Urinary tract infections(UTIs)are among the most prevalent pediatric bacterial infections,and undertreated episodes may lead to renal scarring,hypertension,or chronic kidney disease.Multidrug-resistant(MDR)Enterobacte...Urinary tract infections(UTIs)are among the most prevalent pediatric bacterial infections,and undertreated episodes may lead to renal scarring,hypertension,or chronic kidney disease.Multidrug-resistant(MDR)Enterobacterales have been increasingly reported in children,with higher rates in Asian and Middle Eastern settings than in high-income countries[1,2].展开更多
Objective:This study aims to develop a drug controlled-release system based on nano-hydrogel technology for stone dissolution and evaluate its dual efficacy in synchronously dissolving calcium oxalate stones and inhib...Objective:This study aims to develop a drug controlled-release system based on nano-hydrogel technology for stone dissolution and evaluate its dual efficacy in synchronously dissolving calcium oxalate stones and inhibiting uropathogenic Escherichia coli.Methods:A pH-responsive chitosan(CS)-sodium alginate(SA)-hydrogel microsphere loaded with potassium sodium hydrogen citrate and fosfomycin(CS/SA@PSHC@CS@F)was constructed using ionic cross-linking.In vitro stone dissolution experiments were conducted to determine drug release kinetics and stone mass reduction rate under different pH environments,and the antibacterial activity against E.coli ATCC 25922 was evaluated using the plate counting method.A rat model of kidney stone combined with infection was established.Stone volume changes were quantified via micro-CT,urinary interleukin-6(IL-6)and tumor necrosis factorα(TNF-α)levels were measured by ELISA,and renal tissue inflammation was scored via histopathological evaluation.Results:The 24-hour cumulative release rate of CS/SA@PSHC@CS@F at pH 5.8 reached 92.3%±4.1%,significantly higher than at pH 7.4(31.2%±3.7%,P<0.01).At 72 h,the mass reduction rate of calcium oxalate stones in CS/SA@PSHC@CS@F was 68.9%±5.2%,significantly higher than that of the PSHC+F mixture(P<0.01).Antibacterial experiments confirmed that the inhibition rate of biofilm colonies by CS/SA@PSHC@CS@F could reach 82.4%±6.7%,compared to 58.2%±5.3%for F,with a statistically significant difference(P<0.01).Animal experiments showed that the stone volume reduction rate in the CS/SA@PSHC@CS@F group was62.3%±8.1%,higher than that in the PSHC+F group,and the decrease in urinary IL-6 level after administration was more significant,while there was no significant difference in TNF-αlevel compared with the other two groups(P>0.05).The renal tissue inflammation score decreased to 2(1,2)points,showing a significant reduction compared with the other two groups(P<0.05).Conclusion:The novel controlled-release system designed in this study achieves targeted drug release in the stone infection microenvironment through the ion exchange mechanism,simultaneously enhancing stone dissolution efficiency and antibacterial effect,thereby providing a new drug delivery strategy for the treatment of urinary stones combined with infection.展开更多
Background:Urinary tract infections(UTIs),primarily caused by uropathogenic Escherichia coli(UPEC),are a significant global health concern.The complications arise from antibiotic resistance and biofilm formation,which...Background:Urinary tract infections(UTIs),primarily caused by uropathogenic Escherichia coli(UPEC),are a significant global health concern.The complications arise from antibiotic resistance and biofilm formation,which reduce the effectiveness of conventional treatments.This study aims to evaluate the antibiofilm activity of the homeopathic medicine Terebinthinae oleum in potencies 30C,200C,and 1M against UTI-causing E.coli,and to compare its effectiveness with the standard antibiotic Gentamycin.Methods:An in-vitro biofilm model was employed.E.coli biofilms were cultivated in microtiter plates and treated with Terebinthinae oleum(30C,200C,1M)and Gentamycin.Biofilm biomass was assessed through crystal violet staining,and optical density(OD)was measured using an ELISA microplate reader.Results:Among the tested potencies,Terebinthinae oleum 30C showed the most prominent inhibitory activity on E.coli biofilms.The inhibition percentage was compared with Gentamycin as a control.Terebinthinae oleum 30C demonstrated 41.88%inhibition of biofilm biomass,while Gentamycin exhibited up to 78.98%inhibition.Higher potencies of Terebinthinae oleum(200C and 1M)showed reduced activity(30.15%and 24.81%,respectively).Conclusion:Terebinthinae oleum,especially at 30C potency,exhibits measurable antibiofilm activity against E.coli,although less effective than Gentamycin.These findings support its use as a complementary therapy in managing biofilm-associated UTIs,justifying further clinical and immunological research.展开更多
BACKGROUND Pelvic fractures are often associated with significant morbidity,including injuries to the urinary tract.Understanding the incidence and risk factors for urinary tract injury in these patients is crucial fo...BACKGROUND Pelvic fractures are often associated with significant morbidity,including injuries to the urinary tract.Understanding the incidence and risk factors for urinary tract injury in these patients is crucial for prompt diagnosis and management.This meta-analysis aims to synthesize existing evidence to determine the overall incidence and identify specific risk factors associated with urinary tract injuries in patients with pelvic fractures.AIM To determine the incidence and risk factors for urinary tract injuries in patients with pelvic fractures.METHODS A systematic search of PubMed,EMBASE,Scopus,and the Cochrane Library was conducted without date restrictions.Studies examining the incidence and risk factors of urinary tract injuries in patients with pelvic fractures were included.Data extracted included demographics,injury mechanism,pelvic fracture type,urinary tract injury incidence,mortality,and discharge disposition.Review Manager 5.4 was used for data analysis.RESULTS Ten studies comprising 22700 patients were included.The pooled incidence of urinary tract injury associated with pelvic fracture was 6.88%(95%CI:6.20%-7.55%).Vehicle,motorcycle,and pedestrian accidents were identified as risk factors for urinary tract injury,with relative risks(RR)of 1.08(95%CI:1.06-1.11),1.89(95%CI:1.78-2.00),and 1.53(95%CI:1.20-1.95),respectively.Pubic fracture and pelvic ring disruption were significantly associated with urinary tract injury[odds ratio(OR)1.94,95%CI:1.09-3.44 and OR 5.53,95%CI:4.67-6.54,respectively)].Patients without urinary tract injury were more likely to be discharged home(RR 0.79,95%CI:0.67-0.92).Mortality was higher in patients with urinary tract injury(OR 1.92,95%CI:1.77-2.09).CONCLUSION Urinary tract injury occurs in nearly 7%of patients with pelvic fractures.Motorcycle accidents,pubic fractures,and pelvic ring disruptions are significant risk factors.Urinary tract injury following pelvic fracture is associated with increased mortality.展开更多
