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Urinary diversion

Mahir Maruf, Matthew Kasprenski, John Jayman, Seth D Goldstein, Karl Benz, Timothy Baumgartner, John P Gearhart
INTRODUCTION: Cloacal exstrophy (CE) is a severe midline congenital abnormality that requires numerous surgical corrections to achieve an acceptable quality of life. Candidates for urinary continence undergo multiple procedures, most often continent bladder diversions, to become socially dry. Here, the authors investigate the number of genitourinary interventions that patients with CE undergo to attain urinary continence. MATERIALS AND METHODS: A retrospective review of a prospectively maintained database of 1311 exstrophy epispadias complex patients was performed...
February 24, 2018: Journal of Pediatric Surgery
Marc A Furrer, Marc P Schneider, Fiona C Burkhard, Patrick Y Wuethrich
BACKGROUND: Early postoperative acute kidney injury (AKI) is associated with increased morbidity and mortality following major surgery. Only few reports exist on postoperative AKI and specifically its risk factors after radical cystectomy (RC) and urinary diversion (UD). We aimed to identify risk factors for AKI in patients undergoing RC and UD. METHODS: In an observational single-center cohort study, 912 consecutive bladder cancer patients undergoing RC and UD from 2000 to 2016 were evaluated for risk factors for AKI...
March 14, 2018: Urologic Oncology
Heidi Cecilie Villmones, Erik Skaaheim Haug, Elling Ulvestad, Nils Grude, Tore Stenstad, Adrian Halland, Øyvind Kommedal
The small bowel is responsible for most of the body's nutritional uptake and for the development of intestinal and systemic tolerance towards microbes. Nevertheless, the human small bowel microbiota has remained poorly characterized, mainly owing to sampling difficulties. Sample collection directly from the distal ileum was performed during radical cystectomy with urinary diversion. Material from the ileal mucosa were analysed using massive parallel sequencing of the 16S rRNA gene. Samples from 27 Caucasian patients were included...
March 16, 2018: Scientific Reports
Shawn Dason, Alvin C Goh
PURPOSE OF REVIEW: More than a century of development has led to contemporary urinary diversion. It is paramount that robotic intracorporeal diversions uphold the principles defined by open surgery. RECENT FINDINGS: In this review, we discuss the fundamental open surgical principles that have led to contemporary techniques of urinary diversion. We then outline the technical aspects of several recently described robotic intracorporeal urinary diversions in the context of these surgical principles...
March 15, 2018: Current Urology Reports
Ryan P Donahue, Andrew W Stamm, Robert P Gibbons, Christopher R Porter, Kathleen C Kobashi, John M Corman, Una J Lee
INTRODUCTION: The ureteral stent is engrained in the fabric of urologic practice. Virginia Mason Medical Center had a unique role in its development through the pioneering work of Dr. Robert Gibbons. Here, we review his contribution to the evolution of the modern ureteral stent. METHODS: We reviewed Dr. Gibbons' extensive work through primary sources, including interviews, projector slides, radiology images, stent prototypes, his personal writings and archived documents...
March 12, 2018: Urology
Ahmed Moustafa, Weizhong Li, Harinder Singh, Kelvin J Moncera, Manolito G Torralba, Yanbao Yu, Oriol Manuel, William Biggs, J Craig Venter, Karen E Nelson, Rembert Pieper, Amalio Telenti
Urine culture and microscopy techniques are used to profile the bacterial species present in urinary tract infections. To gain insight into the urinary flora, we analyzed clinical laboratory features and the microbial metagenome of 121 clean-catch urine samples. 16S rDNA gene signatures were successfully obtained for 116 participants, while metagenome sequencing data was successfully generated for samples from 49 participants. Although 16S rDNA sequencing was more sensitive, metagenome sequencing allowed for a more comprehensive and unbiased representation of the microbial flora, including eukarya and viral pathogens, and of bacterial virulence factors...
March 12, 2018: Scientific Reports
Atsushi Aikawa, Masaki Muramatsu, Yusuke Takahashi, Yuko Hamasaki, Junya Hashimoto, Mai Kubota, Youji Hyoudou, Yoshihiro Itabashi, Takeshi Kawamura, Seiichiro Shishido
Lower urinary tract abnormalities are difficult to resolve in pediatric kidney transplant patients. Measure of residual urine, voiding cystourethrography, retrograde urethrography, cystometry, electromyography of urethral external sphincter muscle, urethrometry, and uroflowmetry are the primary methods for evaluation of lower urinary tract abnormalities. Endoscopic resection or ablation of urethral valves is required in children with posterior urethral valve to treat obstruction, but bladder function does not always recover and may deteriorate to end-stage renal failure even after the obstruction is released...
