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PubMed1992

Survey of mycobacteria isolated from urine and the genitourinary tract in south-east England from 1980 to 1989.

Between 1980 and 1989, the Public Health Laboratory Service Regional Tuberculosis Centre, Dulwich, received cultures of mycobacteria isolated from urine and the genitourinary tract of 1392 new patients: 803 isolates were members of the tuberculosis complex (753 M. tuberculosis, 45 M. bovis, 4 M. africanum) and 589 were various species of environmental mycobacteria. The incidence of the latter isolations varied by region and by year and, with 17 exceptions (13 from endometrial curettings, 2 from hydrocele fluid, 1 from a scrotal abscess and 1 from a kidney), all isolations of environmental mycobacteria were from urine; very few of them appeared to be clinically significant. Those that could be significant included 1 isolate from a kidney, 1 from a post-renal transplant patient and 4 from patients with AIDS, 3 of whom had disseminated mycobacterial disease. Reports of clinically significant isolations of environmental mycobacteria from the genitourinary tract are reviewed.

England↗
PubMed1990

The fetal genitourinary tract.

Early recognition of fetal urinary tract anomalies may dramatically influence obstetric or neonatal management. Major fetal urinary abnormalities, including renal agenesis, obstructive lesions, and cystic disease, may be clinically silent but readily identified by sonography. Careful evaluation of the fetal genitourinary tract should therefore be an important component of the routine screening obstetric sonogram. Appreciation of normal sonographic appearances of the fetal genitourinary tract may facilitate early recognition of the abnormal fetus. Accurate prenatal sonographic characterization of a renal abnormality and evaluation of renal function are essential for fetal prognosis and management.

Constriction, Pathologic↗
PubMed2006

Age related changes in the functional, biochemical and molecular properties of alpha1-adrenoceptors in the rat genitourinary tract.

PURPOSE: Because age related changes occur in the properties of alpha(1)-adrenoceptor in several mammalian tissues and alpha(1)-adrenoceptor antagonists are extensively used to treat lower urinary tract symptoms secondary to benign prostatic hyperplasia, we investigated age related changes in the functional, biochemical and molecular properties of alpha(1)-adrenoceptor in the rat genitourinary tract. MATERIALS AND METHODS: The characteristics of alpha(1)-adrenoceptor in the ventral and dorsolateral prostate, and bladder base and dome of 3 and 22-month-old rats were determined using an isolated muscle bath, radioligand receptor binding and real-time reverse transcriptase-polymerase chain reaction techniques. RESULTS: Old rats had significantly higher body weight, lower testosterone, a smaller ventral prostate and a larger bladder dome than young rats. Although there was no significant age dependent difference in the properties of alpha(1)-adrenoceptor in the bladder base and dome, total alpha(1)-adrenoceptor density, mRNA expression of all 3 alpha(1)-adrenoceptor subtypes (alpha(1A), alpha(1B) and alpha(1D)) and the maximum contractile responses to phenylephrine were significantly lower in the ventral and dorsolateral prostate of 22 vs 3-month-old rats. CONCLUSIONS: Age related differences in the molecular, biochemical and functional properties of alpha(1)-adrenoceptors in the rat genitourinary tract may indicate potential differences in the response to alpha(1)-adrenoceptor antagonists with aging, ie a decrease in the therapeutic response in old vs young rats in the response to alpha(1)-adrenoceptor antagonists when used to treat lower urinary tract symptoms secondary to benign prostatic hyperplasia.

Age Factors↗
PubMed1991

[A study of Ureaplasma urealyticum pathogenicity in human genitourinary tract].

Ureaplasma urealyticum was investigated in urine from 765 outpatients who visited Jikei University Affiliated Hospital and Tokyo Metropolitan Taito Hospital from June, 1988 to December, 1989 in order to clarify the pathogenicity of U. urealyticum in human genitourinary tract. U. urealyticum in urine was detected by means of Taylor-Robinson's method. The positive rates of U. urealyticum were 31.5% in 146 patients with gonococcal urethritis, 33.8% in 334 patients with non-gonococcal urethritis, 17.5% in non-bacterial chronic prostatitis and 27.5% in the other patients without infectious diseases, respectively; no significant difference was seen among these groups. U. urealyticum was detected in the urine from 32.1% of the 28% patients who were younger than 12. However, U. urealyticum was detected in the urine from 5.6% of the 18 patients who were older than 70. Therefore, there was no relationship between the age and U. urealyticum-positive rate in urine. Furthermore, there was no relationship between the detection of U. urealyticum and the subjective and objective findings in the patients with urethritis before and after the treatment. From these results, it is presumed that U. urealyticum has no pathogenicity in human genitourinary tract.