Colorectal cancer is a common tumor of the digestive system and is the third leading cause of cancer-related death worldwide.The global incidence of colorectal cancer is currently increasing.In some patients,the tumor...Colorectal cancer is a common tumor of the digestive system and is the third leading cause of cancer-related death worldwide.The global incidence of colorectal cancer is currently increasing.In some patients,the tumor has already spread to nearby organs at the time of diagnosis,with the small intestine and bladder being common sites of invasion.[1,2]The diagnosis of colorectal cancer that has spread to the bladder can be challenging.Aside from a few patients who experience urinary symptoms due to invasion of the bladder trigone or the entire bladder wall,there are no distinct clinical signs,which often leads to misdiagnosis.The following case report details one such instance.展开更多
Urinary tract infections(UTIs)are the most common bacterial infections.Escherichia coli is the most common cause of UTIs,accounting for 50%of hospital-reported and 90%of community-reported cases.Also,this includes spe...Urinary tract infections(UTIs)are the most common bacterial infections.Escherichia coli is the most common cause of UTIs,accounting for 50%of hospital-reported and 90%of community-reported cases.Also,this includes species of Klebsiella,Proteus,Acinetobacter,Pseudomonas,Staphylococcus,Streptococcus,and Enterococcus.Patients experience cystitis,polyuria,and dysuria.If untreated,this affects the kidneys,further leading to septicemia.UTIs majorly affect adult females(40%-60%).Microbiological culture has been proven to be the standard method.However,it takes 48-72 hours for the tests to be reported.In cases of recurrent UTI,it is mandatory to have a quick,sensitive,and specific diagnostic procedure.Dipstick tests are considered early methods for diagnosing UTIs;however,they have limitations.Recently,biomarkers are being used to assess the severity of the disease.To achieve the United Nations Sustainable Development Goals 3 and 8,the expertise from General Medicine,Biotechnology,and Microbiology come together in achieving the set targets by 2030.In addition to diagnosis of UTI,resistance to antibiotics should not be neglected.This review aimed to examine the clinical relevance of biomarkers such as neutrophil gelatinase-associated lipocalin,kidney injury molecule-1,interleukin(IL)6,IL-8,heparin-binding protein,procalcitonin,lipopolysaccharide-binding protein,xanthine oxidase,cell-free DNA,and transrenal DNA.展开更多
Background:Studies have shown that individuals who receive early treatment for rheumatoid arthritis(RA)are more likely to approach life positively,avoiding joint damage and the need for joint replacement surgery.The d...Background:Studies have shown that individuals who receive early treatment for rheumatoid arthritis(RA)are more likely to approach life positively,avoiding joint damage and the need for joint replacement surgery.The diagnosis of early rheumatoid arthritis(ERA)is crucial for effective treatment and prognosis of patients.Urine,as a diagnostic medium,offers the advantages of non-invasive diagnosis.Urinary metabolites can serve as biomarkers for diagnosis,prognosis,and risk prediction,improving specificity and accuracy.Methods:We recruited 37 ERA patients with a history of less than 3 months and a score of 6,26 osteoarthritis(OA)patients,and 30 healthy controls(HC).Urine samples were collected for 16S rRNA sequencing,and untargeted liquid chromatography-mass spectrometry(LC-MS)was used to detect metabolites.Bioinformatics approaches were employed to identify pathogenic metabolites as specific risk factors for ERA precisely.Results:2-methylnaphthalene was identified as a biomarker for ERA in urine.Prevotella,a major part of the urinary microbiome in ERA patients,exhibited a positive correlation with 2-methylnaphthalene.Notably,there were significant variations in urine metabolites among patients with ERA,OA,and HC.2-Methylnaphthalene was found to be significantly enriched in ERA.Besides,inflammatory factors were elevated in ERA patients.The research further demonstrated a positive correlation between rheumatoid factor(RF),erythrocyte sedimentation rate(ESR),and C-reactive protein(CRP)and the metabolite 2-methylnaphthalene.Conclusion:The urine metabolite 2-methylnaphthalene can be a risk factor for early urinary tract infections and may contribute to accurately screening early-risk metabolites in ERA.展开更多
Background:The burden of common urologic diseases,including benign prostatic hyperplasia(BPH),urinary tract infections(UTI),urolithiasis,bladder cancer,kidney cancer,and prostate cancer,varies both geographically and ...Background:The burden of common urologic diseases,including benign prostatic hyperplasia(BPH),urinary tract infections(UTI),urolithiasis,bladder cancer,kidney cancer,and prostate cancer,varies both geographically and within specific regions.It is essential to conduct a comprehensive and precise assessment of the global burden of urologic diseases.Methods:We obtained data on incidence,prevalence,mortality,and disability-adjusted life-years(DALYs)for the aforementioned urologic diseases by age,sex,location,and year from the Global Burden of Disease(GBD)2021.We analyzed the burden associated with urologic diseases based on socio-demographic index(SDI)and attributable risk factors.The trends in burden over time were assessed using estimated annual percentage changes(EAPC)along with a 95%confidence interval(CI).Results:In 2021,BPH and UTI were the leading causes of age-standardized incidence rate(ASIR)and age-standardized prevalence rate(ASPR),with rates of 5531.88 and 2782.59 per 100,000 persons,respectively.Prostate cancer was the leading cause of both age-standardized mortality rate(ASMR)and age-standardized DALYs rate(ASDR),with rates of 12.63 and 217.83 per 100,000 persons,respectively.From 1990 to 2021,there was an upward trend in ASIR,ASPR,ASMR,and ASDR for UTI,while urolithiasis showed a downward trend.The middle and low-middle SDI quintile levels exhibited higher incidence,prevalence,mortality,and DALYs related to UTI,urolithiasis,and BPH,while the high and high-middle SDI quintile levels showed higher rates for the three cancers.The burden of these 6 urologic diseases displayed diverse age and sex distribution patterns.In 2021,a high body mass index(BMI)contributed to 20.07%of kidney cancer deaths worldwide,while smoking accounted for 26.48%of bladder cancer deaths and 3.00%of prostate cancer deaths.Conclusions:The global burden of 6 urologic diseases presents a significant public health challenge.Urgent international collaboration is essential to advance the improvement of urologic disease management,encompassing the development of effective diagnostic screening tools and the implementation of high-quality prevention and treatment strategies.展开更多