March 2018: Experimental and Clinical Transplantation
Govindan Rajivgandhi, Ramachandran Vijayan, Muthuchamy Maruthupandy, Baskaralingam Vaseeharan, Natesan Manoharan
Urinary tract infections (UTIs) are a diverse public health complication and are caused by range of pathogens, however most often by Gram negative bacteria which cause significant life threatening risks to different populations. The prevalence rate and antimicrobial resistance among the Gram negative uropathogens alarmed to significantly heighten the economic burden of these infections. In this study, we investigated the role of Pyrrolo[1,2-a] pyrazine-1,4-dione,hexahydro-3-(2-methylpropyl) on endophytic actinomycetes Nocardiopsis sp...
March 7, 2018: Microbial Pathogenesis
Roman Mayr, Hans-Martin Fritsche, Florian Zeman, Marieke Reiffen, Leopold Siebertz, Christoph Niessen, Armin Pycha, Bas W G van Rhijn, Maximilian Burger, Michael Gierth
PURPOSE: A single-center study was conducted to investigate the impact of sarcopenia as a predictor for 90-day mortality (90 dM) and complications within 90 days after radical cystectomy for bladder cancer. METHODS: In total, 327 patients with preoperative available digital computed tomography (CT) scans of the abdomen and pelvis were identified. The lumbar skeletal muscle index was measured using preoperative abdominal CT to assess sarcopenia. Complications were recorded and graded according to Clavien-Dindo (CD)...
March 8, 2018: World Journal of Urology
S Parvez, R R Gerona, C Proctor, M Friesen, J L Ashby, J L Reiter, Z Lui, P D Winchester
BACKGROUND: Glyphosate (GLY) is the most heavily used herbicide worldwide but the extent of exposure in human pregnancy remains unknown. Its residues are found in the environment, major crops, and food items that humans, including pregnant women, consume daily. Since GLY exposure in pregnancy may also increase fetal exposure risk, we designed a birth-cohort study to determine exposure frequency, potential exposure pathways, and associations with fetal growth indicators and pregnancy length...
March 9, 2018: Environmental Health: a Global Access Science Source
G Yu, W J Wang, D R Liu, Z F Tao, X Y Hui, J Hou, J Q Sun, X C Wang
Objective: To investigate the clinical characteristics of 8 immunodeficiency cases caused by human recombination activating gene 1 (RAG1) mutations, and to explore the relationship among genotypes, clinical manifestations and immunophenotypes. Methods: Clinical data were collected and analyzed from patients with RAG1 mutations who visited the Department of Clinical Immunology, Children's Hospital of Fudan University between October 2013 and June 2017. The data included clinical manifestations, immunophenotypes and genotypes...
March 2, 2018: Zhonghua Er Ke za Zhi. Chinese Journal of Pediatrics
Cyrille Guillot-Tantay, Emmanuel Chartier-Kastler, Marie-Aimée Perrouin-Verbe, Pierre Denys, Priscilla Léon, Véronique Phé
STUDY DESIGN: Retrospective cohort study. OBJECTIVES: To report the long-term complications of non-continent cutaneous urinary diversion (NCCUD) in adult patients with spinal cord injury (SCI). SETTING: Hospital in Paris, France. METHODS: A retrospective single center study included all adult patients with SCI who underwent an ileal conduit between 1997 and 2014. Early complications were reported according to Clavien-Dindo classification...
March 7, 2018: Spinal Cord
Kunihiko Hanew, Toshiaki Tanaka, Reiko Horikawa, Tomonobu Hasegawa, Susumu Yokoya
The reported prevalence of complications in Turner Syndrome (TS) was highly variable because of the rarity and the limited numbers analyzed. Again, possible presence of other complications that are not described as specific for TS, is also speculated. To resolve these issues, a questionnaire survey was conducted in hGH treated 492 patients with adult TS (17-42 years). The possible association with these complications and karyotypes were also analyzed. The complications and their prevalence were as follows: chronic thyroiditis (25...
March 7, 2018: Endocrine Journal
Aurore Bouty, Eric Dobremez, Luke Harper, Jérôme Harambat, Cécile Bouteiller, Brigitte Zaghet, Pierre Wolkenstein, Stéphane Ducassou, Yan Lefevre
AIM: Neurofibromatosis type 1 (NF1) is a rare autosomal dominant disorder. Malignant transformation into malignant peripheral nerve sheath tumors (MPNST) can occur. However, urinary tract involvement is rare. We report 4 cases of NF1 with bladder dysfunction. METHODS: A retrospective single center analysis of 4 patients was conducted over a 17-year period, focusing on urinary tract involvement. RESULTS: NF1 was diagnosed at a median of 16...
