan Kumar Sinha ◽  
Mussab Hamdoon ◽  
Jai Abbaraju
Keyword(s):  
Urinary Tract ◽  
Urinary Bladder ◽  
Obstructive Uropathy ◽  
Outlet Obstruction ◽  
Emergency Admission ◽  
Urethral Catheter ◽  
Bladder Stone ◽  
Urinary Flow ◽  
Ultrasound Scan ◽  
Tract Infections

A 53-year-old man presented with lower urinary tract symptoms and recurrent urinary tract infections since last 3 years without being investigated or treated properly. Examination revealed a hard mobile lump in the pelvis, and blood investigations showed raised serum creatinine of 2.9 mg/dL. Subsequent urgent ultrasound scan showed a large urinary bladder stone with bilateral hydroureteronephrosis, and X-ray kidney, ureter and bladder demonstrated a 9 cm×6 cm elliptical radio-opaque shadow in the pelvis. He underwent emergency admission followed by open cystolithotomy on the next day. He was discharged after 48 hours with a urethral catheter. After 2 weeks, his renal function recovered completely; repeat ultrasound scan revealed complete resolution of hydronephrosis. Urethral catheter was removed following a normal cystogram. Uroflowmetry after 6 weeks revealed underlying bladder outlet obstruction, and he was started on alpha blocker which improved his urinary flow.

scholarly journals Urinothorax Caused by Xanthogranulomatous Pyelonephritis

2018 ◽  
Vol 2018 ◽  
pp. 1-3
Author(s):  
Waiel Abusnina ◽  
Hazim Bukamur ◽  
Zeynep Koc ◽  
Fauzi Najar ◽  
Nancy Munn ◽  
...  
Keyword(s):  
Urinary Tract ◽  
Obstructive Uropathy ◽  
Xanthogranulomatous Pyelonephritis ◽  
Robot Assisted ◽  
Rare Form ◽  
X Ray ◽  
History Of ◽  
Chest X Ray ◽  
Tract Infections

Xanthogranulomatous pyelonephritis is a rare form of chronic pyelonephritis that generally afflicts middle-aged women with a history of recurrent urinary tract infections. Its pathogenesis generally involves calculus obstructive uropathy and its histopathology is characterized by replacement of the renal parenchyma with lipid filled macrophages. This often manifests as an enlarged, nonfunctioning kidney that may be complicated by abscess or fistula. This case details the first reported case of xanthogranulomatous pyelonephritis complicated by urinothorax, which resolved on follow-up chest X-ray after robot-assisted nephrectomy.

scholarly journals 1152. Implementation of Enhanced Data Surveillance Methods to Reduce Catheter-Associated Urinary Tract Infections

2019 ◽  
Vol 6 (Supplement_2) ◽  
pp. S411-S411
Author(s):  
Jordan Ehni ◽  
Marie Moss ◽  
Brian Koll ◽  
Dana Mazo ◽  
Waleed Javaid ◽  
...  
Keyword(s):  
Urinary Tract ◽  
Urinary Tract Infections ◽  
Surveillance System ◽  
Urinary Flow ◽  
Flow Sheet ◽  
Care Hospital ◽  
Electronic Surveillance ◽  
Tract Infections ◽  
Healthcare Associated ◽  
E Mail

Abstract Background Urinary tract infections (UTIs) continue to be one of the most common types of healthcare-associated infections (HAIs). Instrumentation of the urinary tract using devices such as indwelling urinary catheters (IUCs) is the leading cause of healthcare-associated UTIs. Every day that a patient has an IUC increases their risk of acquiring a UTI. After an increase in the number of catheter-associated urinary tract infections (CAUTIs), a mid-sized acute care hospital in the Northeast United States used an electronic surveillance system to monitor IUC order compliance and appropriateness in order to reduce IUC utilization and prevent CAUTIs. Methods Using an Infection Prevention (IP) electronic surveillance system, a line list was generated of patients who had an IUC documented in the urinary flow sheet of their electronic medical record. This list contained variables such as: catheter insert date, catheter order status, and catheter indication. IP staff sent this list in a daily e-mail to clinical leadership and front line staff over a 14 month period. The e-mail notified providers when their patients had an IUC without an order. Clinical staff was directed to discontinue the IUC if it was no longer indicated or to place a new IUC order if still indicated. The National Healthcare Safety Network (NHSN) CAUTI definition and data functions were used for the purposes of this study. Results A statistically significant (P = 0.017) reduction in the hospital CAUTI rate was found when a comparison was made between the 14-month pre-intervention baseline period (1.12 CAUTI per 1,000 catheter days) and the 14 month post-intervention period (0.29 CAUTI per 1,000 catheter days). A statistically significant decrease (P = 0.0004) in IUC utilization was also noted for the same time period, decreasing from 8.2 catheters per 100 patient-days to 7.8 catheters per 100 patient-days. Conclusion A significant reduction in CAUTIs and IUC utilization was seen over the 14-month IP-driven e-mail intervention. This study suggests that regular electronic communication of surveillance system information to providers may reduce CAUTIs. Disclosures All authors: No reported disclosures.