Adolescent↗
PubMed1988

Biotypes, serotypes, and susceptibility to antibiotics of 60 Haemophilus influenzae strains from genitourinary tracts.

Sixty strains of Haemophilus influenzae were isolated from the genitourinary tracts of adults: 19 from cervicovaginal secretions, one from a woman with bartholinitis, 37 from urethral exudates, and three from urine. Non-capsulated strains were recovered predominantly, and biotype III accounted for 28 isolates and biotype IV for 25. Many of the H influenzae strains were found to be resistant to one or more of the antibiotics commonly used against sexually transmitted diseases. Resistance to tetracycline was prevalent and was found in 17 of the strains. Ten strains were ampicillin resistant and beta lactamase producing. Kanamycin resistance was less common (two strains). Trospectomycin (U-63366), a new spectinomycin analogue, was eight to 16 times more active than spectinomycin. All the quinolones tested were very active against all strains and may provide an effective alternative for the treatment of resistant H influenzae in genitourinary infections.

Adult↗
PubMed1995

Biopsy of lesions of the male genitourinary tract.

Biopsy of benign and malignant lesions of the male genitourinary tract using a variety of open and endourologic techniques is possible. A multidisciplinary approach involving close communication between clinicians, radiologists, and pathologists is imperative to a favorable outcome. Urologic practice has pioneered many of these techniques, which continue to evolve as new technologies become available.

Adrenal Gland Neoplasms↗
PubMed1988

Maternal cocaine use and genitourinary tract malformations.

A specific fetal disruption syndrome associated with maternal cocaine use has not as yet been documented. In the first 23 pregnancies evaluated in our program for chemically dependent women, one infant with prune belly syndrome and one infant with hypospadias were delivered to cocaine-using women. In the present study, all infants delivered in our program received a renal ultrasound at 2-3 days of life. Fifty infants born to cocaine-using women (group I) and 30 born to polydrug, noncocaine-using women (group II) were evaluated. The two groups of women were similar for age, gravidity, and race. Mean birth weight of the infants in the two groups was similar. Seven infants in group I demonstrated genitourinary tract malformations while there were no infants with such malformations in group II. It is hypothesized that the vasoconstrictive effects of cocaine could explain the abnormalities of the genitourinary tract found in the cocaine-exposed infants.

Cocaine↗
PubMedDate not supplied

Quantification of endothelins, their receptors, and endothelin-converting enzyme mRNAs in rat genitourinary tract using real-time RT-PCR.

INTRODUCTION: Quantification of mRNA expression is essential for the assessment of endothelin (ET) receptor-mediated mechanisms. Recently, a novel technique for the determination of mRNA expression, termed real-time reverse transcription polymerase chain reaction (RT-PCR), has been developed. We therefore applied real-time PCR using SYBR Green I to quantify ET-1, ET-3, ET-converting enzyme-1 (ECE-1), and ETA and ETB receptor subtype mRNA expression in the rat genitourinary tract. METHODS: The cDNA was synthesized by RT of RNA extracted from the rat bladder, ventral prostate, dorsolateral prostate, and vas deferens. All steps subsequent to the RT reaction were carried out by the thermal cycler/detector and computer-assisted programs processed a quantitative result. RESULTS: Designing optimal primer sequences that minimized primer-dimer formation and adjusting annealing temperatures that prevented nonspecific product amplification have made it possible to identify a single peak in the melt curve and to obtain an appropriate standard curve for each gene transcript. In our experiments, input cDNA levels as low as 100 copies of the product could be detected. DISCUSSION: We demonstrated that significant quantitative variations existed in the expression levels of ET-1, ET-3, ECE-1, and ETA and ETB receptor subtype mRNAs within a tissue and between different regions of the genitourinary tract and that the predominant expression of ETs and their receptor mRNAs in all tissues studied were ET-1 and the ETA receptor subtype, respectively.

Animals↗
PubMed1987

Foreign body migration to the genitourinary tract.

Foreign body migration from the gastrointestinal tract to any of several sites within the genitourinary tract has been well documented. We report 3 such cases involving the upper and lower urinary tract to highlight the varied presentations, manifestations and prognosis associated with this entity.

Adult↗
PubMed1980

Arylsulfatase A activity of urine in patients with various genitourinary tract disorders.