BACKGROUND Urinary tract infections(UTIs)in kidney transplant patients are a challenge.AIM To evaluate epidemiology,clinical status,therapeutic management,and clinical outcome of kidney transplant patients in a univer...BACKGROUND Urinary tract infections(UTIs)in kidney transplant patients are a challenge.AIM To evaluate epidemiology,clinical status,therapeutic management,and clinical outcome of kidney transplant patients in a university hospital for UTI.METHODS We conducted a retrospective observational study,enrolling all kidney transplant patients hospitalized for UTI,with the objective to evaluate the epidemiology,clinical status,therapeutic management,and clinical outcome of kidney transplant patients.RESULTS From our real-life experience,infection with multidrug-resistant germs was confirmed as a risk factor for the severe evolution of the infection.At the same time,the re-evaluation of immunosuppressive therapy could be an important therapeutic strategy in the course of infection.CONCLUSION Prompt initiation of empiric antibiotic therapy upon initiation of microbiological investigations may reduce the risk of severe infection progression.展开更多
Objective:To investigate the preventive effect of evidence-based preventive nursing on urinary tract infections(UTIs)in elderly female diabetic patients.Methods:Seventy-nine elderly female diabetic patients admitted t...Objective:To investigate the preventive effect of evidence-based preventive nursing on urinary tract infections(UTIs)in elderly female diabetic patients.Methods:Seventy-nine elderly female diabetic patients admitted to our hospital from March 2023 to March 2025 were selected and randomly divided into observation group(40 cases)and control group(39 cases)using the envelope method.The control group received routine nursing,while the observation group received evidence-based preventive nursing.The outcomes were compared between the two groups.Results:After treatment,blood glucose levels in both groups were significantly reduced,and the improvement in various indicators in the observation group was better than that in the control group(P<0.05).Additionally,quality of life scores were significantly improved in both groups,with the observation group showing better improvement than the control group(P<0.05).The duration of catheter indwelling and hospital stay in the observation group were lower than those in the control group(P<0.05).Conclusion:Evidence-based preventive nursing can systematically reduce the risk of urinary tract infections,improve patient outcomes,and provide effective references for clinical nursing practice.展开更多
ObjectiveTo review the current literature on ketamine-associated upper urinary tract (UUT) dysfunction and provide an overview of its pathogenesis and treatment principles.MethodsA literature search was conducted usin...ObjectiveTo review the current literature on ketamine-associated upper urinary tract (UUT) dysfunction and provide an overview of its pathogenesis and treatment principles.MethodsA literature search was conducted using PubMed and Cochrane databases for relevant articles published in English between 2008 and 2023. Keywords used included “ketamine” and “upper urinary tract”.ResultsA total of 22 papers were included. Relatively few studies have focused on ketamine-associated UUT dysfunction. Exclusion criteria included lack of hydronephrosis, or pathological findings. After careful screening and exclusion, we finally adopted 11 of these papers and analyzed them. Ketamine-associated UUT dysfunction may be a concern in this field.ConclusionKetamine abuse can lead to UUT impairment and dysfunction, with symptoms such as bladder dysfunction and contracted bladder with vesicoureteral reflux, direct damage and barrier dysfunction, inflammation, apoptosis, fibrosis and stricture, and papillary necrosis. Oxidative stress, autophagy, and microvascular injury are also potential pathogenic mechanisms. The detection of these symptoms largely depends on laboratory and imaging examinations. The treatment principles of ketamine-associated UUT dysfunction are protecting the UUT, improving bladder dysfunction, and resuming normal social life. More investigations are needed to clarify the mechanisms and shed light on the treatment of ketamine-associated UUT damage.展开更多
Objective Coronavirus disease 2019(COVID-19)can result in fatigue and post-exertional malaise;however,whether severe acute respiratory syndrome coronavirus 2(SARS-CoV-2)infection exacerbates lower urinary tract sympto...Objective Coronavirus disease 2019(COVID-19)can result in fatigue and post-exertional malaise;however,whether severe acute respiratory syndrome coronavirus 2(SARS-CoV-2)infection exacerbates lower urinary tract symptoms(LUTS)is unclear.This study investigated the association between prenatal SARS-CoV-2 infection and postpartum LUTS.Methods A multicenter,retrospective cohort study was conducted at two tertiary hospitals in China from November 1,2022,to November 1,2023.Participants were classified into infected and uninfected groups based on SARS-CoV-2 antigen results.LUTS prevalence and severity were assessed using self-reported symptoms and the Incontinence Impact Questionnaire-Short Form(IIQ-7).Pelvic floor muscle activity was measured using electromyography following the Glazer protocol.Group comparisons were performed to evaluate the association of SARS-CoV-2 infection with LUTS and electromyography parameters,with stratified analyses conducted using SPSS version 26.0.Results Among 3,652 participants(681 infected,2,971 uninfected),no significant differences in LUTS prevalence or IIQ-7 scores were observed.However,SARS-CoV-2 infection was an independent factor influencing the electromyographic activity of the pelvic floor muscles(mean tonic contraction amplitudes),regardless of delivery mode(P=0.001).Conclusion Prenatal SARS-CoV-2 infection was not significantly associated with an increased risk of postpartum LUTS but independently altered pelvic floor muscle electromyographic activity,suggesting potential neuromuscular effects.展开更多