scholarly journals Sexual Dysfunction in Patients With Urinary Bladder Stones but no Bladder Outlet Obstruction

2021 ◽  
Vol 8 ◽  
Author(s):  
Zhi-Cheng Gong ◽  
Zhi-Liang Wu ◽  
Yao-An Wen ◽  
Jie-Peng Zou ◽  
Xisheng Wang ◽  
...  
Keyword(s):  
Urinary Tract ◽  
Sexual Dysfunction ◽  
Urinary Bladder ◽  
Sexual Function ◽  
Repeated Measures ◽  
Bladder Stone ◽  
Surgical Removal ◽  
Bladder Stones ◽  
Male Patients ◽  
Primary Bladder

Objective: To explore the correlates of sexual dysfunction and lower urinary tract symptoms (LUTS) in male patients with urinary bladder stones and to determine the effect of stone extraction on recovery of sexual function.Materials and Methods: A total of 87 male patients with primary bladder stones were studied from January 2015 to May 2016. All patients underwent pneumatic lithotripsy for bladder stones. Sexual dysfunction was assessed based on sexual function assessment scales. The relationship of bladder stones with sexual dysfunction or LUTS was assessed using a two-sample t-test. Postoperative improvement of sexual function was assessed by repeated measures Analysis of Variance (ANOVA).Results: Forty-one patients had primary bladder stones and 46 had secondary stones from the kidneys. Eighty-three of 87 patients (95%) had sexual dysfunction; 79 patients (91%) had both sexual dysfunction and LUTS. There was a significant association between bladder stones and sexual dysfunction, between sexual dysfunction and LUTS, and between bladder stone and LUTS (p < 0.05). There was no significant association between the course of illness, size and number of bladder stones, or urinary tract infection with sexual function (p > 0.05). In addition, among 83 patients with both bladder stone and sexual dysfunction, 61 patients (73%) had benign prostatic hyperplasia (BPH) and 22 patients (27%) had no BPH. On postoperative evaluation at 3 months, sexual dysfunction scores were significantly improved in 77 patients (88.5%)Conclusion: Patients with bladder stones have a high incidence of sexual dysfunction, particularly those with co-existing LUTS and BPH. About 1/3 patients without BPH had sexual dysfunction and surgical removal of bladder stones significantly improved sexual function and LUTS.

Rare case of pseudohypoaldosteronism in a neonate secondary to congenital hydrometrocolpos

2020 ◽  
Vol 13 (6) ◽  
pp. e234813
Author(s):  
Shruti Kumar ◽  
Helen McDermott ◽  
Sheilah Kamupira ◽  
Juliana Chizo Agwu
Keyword(s):  
Weight Gain ◽  
Urinary Tract ◽  
Rare Case ◽  
Obstructive Uropathy ◽  
Tubular Dysfunction ◽  
Renal Tubular Dysfunction ◽  
Outflow Obstruction ◽  
Renal Tubular ◽  
Tract Infections ◽  
Poor Weight Gain

Pseudohypoaldosteronism (PHA) due to obstructive uropathy, urinary tract infections and congenital urogenital malformations has been reported in the literature; however, there are no reports of PHA associated with hydrometrocolpos due to a common urogenital tract. Hydrometrocolpos is a condition resulting in distension of the vagina and uterus due to accumulation of secretions (other than blood), caused by increased oestrogenic stimulation and vaginal outflow obstruction. We report on a neonatal case of PHA caused by recurrent hydrometrocolpos presenting with vomiting and poor weight gain. There was significant hyponatraemia, hyperkalaemia, and anaemia requiring medical stabilisation prior to surgery. The mechanism by which PHA occurs in obstruction involves renal tubular dysfunction due to pressure from hydronephrosis and the release of intrarenal cytokines. In addition, there is an immature or resistant renal tubular responsiveness to aldosterone during infancy. Clinicians should be aware of this uncommon but serious presentation.