Arylsulfatase A activity was measured in urine from patients with various genitourinary tract disorders such as bladder tumor and inflammation. No significant difference in enzyme activity was found between normal and affected urine on the basis of either the volume or protein content of urine, a finding which differed from previous results. However, it was demonstrated that urine from affected patients was more labile to heat treatment in comparison with the control. Upon pretreatment of urine arylsulfatase A at 62.5 degrees C for 10 min, an average of 57% of the original activity was lost in samples from patients with bladder tumor, 58% in those with testicular tumor and 62% in cystitis and urethritis, respectively, while the enzyme activity in the control urine lost only 27% with similar heat treatment. These results were statistically significant with p < 0.001. The arylsulfatase A from patients with advanced bladder tumors demonstrated the presence of a variant form (pI 5.3) which was not detected in normal urine. This variant of arylsulfatase A was also demonstrated in nephrostomy urine from patients with congenital obstruction of the pelvi-ureteric junction.

Adult↗
PubMed1992

Magnetic resonance imaging of the genitourinary tract.

Advances have occurred in practically all aspects of MR imaging of the genitourinary tract. Fat-suppressed T1 weighting and dynamic-enhanced imaging are two new methods for evaluating renal and adrenal masses. MR angiography techniques are beginning to depict anatomy with sufficient detail to be considered clinical tools. Bladder cancers can be better staged with enhanced high-resolution images, especially when combined with surface coils. Endorectal surface coils continue to provide dramatic images of the prostate and have significantly improved local staging with MR imaging. MR imaging is proving superior to all other techniques in staging endometrial and cervical cancers, and high-resolution, fat-suppressed, fast spin-echo techniques will undoubtedly further improve the diagnostic utility of this modality.

Female Urogenital Diseases↗
PubMed2001

Oral gabapentin (neurontin) treatment of refractory genitourinary tract pain.

PURPOSE: Refractory genitourinary pain is a common but difficult condition to treat. Examples of chronic genitourinary pain include orchalgia, interstitial cystitis, pain after bladder suspension surgery, nonbacterial prostatitis, and genital pain related to lumbosacral neuropathy. We report our experience with oral gabapentin treatment for this condition. Gabapentin is an anticonvulsant with unclear but therapeutic effects on neurologic pain. MATERIALS AND METHODS: Twenty-one patients referred with refractory genitourinary pain were treated with oral gabapentin. There were 9 men and 12 women. In the male patients, the location of pain was testicle (4), bladder (2), penis (1), or prostate (2). In female patients, the pain was located in the urethra (4), bladder (6), vulva (1), or vagina (1). The dose of gabapentin was titrated from 300 up to 2,100 mg/day. Subjective pain severity and 10-cm visual pain scale was used before and 6 months after therapy. RESULTS: The mean dose of gabapentin was 1,200 mg/day (range 300-2,100 mg). Ten of 21 patients reported subjective improvement of their pain. The remaining patients did not perceive any improvement. Gabapentin was well tolerated; only 4 patients dropped out due to side effects. The most common adverse effects were dizziness and drowsiness. Five of 8 patients with interstitial cystitis reported improvement. CONCLUSIONS: Although only 10 of 21 patients improved with gabapentin, this cohort included only patients with refractory genitourinary pain that failed a wide range of prior treatments. Gabapentin belongs in the armaterium of the urologist who treats genitourinary pain.

Acetates↗
PubMed1989

Quinolone antibacterial agents for the treatment of genitourinary tract infections.

The fluoroquinolones have expanded the therapeutic options available for the treatment of genitourinary tract infections. Their ease of oral administration, favourable pharmacokinetics, low incidence of adverse reactions, and broad spectrum of in vitro activity against aerobic and facultative organisms make them especially suitable for treating bacteriuria, particularly when pathogens are resistant to other available oral agents. Their efficacy has also been established in the treatment of prostatis, gonorrhea and chancroid. They have lower in vitro activity against chlamydia, ureaplasma and anaerobes, and their role in the treatment of non-gonococcal urethritis, vaginitis and acute pelvic inflammatory disease is less well established.

4-Quinolones↗
PubMed1999

Sonography of the neonatal genitourinary tract.

Ultrasound has become the modality of choice for the evaluation of the neonatal genitourinary tract. High frequency linear, vector, and curved array transducers (7 MHz, 5 MHz, 12 MHz) and portability of the equipment make a rapid bedside evaluation with exquisite anatomic detail possible. A major advantage of sonography over other modalities is real time observation and circumvention of sedation.

Female↗
PubMed1970

Mycoplasma recovery from the male genitourinary tract: voided urine versus the urethral swab.

