scholarly journals Anti-inflammatory therapy of lower urinary tract infection in patients with distal urethral diseases

2021 ◽  
Vol 14 (2) ◽  
pp. 100-104
Author(s):  
T.I. Derevyanko ◽  
◽  
S.V. Pridchin ◽  
E.V Ryzhkova ◽  
◽  
...  
Keyword(s):  
Urinary Tract ◽  
Surgical Treatment ◽  
Lower Urinary Tract ◽  
Hydrolytic Enzymes ◽  
Recurrent Infection ◽  
Enzyme Therapy ◽  
Lower Urinary Tract Infection ◽  
Anti Inflammatory ◽  
Real Chance ◽  
Lower Urinary

Introduction. Recurrent infection of the lower urinary tract (UTI) is a very common pathology in women of different age groups. This category of urological patients is most often found in the practice of an outpatient urologist. Aim. To study the possibilities of the effect of hydrolytic enzymes on the effectiveness of complex antiinflammatory therapy of chronic infectious and inflammatory diseases of the lower urinary tract in women with pathology of the distal urethra, paraurethral region and on the results of surgical treatment of patients with female hypospadias, paraurethral cysts. Materials and methods. 96 patients with various forms of chronic lower UTI and its complications as a result of diseases of the urethra and paraurethral zone (female hypospadias, hypermobility of the urethra, paraurethral cyst) we was observed. In the course of our study, all the observed patients, were divided into 2 groups. Group I – 40 people (control) patients who received only anti-inflammatory and antibacterial therapy according to the spectrum of the detected pathogen of UTI in combination with surgical treatment, and the group II – 56 patients who received anti-inflammatory and antibacterial therapy according to the spectrum of the detected pathogen of UTI and surgical treatment in combination with enzyme therapy for a course of 14 days. Results. In the II group all patients after discharge from the hospital were monitored for 6 months. Only 1 patient had a relapse of exacerbation of chronic lower urinary tract infection. Enzyme therapy as a component that optimizes anti-inflammatory therapy provides a real chance for earlier relief of the infectious process in these patients and improvement of the results of surgical treatment of paraurethral pathology. Discussion. Chronic recurrent infection of the lower urinary tract in women is often associated with the presence of pathological conditions of the distal urethra in the form of female hypospadias and hypermobility of the urethra, as well as paraurethral pathology in the form of paraurethral cysts. Patients with this pathology need surgical treatment and mandatory complex anti-inflammatory therapy. Enzyme therapy as a component that optimizes anti-inflammatory therapy provides a real chance for earlier relief of the infectious process in these patients and improvement of the results of surgical treatment of paraurethral pathology. Conclusion. The inclusion of hydrolytic enzymes in patients with UTI and with diseases of the distal urethra and paraurethral region in the anti-inflammatory therapy regimen increases the effectiveness of etiotropic therapy and improves the results of surgical treatment of diseases of the distal urethra and paraurethral region.

scholarly journals Symptomatic treatment (using NSAIDS) versus antibiotics in uncomplicated lower urinary tract infection: a meta-analysis and systematic review of randomized controlled trials

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Albert Macaire C. Ong Lopez ◽  
Charles Jeffrey L. Tan ◽  
Antonio S. Yabon ◽  
Armin N. Masbang
Keyword(s):  
Urinary Tract Infection ◽  
Urinary Tract ◽  
Tract Infection ◽  
Lower Urinary Tract ◽  
Meta Analysis ◽  
Lower Urinary Tract Infection ◽  
Randomized Controlled ◽  
Inflammatory Drugs ◽  
Anti Inflammatory ◽  
Lower Urinary