In this study, we examined the relationship between sex hormone levels and lower urinary tract symptoms （LUTS） in men with benign prostatic hyperplasia （BPH） who underwent transurethral surgery. The study was cond...In this study, we examined the relationship between sex hormone levels and lower urinary tract symptoms （LUTS） in men with benign prostatic hyperplasia （BPH） who underwent transurethral surgery. The study was conducted in 158 patients who came to our hospital for surgery. Clinical conditions were assessed by body mass index （BMI）, digital rectal examination, International Prostate Symptom Score （IPSS） and transrectal ultrasound （TRUS）. The levels of sex hormones （including total testosterone （TT）, estradiol （E2）, progesterone （P）, luteinizing hormone （LH）, follicle-stimulating hormone （FSH） and prolactin （PRL）） and prostate-specific antigen （PSA） were reviewed. Correlations were determined through statistical analysis. The mean age was 72.06 _＋ 8.68 years. The total IPSS was significantly associated with the TT level （r = -0.21, P = 0.01）. Other sex hormone levels were not correlated with total IPSS. However, some ratios such as E2/TT （r = 0.23, P = 0o00） and FSH/LH （r = -0.17, P = 0.04） were associated with total IPSS. Further analysis showed that the nocturia was associated with age （r = 0.16, P = 0.04）, BMI （r = 0.21, P = 0.01）, and TT （r = -0.19, P = 0.02）. Moreover, we divided the patients into two subgroups based on IPSS severity （〈20 or 〉20）. The mean TT level was in the normal range, but it was significantly related to the presence of severe LUTS. In summary, our study has shown that the severity of LUTS is associated with TT, EJTT and FSH/LH in men who underwent prostate surgery. Increasing nocturia was observed in lower testosterone patients. Additional larger studies are needed to elucidate the potential mechanisms.展开更多
TanshinoneⅡA,extracted from Salvia miltiorrhiza Bunge,exerts neuroprotective effects through its anti-inflammatory,anti-oxidative and anti-apoptotic properties.This study intravenously injected tanshinoneⅡA 20 mg/kg...TanshinoneⅡA,extracted from Salvia miltiorrhiza Bunge,exerts neuroprotective effects through its anti-inflammatory,anti-oxidative and anti-apoptotic properties.This study intravenously injected tanshinoneⅡA 20 mg/kg into rat models of spinal cord injury for 7 consecutive days.Results showed that tanshinoneⅡA could reduce the inflammation,edema as well as compensatory thickening of the bladder tissue,improve urodynamic parameters,attenuate secondary injury,and promote spinal cord regeneration.The number of hypertrophic and apoptotic dorsal root ganglion(L6–S1)cells was less after treatment with tanshinoneⅡA.The effects of tanshinoneⅡA were similar to intravenous injection of 30 mg/kg methylprednisolone.These findings suggested that tanshinoneⅡA improved functional recovery after spinal cord injury-induced lower urinary tract dysfunction by remodeling the spinal pathway involved in lower urinary tract control.展开更多
Objective:To examine the relationship between benign prostatic hyperplasia(BPH)and the presence of lower urinary tract stones.Methods:We retrospectively reviewed the records of men with lower urinary tract stones who ...Objective:To examine the relationship between benign prostatic hyperplasia(BPH)and the presence of lower urinary tract stones.Methods:We retrospectively reviewed the records of men with lower urinary tract stones who presented to three clinical centers in Korea over a 4-year period.We divided the patients into two groups based on the location of urinary stones:Group 1(bladder calculi)and Group 2(urethral calculi).We compared the characteristics of both groups and performed univariate and multivariate analyses with a logistic regression model to investigate the relationship between BPH and lower urinary tract stones.Results:Of 221 patients,194(87.8%)had bladder calculi and 27(12.2%)had urethral calculi.The mean age of Group 1 was higher than that of Group 2(68.9612.11 years vs.55.7414.20 years,p<0.001).The mean prostate volume of Group 1 was higher than that of Group 2(44.4727.14 mL vs.24.706.41 mL,respectively,p<0.001).Multivariate logistic regression showed that age(OR Z 1.075,95%CI:1.023e1.129)and prostate volume(OR Z 1.069,95%CI:1.017e1.123)were independently associated with increased risk for bladder calculi.Upper urinary tract stones and/or hydronephrosis conferred a 3-fold risk for urethral calculi(OR Z 3.468,95%CI:1.093e10.999).Conclusion:Age and prostate volume are independent risk factors for bladder calculi.In addition,men with upper urinary tract disease are at greater risk for urethral calculi,which may migrate from the upper urinary tract rather than from the bladder.展开更多
Background:Urinary tract infections(UTI),urolithiasis,and benign prostatic hyperplasia(BPH)are three of the most common nonmalignant conditions in urology.However,there is still a lack of comprehensive and updated epi...Background:Urinary tract infections(UTI),urolithiasis,and benign prostatic hyperplasia(BPH)are three of the most common nonmalignant conditions in urology.However,there is still a lack of comprehensive and updated epidemiological data.This study aimed to investigate the disease burden of UTI,urolithiasis,and BPH in 203 countries and territories from 1990 to 2019.Methods:Data were extracted from the Global Burden of Disease 2019,including incident cases,deaths,disabilityadjusted life-years(DALYs)and corresponding age-standardized rate(ASR)from 1990 to 2019.Estimated annual percentage changes(EAPC)were calculated to evaluate the trends of ASR.The associations between disease burden and social development degrees were analyzed using a sociodemographic index(SDI).Results:Compared with 1990,the incident cases of UTI,urolithiasis,and BPH increased by 60.40%,48.57%,and 105.70%in 2019,respectively.The age-standardized incidence rate(ASIR)of UTI increased(EAPC=0.08),while urolithiasis(EAPC=–0.83)and BPH(EAPC=–0.03)decreased from 1990 to 2019.In 2019,the age-standardized mortality rate(ASMR)of UTI and urolithiasis were 3.13/100,000 and 0.17/100,000,respectively.BPH had the largest increase(110.56%)in DALYs in the past three decades,followed by UTI(68.89%)and urolithiasis(16.95%).The burden of UTI was mainly concentrated in South Asia and Tropical Latin America,while the burden of urolithiasis and BPH was recorded in Asia and Eastern Europe.Moreover,the ASIR and SDI of urolithiasis in high-SDI regions from 1990to 2019 were negatively correlated,while the opposite trend was seen in low-SDI regions.In 2019,the ASIR of UTI in females was 3.59 times that of males,while the ASIR of urolithiasis in males was 1.96 times higher than that in females.The incidence was highest in the 30–34,55–59,and 65–69 age groups among the UTI,urolithiasis,and BPH groups,respectively.Conclusions:Over the past three decades,the disease burden has increased for UTI but decreased for urolithiasis and BPH.The allocation of medical resources should be based more on the epidemiological characteristics and geographical distribution of diseases.展开更多