March 7, 2018: Urologia Internationalis
Maria Angela Cerruto, Carolina D'Elia, Salvatore Siracusano, Omar Saleh, Mauro Gacci, Giovanni Cacciamani, Vincenzo De Marco, Antonio Benito Porcaro, Matteo Balzarro, Mauro Niero, Cristina Lonardi, Massimo Iafrate, Pierfrancesco Bassi, Ciro Imbimbo, Marco Racioppi, Renato Talamini, Stefano Ciciliato, Sergio Serni, Marco Carini, Paolo Verze, Walter Artibani
OBJECTIVE: To evaluate health-related quality of life (HR-QoL) outcomes in elderly patients with different type of urinary diversion (UD), ileal conduit (IC) and ileal orthotopic neobladder (IONB), after radical cystectomy (RC) for bladder cancer, by using validated self-reported cancer-specific instruments. PATIENTS AND METHODS: We retrospectively reviewed 77 patients who received an IC or an IONB after RC. HR-QoL was assessed with specific and validated disease questionnaires, administered at last follow-up...
March 7, 2018: Urologia Internationalis
Zahra Hashemizadeh, Davood Kalantar-Neyestanaki, Shahla Mansouri
INTRODUCTION: Multidrug-resistant (MDR) Escherichia coli, a species that is a leading cause of urinary tract infections (UTIs) and is a major global public health concern. This study was designed to detect the differences in antibiotic resistance patterns, the production and type of extended spectrum β-lactamases (ESBLs), and the clonal relationships among E. coli isolates from UTIs and fecal samples. METHODS: Antibacterial resistance was determined by the disk diffusion method...
January 2018: Revista da Sociedade Brasileira de Medicina Tropical
R Andrew Taylor, Christopher L Moore, Kei-Hoi Cheung, Cynthia Brandt
BACKGROUND: Urinary tract infection (UTI) is a common emergency department (ED) diagnosis with reported high diagnostic error rates. Because a urine culture, part of the gold standard for diagnosis of UTI, is usually not available for 24-48 hours after an ED visit, diagnosis and treatment decisions are based on symptoms, physical findings, and other laboratory results, potentially leading to overutilization, antibiotic resistance, and delayed treatment. Previous research has demonstrated inadequate diagnostic performance for both individual laboratory tests and prediction tools...
2018: PloS One
Sang Won Kim, Jun Nyung Lee, Hyun Tae Kim, Eun Sang Yoo
A vesicocutaneous fistula (VCF) is a tract that is formed abnormally between the bladder and the external surface of the body. VCF results in a great deal of inconvenience, discomfort, and physical disability for the affected patient. This condition can be caused by extensive trauma with pelvic bone fracture, radical pelvic surgery, irradiation of pelvic malignancies, hip arthroplasty, a large bladder calculus, and various other pathologies. The management of VCF should be approached on a case-by-case basis because of the complexity of the disease...
March 2018: Turkish Journal of Urology
Spatola Leonardo, Ferraro Manuel Pietro, Gambaro Giovanni, Badalamenti Salvatore, Dauriz Marco
Uric acid nephrolithiasis (UAN) is an increasingly common disease in ethnically diverse populations and constitutes about 10% of all kidney stones. Metabolic syndrome and diabetes mellitus are accounted amongst the major risk factors for UAN, together with environmental exposure, individual lifestyle habits and genetic predisposition. The development and overt manifestation of UAN appears to stem on the background of insulin resistance, which acts at the kidney level by reducing urinary pH, thus hampering the ability of the kidney to generate renal ammonium in response to an acid load...
March 3, 2018: Metabolism: Clinical and Experimental
Vasilios Kalas, Michael E Hibbing, Amarendar Reddy Maddirala, Ryan Chugani, Jerome S Pinkner, Laurel K Mydock-McGrane, Matt S Conover, James W Janetka, Scott J Hultgren
Treatment of bacterial infections is becoming a serious clinical challenge due to the global dissemination of multidrug antibiotic resistance, necessitating the search for alternative treatments to disarm the virulence mechanisms underlying these infections. Uropathogenic Escherichia coli (UPEC) employs multiple chaperone-usher pathway pili tipped with adhesins with diverse receptor specificities to colonize various host tissues and habitats. For example, UPEC F9 pili specifically bind galactose or N -acetylgalactosamine epitopes on the kidney and inflamed bladder...
March 5, 2018: Proceedings of the National Academy of Sciences of the United States of America
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