Abstract Background Current guidelines recommend empiric antibiotics as first-line treatment for uncomplicated UTI. Despite proven benefits in treatment, antibiotic resistance rates remain on the rise. This meta-analysis aims to determine whether non-steroidal anti-inflammatory drugs can serve as an effective and safe option in the treatment of uncomplicated lower UTI among non-pregnant women compared to antibiotics. Methods A systematic literature search in PUBMED, CENTRAL, and ACP databases from inception to April 2021 was conducted to identify randomized controlled trials that compare the use of non-steroidal anti-inflammatory drugs versus antibiotics in non-pregnant women ≥18 years old with uncomplicated lower urinary tract infection. Primary outcomes were symptom resolution of UTI by Day 3 or 4 of intervention, and upper UTI complications. Secondary outcomes include persistence of positive urine culture despite treatment and need for another rescue antibiotic. Random and fixed-effects model for dichotomous data using Mantel-Haenszel and Peto odds method were reported at 95% CI followed by sensitivity analysis for substantial heterogeneity. Results Four RCTs involving 1165 patients were analyzed. The probability of having a symptom resolution by Day 3 or 4 with NSAID use is only less than three-fourths of that with antibiotic treatment (RR: 0.69, 95% CIs [0.55, 0.86], p = 0.0008, I2 = 73%, moderate certainty of evidence). The odds of developing upper UTI complications with use of NSAIDs are 6.49 to 1 for antibiotics (Peto OR: 6.49, 95% CIs [3.02, 13.92], p < 0.00001, I2 = 0%, moderate certainty of evidence). Secondary analysis showed that the NSAID group is 2.77x more likely to have persistence of a positive microbiologic urine culture than the antibiotic group (RR: 2.77, 95% CIs [1.95, 3.94], p < 0.00001, I2 = 36%, moderate certainty of evidence). Treatment with NSAIDs are three times more likely to use a secondary or rescue antibiotic due to persistent or worsening symptoms as compared to antibiotics (RR: 3.16, 95% CIs [2.24, 4.44], p < 0.00001, I2 = 47%, low certainty of evidence). Conclusion Antibiotic treatment was more effective than use of non-steroidal anti-inflammatory drugs for acute uncomplicated lower urinary tract infection with an overall moderate certainty of evidence.

scholarly journals Emphysematous Cystitis Responsible for a Bladder Perforation

2020 ◽  
Vol 2 (1) ◽  
Author(s):  
Moussaab Rachid ◽  
El Mahdi Graiouid ◽  
Mohammed Dakir ◽  
Adil Debbagh ◽  
Rachid Aboutaieb
Keyword(s):  
Urinary Tract Infection ◽  
Urinary Tract ◽  
Surgical Treatment ◽  
Lower Urinary Tract ◽  
Bladder Wall ◽  
Bladder Perforation ◽  
Rare Form ◽  
Lower Urinary Tract Infection ◽  
Emphysematous Cystitis ◽  
Lower Urinary

Emphysematous cystitis is a rare form of lower urinary tract infection characterized by the presence of gas in the lumen and / or bladder wall. We report a case of a 64 year old patient hospitalized for an acute abdominal table. The diagnosis of emphysematous cystitis complicated by bladder perforation was made after performing an abdominal scan. Medico-surgical treatment has been initiated.

scholarly journals Risk of Cancer after Lower Urinary Tract Infection: A Population-Based Cohort Study

2019 ◽  
Vol 16 (3) ◽  
pp. 390 ◽  
Author(s):  
Chia-Hung Huang ◽  
Ying-Hsiang Chou ◽  
Han-Wei Yeh ◽  
Jing-Yang Huang ◽  
Shun-Fa Yang ◽  
...  
Keyword(s):  
Urinary Tract Infection ◽  
Cohort Study ◽  
Urinary Tract ◽  
Urinary Bladder ◽  
Tract Infection ◽  
Lower Urinary Tract ◽  
Population Based ◽  
Control Group ◽  
Lower Urinary Tract Infection ◽  
Lower Urinary