Summary: In order to study the association between lower urinary tract infection and cystitis glandularis (CG), 120 cases of CG were diagnosed by cystoscopic biopsy in the suspicious foci of the bladder. Among them, 7...Summary: In order to study the association between lower urinary tract infection and cystitis glandularis (CG), 120 cases of CG were diagnosed by cystoscopic biopsy in the suspicious foci of the bladder. Among them, 72 cases were subjected to bacterial counting culture of urine and microscopic examination of urinary sediment, and 60 cases to fluorescence quantitative polymerase chain reaction (FQ-PCR) assay to detect HPV, CMV and HSV DNA in urine samples. In the 72 cases of CG, the positive rate of bacterial counting culture of urine was 15.3 % (11/72), and gray zone rate was 18.1 % (13/72). 31.9 % (23/72) patients were positive in bacterioscopy of urinary sediment. There was statistically significant difference as compared with the control group (P<0.01). Only 4 of 60 urine samples were positive by FQ-PCR in detection of the three viruses mentioned above with the positive rate being 6.67 %. Compared with the control group, there was no significant difference (P>0.05). It was concluded that the genesis of CG was closely correlated with the chronic lower urinary tract infection, especially caused by Esch coli.展开更多
The present paper serves as a review of the associations between lower urinary tract symptoms （LUTS） and erectile dysfunction （ED）, with a focus on common and combined pathways for treatment. LUTS and ED are commo...The present paper serves as a review of the associations between lower urinary tract symptoms （LUTS） and erectile dysfunction （ED）, with a focus on common and combined pathways for treatment. LUTS and ED are common conditions seen in general urologic practice. Research has started to establish epidemiologic and pathophysiologic links between the two conditions and a strong association confirmed across multiple studies. Men seeking care for one condition should always be interviewed for complaints of the other condition. Proposed common pathways include α-1 adrenergic receptor imbalance, Rho-kinase overactivity, endothelial cell dysfunction and atherosclerosis-induced ischemia. Medical therapy has replaced surgery as the first-line treatment for LUTS in most patients, with the incorporation of α-adrenergic receptor antagonists （α-ARAs） and 5-α-reductase inhibitors （5-ARIs） into everyday practice. Treatment with α-ARAs contributes to some improvement in ED, whereas use of 5-ARIs results in worsened sexual function in some patients. Phosphodiesterase-5 （PDE-5） inhibitors have revolutionized the treatment of ED with a simple oral regimen, and new insights demonstrate a benefit of combined use of PDE-5 inhibitors and α-ARAs. The mechanisms of action of these medications support these observed benefits, and they are being studied in the basic science and clinical settings. In addition, novel mechanisms for therapy have been proposed based on clinical and research observations. The minimally invasive and surgical treatments for LUTS are known to have adverse effects on ejaculatory function, while their effects on erectile function are still debated. Much remains to be investigated, but it is clear that the associations between LUTS and ED lay the foundation for future therapies and possible preventative strategies.展开更多
Lower urinary tract symptoms suggestive of benign prostate hyperplasia(LUTS/BPH)and depression are both increasing in Chinese aging males.However,the relationship still remains unknown.To explore their relationship,a ...Lower urinary tract symptoms suggestive of benign prostate hyperplasia(LUTS/BPH)and depression are both increasing in Chinese aging males.However,the relationship still remains unknown.To explore their relationship,a retrospective cohort study based on propensity score matching(PSM)was conducted by analyzing the China Health and Retirement Longitudinal Study dataset.After data cleaning,a total of 5125 participants were enrolled and subjected to PSM;1351 pairs were matched and followed for 2 years.Further logistic regression and restricted cubic spline(RCS)were performed to evaluate,model and visualize the relationship between depression and LUTS/BPH.Moreover,subgroup analyses and sensitivity analyses were adopted to verify the robustness of the conclusions.Before PSM,depressive patients showed higher odds of LUTS/BPH in all three models adjusting for different covariates(P<0.001).After PSM,univariate logistic regression revealed that depressive patients had higher risks for LUTS/BPH than participants in the control group(odds ratio[OR]=2.10,P<0.001).The RCS results indicated a nonlinear(P<0.05)and inverted U-shaped relationship between depression and LUTS/BPH.In the subgroup analyses,no increased risks were found among participants who were not married or cohabitating,received an education,had an abnormal body mass index(<18.5 kg m−2 and≥28 kg m−2),slept more than 6 h,did not smoke,and drank less than once a month(all P>0.05).The results of sensitivity analyses indicated identical increased risks of LUTS/BPH in all four models(all P<0.001).In conclusion,depression enhances the risks of LUTS/BPH in aging males.展开更多
We analyzed the effects of obesity on lower urinary tract symptoms （LUTSs） in Korean benign prostatic hyperplasia （BPH） patients. This is a multicenter, cross-sectional, prospective study conducted in four centers...We analyzed the effects of obesity on lower urinary tract symptoms （LUTSs） in Korean benign prostatic hyperplasia （BPH） patients. This is a multicenter, cross-sectional, prospective study conducted in four centers in Korea. A total of 602 men with LUTSs secondary to BPH were included. BPH/LUTSs cases were men aged ≥ 40 years with intemational prostate symptom scores （IPSS） ≥ 8 points. Height, weight and waist circumference were measured. Among the 602 patients, 156 patients had a waist circumference above 90 cm, representing central obesity, and 215 patients had a body mass index above 25 kg m2. Waist circumference was positively correlated with prostate volume （P = 0.034）. Men with waist circumference 〉 90 cm experienced a 1.36-fold increased risk of severe LUTSs （95% CI 0.82-2.41） compared with men with waist circumference ≤ 90 cm. Prostate volume was positively correlated with urgency and nocturia in men with central obesity. In this population of Korean men diagnosed with BPH, central obesity rather than overall obesity seems to be the more important predictor of LUTSs correlated with BPH.展开更多
文摘Urinary tract infections(UTIs)are among the most prevalent pediatric bacterial infections,and undertreated episodes may lead to renal scarring,hypertension,or chronic kidney disease.Multidrug-resistant(MDR)Enterobacterales have been increasingly reported in children,with higher rates in Asian and Middle Eastern settings than in high-income countries[1,2].