A CRITICAL EVALUATION OF URETHRAL OBSTRUCTION IN FEMALE CHILDREN

PEDIATRICS ◽  
1973 ◽  
Vol 51 (2) ◽  
pp. 272-277
Author(s):  
Dixon Walker ◽  
George A. Richard
Keyword(s):  
Urinary Tract ◽  
Urinary Tract Infections ◽  
Bladder Neck ◽  
Bladder Outlet Obstruction ◽  
Critical Evaluation ◽  
Outlet Obstruction ◽  
Significant Degree ◽  
Surgical Correction ◽  
Female Children ◽  
Tract Infections

In this article we have attempted to partially review the literature in regard to bladder outlet obstruction in female children. It should be reiterated that, despite the great amount of information available and the number of studies done, when subjected to critical evaluation, there is no distinctive study at this time which clearly indicates that routine surgical correction, either by bladder neck revision, dilation, urethrotomy, or meatotomy, alters the course of recurrent urinary tract infections to any significant degree.

scholarly journals Urinary Tract Infections among Bladder Outlet Obstruction Patients in Accra, Ghana: Aetiology, Antibiotic Resistance, and Risk Factors

Diseases ◽  
2018 ◽  
Vol 6 (3) ◽  
pp. 65
Author(s):  
Karikari Asafo-Adjei ◽  
James Mensah ◽  
Appiah-Korang Labi ◽  
Nicholas Dayie ◽  
Eric Donkor
Keyword(s):  
Risk Factors ◽  
Urinary Tract ◽  
Urinary Tract Infections ◽  
Bladder Outlet Obstruction ◽  
Outlet Obstruction ◽  
Bacterial Isolates ◽  
Microbiological Methods ◽  
Wide Range ◽  
Tract Infections ◽  
Urine Specimens

The aim of this study was to investigate urinary tract infections among patients with Bladder Outlet Obstruction (BOO) at the Korle Bu Teaching Hospital (KBTH) in Accra, Ghana, including the prevalence, risk factors, aetiological agents and their antibiogram. Urine specimens were collected from 188 male patients presenting with BOO and cultured for bacteria. The bacterial isolates were identified using standard microbiological methods and tested against a spectrum of antimicrobial agents using the Kirby Bauer method. Demographic information and the clinical history of study participants were also recorded. The prevalence of urinary tract infection among the BOO patients was 76.6% and the main risk factor identified was catheterization (p < 0.0001). A wide range of bacterial organisms was isolated from urine specimens and they were predominantly, Enterobacteriaceae; Escherichia coli was the most frequent cause of bacteriuria (33.3%), followed by Klebsiella (17.3%). Bacterial isolates were most resistant to Augmentin (97.8%) followed by tetracycline (85.8%), nalidixic acid (82.8%) and ciprofloxacin (75%) while 93.6% were multi-drug resistant. The highest susceptibility was observed with amikacin, which had a resistance prevalence of 4.4% resistance. These findings have important implications in the treatment of urinary tract infections among the BOO patients in Ghana.

scholarly journals Erratum to “Does Urinary Bladder Shape Affect Urinary Flow Rate in Men with Lower Urinary Tract Symptoms?”

2014 ◽  
Vol 2014 ◽  
pp. 1-1
Author(s):  
Yusuf Ziya Ateşçi ◽  
Özgü Aydoğdu ◽  
Ayhan Karaköse ◽  
Mahmut Pekedis ◽  
Ömer Karal ◽  
...  
Keyword(s):  
Urinary Tract ◽  
Urinary Bladder ◽  
Lower Urinary Tract Symptoms ◽  
Flow Rate ◽  
Lower Urinary Tract ◽  
Urinary Flow Rate ◽  
Urinary Flow ◽  
Urinary Tract Symptoms ◽  
Lower Urinary
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