A study of Mycoplasma recovery from the genitourinary tract was made on a group of 50 males attending a venereal disease clinic. The purpose of the investigation was to compare recovery rates of mycoplasma from two types of clinical specimens-the urethral swab and voided urine. The total number of positive cultures did not differ significantly when either the swab or urine was used; Mycoplasma hominis type 1 was the only taxonomic species isolated, either alone or mixed with T-strain mycoplasma. Recovery rates of the two types from both the swab and the urine did not differ significantly. Age did not relate to the presence of mycoplasma in the group studied.

Adolescent↗
PubMed1998

Ofloxacin. A reappraisal of its use in the management of genitourinary tract infections.

UNLABELLED: Ofloxacin is an established fluoroquinolone agent which achieves good concentrations in genitourinary tract tissues and fluids. It has good in vitro activity against most Enterobacteriaceae, Staphylococcus saprophyticus, methicillin-susceptible S. aureus, Neisseria gonorrhoeae, Chlamydia trachomatis and Haemophilus ducreyi, intermediate activity against Ureaplasma urealyticum and most enterococci, but limited or no in vitro activity against enterococci, Serratia marcescens, Pseudomonas aeruginosa and many anaerobes. However, high concentrations achieved in the urine ensure its activity against most urinary tract pathogens. Ofloxacin demonstrates consistent efficacy in a broad range of urinary tract infections, achieving bacteriological response rates in excess of 80% in uncomplicated and 70% in complicated infections. The efficacy of ofloxacin was similar to that of all comparators tested including other fluoroquinolones, cephalosporins and cotrimoxazole (trimethoprim/sulfamethoxazole). Ofloxacin is also effective as a single-dose regimen in the treatment of uncomplicated gonorrhoea, as a 7-day regimen in uncomplicated C. trachomatis infections, and as monotherapy in uncomplicated pelvic inflammatory disease (PID). Again, ofloxacin demonstrated similar efficacy to alternative treatments in each type of infection. The availability of an intravenous formulation and near-complete oral bioavailability allow ofloxacin to be administered as a sequential regimen without loss of activity. The tolerability and drug interaction profile of ofloxacin is consistent with that of other fluoroquinolones. The most commonly reported adverse events with ofloxacin are gastrointestinal, neurological and dermatological. It was associated with a lower incidence of photosensitivity and tendinitis and higher incidence of some neurological events than some other fluoroquinolones. Ofloxacin seems to have a lower propensity to interact with xanthines than other fluoroquinolones. CONCLUSION: ofloxacin has established efficacy in the treatment of a wide variety of urinary tract infections, although, like other fluoroquinolones, it should be used rationally to preserve its activity. Currently, ofloxacin also holds an important place among fluoroquinolones in the treatment of C. trachomatis infections and uncomplicated PID, although its acceptance as monotherapy in PID is likely to depend on clarification of the causative role of anaerobic pathogens in this infection.

Anti-Infective Agents↗
PubMed1991

[Clinical studies of bacteriuria in renal transplantation recipients. Correlation with pyuria and symptomatic genitourinary tract infection].

The clinical state of bacteriuria and its correlation with pyuria and symptomatic genitourinary tract infection (GUTI) were studied in 42 renal transplantation recipients who were followed up in the Kidney Center of Tokyo Women's Medical College over 6 months and who showed bacteriuria more than 3 times between January and December in 1987. The results were as follows. 1) Of the 42 recipients, bacteriuria was found less than 5 times in 19 patients, 6 to 10 times in 18 patients and more than 11 times in 5 patients. There was a tendency for the same bacteria to be isolated several times from the same patient. The most commonly isolated bacterias were Enterobacter, Enterococcus, Serratia and E. coli. 2) Bacteriuria was accompanied by pyuria in 33 patients (79%) and by symptomatic GUTI in 12 patients (29%). Bacteriuria without pyuria was shown in 9 patients (21%) without symptomatic GUTI and it was suggested that bacteriuria did not result in graft hypofunction after two years. 3) Of 16 patients with bacteriuria accompanied by pyuria, symptomatic GUTI occurred in 9 patients (56%). Of these, one patient was found to have VUR of the transplanted kidney, another was found to have VUR of the native kidney, and a third patient died due to interstitial pneumonitis presumably as a result of overimmunosuppression. Transplantation recipients with bacteriuria accompanied by pyuria develop symptomatic GUTIs frequently and should be treated with proper antibacterial agents. When bacteriuria continues, further examination should be performed for an organic disease of the urinary tract or an overimmunosuppressed state. When a patient shows bacteriuria without pyuria, chemotherapy is not needed and it is sufficient to observe the course carefully.

Adult↗