文摘Objective:This study aims to develop a drug controlled-release system based on nano-hydrogel technology for stone dissolution and evaluate its dual efficacy in synchronously dissolving calcium oxalate stones and inhibiting uropathogenic Escherichia coli.Methods:A pH-responsive chitosan(CS)-sodium alginate(SA)-hydrogel microsphere loaded with potassium sodium hydrogen citrate and fosfomycin(CS/SA@PSHC@CS@F)was constructed using ionic cross-linking.In vitro stone dissolution experiments were conducted to determine drug release kinetics and stone mass reduction rate under different pH environments,and the antibacterial activity against E.coli ATCC 25922 was evaluated using the plate counting method.A rat model of kidney stone combined with infection was established.Stone volume changes were quantified via micro-CT,urinary interleukin-6(IL-6)and tumor necrosis factorα(TNF-α)levels were measured by ELISA,and renal tissue inflammation was scored via histopathological evaluation.Results:The 24-hour cumulative release rate of CS/SA@PSHC@CS@F at pH 5.8 reached 92.3%±4.1%,significantly higher than at pH 7.4(31.2%±3.7%,P<0.01).At 72 h,the mass reduction rate of calcium oxalate stones in CS/SA@PSHC@CS@F was 68.9%±5.2%,significantly higher than that of the PSHC+F mixture(P<0.01).Antibacterial experiments confirmed that the inhibition rate of biofilm colonies by CS/SA@PSHC@CS@F could reach 82.4%±6.7%,compared to 58.2%±5.3%for F,with a statistically significant difference(P<0.01).Animal experiments showed that the stone volume reduction rate in the CS/SA@PSHC@CS@F group was62.3%±8.1%,higher than that in the PSHC+F group,and the decrease in urinary IL-6 level after administration was more significant,while there was no significant difference in TNF-αlevel compared with the other two groups(P>0.05).The renal tissue inflammation score decreased to 2(1,2)points,showing a significant reduction compared with the other two groups(P<0.05).Conclusion:The novel controlled-release system designed in this study achieves targeted drug release in the stone infection microenvironment through the ion exchange mechanism,simultaneously enhancing stone dissolution efficiency and antibacterial effect,thereby providing a new drug delivery strategy for the treatment of urinary stones combined with infection.
文摘Background:Urinary tract infections(UTIs),primarily caused by uropathogenic Escherichia coli(UPEC),are a significant global health concern.The complications arise from antibiotic resistance and biofilm formation,which reduce the effectiveness of conventional treatments.This study aims to evaluate the antibiofilm activity of the homeopathic medicine Terebinthinae oleum in potencies 30C,200C,and 1M against UTI-causing E.coli,and to compare its effectiveness with the standard antibiotic Gentamycin.Methods:An in-vitro biofilm model was employed.E.coli biofilms were cultivated in microtiter plates and treated with Terebinthinae oleum(30C,200C,1M)and Gentamycin.Biofilm biomass was assessed through crystal violet staining,and optical density(OD)was measured using an ELISA microplate reader.Results:Among the tested potencies,Terebinthinae oleum 30C showed the most prominent inhibitory activity on E.coli biofilms.The inhibition percentage was compared with Gentamycin as a control.Terebinthinae oleum 30C demonstrated 41.88%inhibition of biofilm biomass,while Gentamycin exhibited up to 78.98%inhibition.Higher potencies of Terebinthinae oleum(200C and 1M)showed reduced activity(30.15%and 24.81%,respectively).Conclusion:Terebinthinae oleum,especially at 30C potency,exhibits measurable antibiofilm activity against E.coli,although less effective than Gentamycin.These findings support its use as a complementary therapy in managing biofilm-associated UTIs,justifying further clinical and immunological research.
文摘BACKGROUND Pelvic fractures are often associated with significant morbidity,including injuries to the urinary tract.Understanding the incidence and risk factors for urinary tract injury in these patients is crucial for prompt diagnosis and management.This meta-analysis aims to synthesize existing evidence to determine the overall incidence and identify specific risk factors associated with urinary tract injuries in patients with pelvic fractures.AIM To determine the incidence and risk factors for urinary tract injuries in patients with pelvic fractures.METHODS A systematic search of PubMed,EMBASE,Scopus,and the Cochrane Library was conducted without date restrictions.Studies examining the incidence and risk factors of urinary tract injuries in patients with pelvic fractures were included.Data extracted included demographics,injury mechanism,pelvic fracture type,urinary tract injury incidence,mortality,and discharge disposition.Review Manager 5.4 was used for data analysis.RESULTS Ten studies comprising 22700 patients were included.The pooled incidence of urinary tract injury associated with pelvic fracture was 6.88%(95%CI:6.20%-7.55%).Vehicle,motorcycle,and pedestrian accidents were identified as risk factors for urinary tract injury,with relative risks(RR)of 1.08(95%CI:1.06-1.11),1.89(95%CI:1.78-2.00),and 1.53(95%CI:1.20-1.95),respectively.Pubic fracture and pelvic ring disruption were significantly associated with urinary tract injury[odds ratio(OR)1.94,95%CI:1.09-3.44 and OR 5.53,95%CI:4.67-6.54,respectively)].Patients without urinary tract injury were more likely to be discharged home(RR 0.79,95%CI:0.67-0.92).Mortality was higher in patients with urinary tract injury(OR 1.92,95%CI:1.77-2.09).CONCLUSION Urinary tract injury occurs in nearly 7%of patients with pelvic fractures.Motorcycle accidents,pubic fractures,and pelvic ring disruptions are significant risk factors.Urinary tract injury following pelvic fracture is associated with increased mortality.