To investigate the association among lower urinary tract infection (UTI), the type and timing of antibiotic usage, and the subsequent risk of developing cancers, especially genitourinary cancers (GUC), in Taiwan. This retrospective population-based cohort study was conducted using 2009–2013 data from the Longitudinal Health Insurance Database. This study enrolled patients who were diagnosed with a UTI between 2010 and 2012. A 1:2 propensity score-matched control population without UTI served as the control group. Multivariate analysis with a multiple Cox regression model was applied to analyze the data. A total of 38,084 patients with UTI were included in the study group, and 76,168 participants without UTI were included in the control group. The result showed a higher hazard ratio of any cancer in both sexes with UTI (for males, adjusted hazard ratio (aHR) = 1.32; 95% confidence interval (CI) = 1.12–1.54; for females, aHR = 1.21; 95% CI = 1.08–1.35). Patients with UTI had a higher probability of developing new GUC than those without UTI. Moreover, the genital organs, kidney, and urinary bladder of men were significantly more affected than those of women with prior UTI. Furthermore, antibiotic treatment for more than 7 days associated the incidence of bladder cancer in men (7–13 days, aHR = 1.23, 95% CI = 0.50–3.02; >14 days, aHR = 2.73, CI = 1.32–5.64). In conclusion, UTI is significantly related to GUC and may serve as an early sign of GUC, especially in the male genital organs, prostate, kidney, and urinary bladder. During UTI treatment, physicians should cautiously prescribe antibiotics to patients.

scholarly journals Bacterial-viral Urine Microbiota in Uncomplicated Recurrent Infection of the Lower Urinary Tract: Results of Pilot Study

2020 ◽  
Vol 7 (4) ◽  
pp. 13-19
Author(s):  
Ju. L. Naboka ◽  
M. I. Kogan ◽  
S. V. Mordanov ◽  
Kh. S. Ibishev ◽  
A. V. Ilyash ◽  
...  
Keyword(s):  
Urinary Tract ◽  
Lower Urinary Tract ◽  
Urine Analysis ◽  
Taxonomic Structure ◽  
Recurrent Infections ◽  
Gram Positive ◽  
Lower Urinary Tract Infection ◽  
E Coli ◽  
Klebsiella Spp ◽  
Lower Urinary

Introduction. Difficulties in the management and treatment of patients with uncomplicated recurrent lower urinary tract infection (LUTI) are largely because bacterial, viral and other components remain unexplored in the etiological structure of the disease.Purpose of the study. To study the urine bacterial-viral associations in uncomplicated recurrent infections of the lower urinary tract (LUT).Materials and methods. The study included 14 patients with uncomplicated recurrent infections of the LUT, the average age was 33.0 ± 4.7 years. The object of the study was the average portion of morning urine collected prior to the appointment of empirical antibiotic therapy. Urine was divided into 3 aliquots: 1 for general urine analysis, 2 for bacteriological examination, 3 for polymerase chain reaction (PCR).Results. Aerobic-anaerobic associations were found in urine in all cases. Enterobacteriaceae family representatives were discovered in 92.8% of cases; they were represented by E. coli (78.6%), Klebsiella spp. (14.2%), Proteus spp. (7.1%). Moreover, in one patient at the same time (7.1%) E. coli + Klebsiella spp was isolated from urine.The gram-positive microflora pattern consisted of 7 genera and / or species and in various combinations was found in all patients. The taxonomic structure of the gram-positive flora was represented by E. faecalis (64.3%), S. lentus (21.4%), Corynebacterium spp., S. warneri, E. faecium (14.3% each), S. epidermidis + E. coli was recorded in 4 (28.6%) women, E. faecalis + E. faecium + E. coli + Klebsiella spp. - in 1 (7.1%), E. faecalis + E. faecium + E. coli also in 1 (7.1%) patients.Non-clostridial anaerobic bacteria (NAB) were isolated from urine in all cases with Eubacterium spp dominating. (57.1%). The taxonomic structure of NAB was represented by 5 genera: Eubacterium spp., Peptostreptococcus spp., Peptococcus spp., Bifidobacterium spp., Propionibacterium spp.Viruses were detected in urine in 6 (42.9%) patients. Epstein-Barr virus (EBV) was detected in 4 (28.6%) of them, moreover, in 1 case, in association with human papillomavirus (HPV53), in two other cases (7.1% each), cytomegalovirus (CMV) was verified and human herpes simplex virus type 6 (HHV6), respectively.Conclusions. In patients with uncomplicated recurrent LUTI, viruses with a prevalence of EBV were verified in urine in 42.9% of cases (28.6%). Apparently, the treatment of this patients` cohort should be directed not only to the bacterial, but also the viral components of the urinary microbiota.