基金supported by the Project of National Natural Science Foundation(82372206)the Project of Jiangsu Provincial Health Commission(H2023107)the Project of Basic and Clinical Research on Cardiac Arrest in the Emergency and Critical Care Department of the Second Affi liated Hospital of Soochow University(XKTJ-XK202408-2).
文摘Colorectal cancer is a common tumor of the digestive system and is the third leading cause of cancer-related death worldwide.The global incidence of colorectal cancer is currently increasing.In some patients,the tumor has already spread to nearby organs at the time of diagnosis,with the small intestine and bladder being common sites of invasion.[1,2]The diagnosis of colorectal cancer that has spread to the bladder can be challenging.Aside from a few patients who experience urinary symptoms due to invasion of the bladder trigone or the entire bladder wall,there are no distinct clinical signs,which often leads to misdiagnosis.The following case report details one such instance.
文摘Urinary tract infections(UTIs)are the most common bacterial infections.Escherichia coli is the most common cause of UTIs,accounting for 50%of hospital-reported and 90%of community-reported cases.Also,this includes species of Klebsiella,Proteus,Acinetobacter,Pseudomonas,Staphylococcus,Streptococcus,and Enterococcus.Patients experience cystitis,polyuria,and dysuria.If untreated,this affects the kidneys,further leading to septicemia.UTIs majorly affect adult females(40%-60%).Microbiological culture has been proven to be the standard method.However,it takes 48-72 hours for the tests to be reported.In cases of recurrent UTI,it is mandatory to have a quick,sensitive,and specific diagnostic procedure.Dipstick tests are considered early methods for diagnosing UTIs;however,they have limitations.Recently,biomarkers are being used to assess the severity of the disease.To achieve the United Nations Sustainable Development Goals 3 and 8,the expertise from General Medicine,Biotechnology,and Microbiology come together in achieving the set targets by 2030.In addition to diagnosis of UTI,resistance to antibiotics should not be neglected.This review aimed to examine the clinical relevance of biomarkers such as neutrophil gelatinase-associated lipocalin,kidney injury molecule-1,interleukin(IL)6,IL-8,heparin-binding protein,procalcitonin,lipopolysaccharide-binding protein,xanthine oxidase,cell-free DNA,and transrenal DNA.
基金financially supported by the Natural Science Foundation of China(No.82003766)Taishan Scholars Program(NO.tsqn202211219)+1 种基金the Key Research and Development Project of Shandong Province(No.2021ZDSYS27)Shandong Province nature fund surface project(Grant No.ZR2024MH088)。
文摘Background:Studies have shown that individuals who receive early treatment for rheumatoid arthritis(RA)are more likely to approach life positively,avoiding joint damage and the need for joint replacement surgery.The diagnosis of early rheumatoid arthritis(ERA)is crucial for effective treatment and prognosis of patients.Urine,as a diagnostic medium,offers the advantages of non-invasive diagnosis.Urinary metabolites can serve as biomarkers for diagnosis,prognosis,and risk prediction,improving specificity and accuracy.Methods:We recruited 37 ERA patients with a history of less than 3 months and a score of 6,26 osteoarthritis(OA)patients,and 30 healthy controls(HC).Urine samples were collected for 16S rRNA sequencing,and untargeted liquid chromatography-mass spectrometry(LC-MS)was used to detect metabolites.Bioinformatics approaches were employed to identify pathogenic metabolites as specific risk factors for ERA precisely.Results:2-methylnaphthalene was identified as a biomarker for ERA in urine.Prevotella,a major part of the urinary microbiome in ERA patients,exhibited a positive correlation with 2-methylnaphthalene.Notably,there were significant variations in urine metabolites among patients with ERA,OA,and HC.2-Methylnaphthalene was found to be significantly enriched in ERA.Besides,inflammatory factors were elevated in ERA patients.The research further demonstrated a positive correlation between rheumatoid factor(RF),erythrocyte sedimentation rate(ESR),and C-reactive protein(CRP)and the metabolite 2-methylnaphthalene.Conclusion:The urine metabolite 2-methylnaphthalene can be a risk factor for early urinary tract infections and may contribute to accurately screening early-risk metabolites in ERA.
基金supported(in part)by the National Key Research and Development Program(2022YFC3600700)the Fundamental Research Funds for the Central Universities(2042024YXA008)the Young Top-Notch Talent Cultivation Program of Hubei Province(for Prof.Xian-Tao Zeng).