scholarly journals Post colonoscopic acute bacterial prostatitis: a case report

2021 ◽  
Vol 9 (5) ◽  
pp. 1482
Author(s):  
Rahim A. Rashid ◽  
Ramalakshmi Karthikeyan
Keyword(s):  
Urinary Tract ◽  
Lower Urinary Tract ◽  
Bacterial Infections ◽  
Common Procedure ◽  
Lower Urinary Tract Infection ◽  
Delayed Treatment ◽  
Bacterial Prostatitis ◽  
Wide Range ◽  
Acute Bacterial Prostatitis ◽  
Lower Urinary

Colonoscopy is a common procedure for diagnosing a wide range of conditions and symptoms affecting the large bowel. Research has shown that the examination itself may induce transient bacterial infections. Specifically acute bacterial prostatitis (ABP) has little mention in medical literature as a recognized complication of this procedure. Here we discuss a 37 year old male presenting with symptoms suggesting lower urinary tract infection after having undergone colonoscopy followed by recurrent episodic haematuria and lower urinary tract symptoms (LUTS). Physicians and endoscopists should be aware of the risk of acute bacterial prostatitis as a potential complication of colonoscopy in order to minimize misdiagnosis as well as the complications associated with the delayed treatment of it. In addition male patients and the immunocompromised should be fully counselled regarding this risk prior to undertaking this procedure.

scholarly journals Impact of surgical treatment of benign prostate hyperplasia on lower urinary tract symptoms and quality of life

2019 ◽  
Vol 76 (1) ◽  
pp. 30-35
Author(s):  
Uros Babic ◽  
Ivan Soldatovic ◽  
Ivan Vukovic ◽  
Svetomir Dragicevic ◽  
Dejan Djordjevic ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Urinary Tract ◽  
Surgical Treatment ◽  
Operative Treatment ◽  
Lower Urinary Tract Symptoms ◽  
Lower Urinary Tract ◽  
Prostate Hyperplasia ◽  
Urinary Tract Symptoms ◽  
Lower Urinary

Background/Aim. Benign prostatic hyperplasia (BPH) is a pathological process, which is one of the most common causes of so-called lower urinary tract symptoms (LUTS). LUTS affect many aspects of daily activities and almost all domains of health-related quality of life (HRQoL). The objective of this study was to evaluate the effects of operative treatment of BPH using standard clinical diagnostic procedures and effects on LUTS using the symptom-score validated to Serbian language as well as implications on HRQoL. Methods. Seventy-four patients underwent surgical treatment for BPH. The study protocol included objective and subjective parameters of the following sets of variables measured before and after the surgery: voiding and incontinence symptoms were measured using the International Continence Society male Short Form (ICS male SF) questionnaire, HRQoL was measured using the SF-36 questionnaire along with standard clinical measurement of residual urine and urine flow. Results. After the surgery, all patients had decrease of voiding scores (13.5 ? 3.3 before and 1.5 ? 1.4 after surgery) and incontinence symptoms (5.7 ? 3.9 before and 0.6 ? 0.8 after surgery) in comparison to period before operative treatment. Significant improvements in all dimensions of HRQoL were noticed, particularly in emotional health. Although mental and physical total scores were significantly better than prior to the surgery, the level of improvement of voiding and incontinence scores were significantly correlated only with the level of improvement of mental score. Conclusion. After BPH surgery, patients are likely to have normal voiding symptoms, barely some involuntary control over urination and overll better HRQoL, particularly in emotional domain.

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