文摘Background:The burden of common urologic diseases,including benign prostatic hyperplasia(BPH),urinary tract infections(UTI),urolithiasis,bladder cancer,kidney cancer,and prostate cancer,varies both geographically and within specific regions.It is essential to conduct a comprehensive and precise assessment of the global burden of urologic diseases.Methods:We obtained data on incidence,prevalence,mortality,and disability-adjusted life-years(DALYs)for the aforementioned urologic diseases by age,sex,location,and year from the Global Burden of Disease(GBD)2021.We analyzed the burden associated with urologic diseases based on socio-demographic index(SDI)and attributable risk factors.The trends in burden over time were assessed using estimated annual percentage changes(EAPC)along with a 95%confidence interval(CI).Results:In 2021,BPH and UTI were the leading causes of age-standardized incidence rate(ASIR)and age-standardized prevalence rate(ASPR),with rates of 5531.88 and 2782.59 per 100,000 persons,respectively.Prostate cancer was the leading cause of both age-standardized mortality rate(ASMR)and age-standardized DALYs rate(ASDR),with rates of 12.63 and 217.83 per 100,000 persons,respectively.From 1990 to 2021,there was an upward trend in ASIR,ASPR,ASMR,and ASDR for UTI,while urolithiasis showed a downward trend.The middle and low-middle SDI quintile levels exhibited higher incidence,prevalence,mortality,and DALYs related to UTI,urolithiasis,and BPH,while the high and high-middle SDI quintile levels showed higher rates for the three cancers.The burden of these 6 urologic diseases displayed diverse age and sex distribution patterns.In 2021,a high body mass index(BMI)contributed to 20.07%of kidney cancer deaths worldwide,while smoking accounted for 26.48%of bladder cancer deaths and 3.00%of prostate cancer deaths.Conclusions:The global burden of 6 urologic diseases presents a significant public health challenge.Urgent international collaboration is essential to advance the improvement of urologic disease management,encompassing the development of effective diagnostic screening tools and the implementation of high-quality prevention and treatment strategies.
文摘BACKGROUND Urinary tract infections(UTIs)in kidney transplant patients are a challenge.AIM To evaluate epidemiology,clinical status,therapeutic management,and clinical outcome of kidney transplant patients in a university hospital for UTI.METHODS We conducted a retrospective observational study,enrolling all kidney transplant patients hospitalized for UTI,with the objective to evaluate the epidemiology,clinical status,therapeutic management,and clinical outcome of kidney transplant patients.RESULTS From our real-life experience,infection with multidrug-resistant germs was confirmed as a risk factor for the severe evolution of the infection.At the same time,the re-evaluation of immunosuppressive therapy could be an important therapeutic strategy in the course of infection.CONCLUSION Prompt initiation of empiric antibiotic therapy upon initiation of microbiological investigations may reduce the risk of severe infection progression.
文摘Objective:To investigate the preventive effect of evidence-based preventive nursing on urinary tract infections(UTIs)in elderly female diabetic patients.Methods:Seventy-nine elderly female diabetic patients admitted to our hospital from March 2023 to March 2025 were selected and randomly divided into observation group(40 cases)and control group(39 cases)using the envelope method.The control group received routine nursing,while the observation group received evidence-based preventive nursing.The outcomes were compared between the two groups.Results:After treatment,blood glucose levels in both groups were significantly reduced,and the improvement in various indicators in the observation group was better than that in the control group(P<0.05).Additionally,quality of life scores were significantly improved in both groups,with the observation group showing better improvement than the control group(P<0.05).The duration of catheter indwelling and hospital stay in the observation group were lower than those in the control group(P<0.05).Conclusion:Evidence-based preventive nursing can systematically reduce the risk of urinary tract infections,improve patient outcomes,and provide effective references for clinical nursing practice.
文摘ObjectiveTo review the current literature on ketamine-associated upper urinary tract (UUT) dysfunction and provide an overview of its pathogenesis and treatment principles.MethodsA literature search was conducted using PubMed and Cochrane databases for relevant articles published in English between 2008 and 2023. Keywords used included “ketamine” and “upper urinary tract”.ResultsA total of 22 papers were included. Relatively few studies have focused on ketamine-associated UUT dysfunction. Exclusion criteria included lack of hydronephrosis, or pathological findings. After careful screening and exclusion, we finally adopted 11 of these papers and analyzed them. Ketamine-associated UUT dysfunction may be a concern in this field.ConclusionKetamine abuse can lead to UUT impairment and dysfunction, with symptoms such as bladder dysfunction and contracted bladder with vesicoureteral reflux, direct damage and barrier dysfunction, inflammation, apoptosis, fibrosis and stricture, and papillary necrosis. Oxidative stress, autophagy, and microvascular injury are also potential pathogenic mechanisms. The detection of these symptoms largely depends on laboratory and imaging examinations. The treatment principles of ketamine-associated UUT dysfunction are protecting the UUT, improving bladder dysfunction, and resuming normal social life. More investigations are needed to clarify the mechanisms and shed light on the treatment of ketamine-associated UUT damage.
基金supported by National High Level Hospital Clinical Research Funding[BJ-2023-112,BJ-2018-204]Central Government Guidance Fund for Local Science and Technology Development[202407AB110013].
文摘Objective Coronavirus disease 2019(COVID-19)can result in fatigue and post-exertional malaise;however,whether severe acute respiratory syndrome coronavirus 2(SARS-CoV-2)infection exacerbates lower urinary tract symptoms(LUTS)is unclear.This study investigated the association between prenatal SARS-CoV-2 infection and postpartum LUTS.Methods A multicenter,retrospective cohort study was conducted at two tertiary hospitals in China from November 1,2022,to November 1,2023.Participants were classified into infected and uninfected groups based on SARS-CoV-2 antigen results.LUTS prevalence and severity were assessed using self-reported symptoms and the Incontinence Impact Questionnaire-Short Form(IIQ-7).Pelvic floor muscle activity was measured using electromyography following the Glazer protocol.Group comparisons were performed to evaluate the association of SARS-CoV-2 infection with LUTS and electromyography parameters,with stratified analyses conducted using SPSS version 26.0.Results Among 3,652 participants(681 infected,2,971 uninfected),no significant differences in LUTS prevalence or IIQ-7 scores were observed.However,SARS-CoV-2 infection was an independent factor influencing the electromyographic activity of the pelvic floor muscles(mean tonic contraction amplitudes),regardless of delivery mode(P=0.001).Conclusion Prenatal SARS-CoV-2 infection was not significantly associated with an increased risk of postpartum LUTS but independently altered pelvic floor muscle electromyographic activity,suggesting potential neuromuscular effects.
文摘In this study, we examined the relationship between sex hormone levels and lower urinary tract symptoms （LUTS） in men with benign prostatic hyperplasia （BPH） who underwent transurethral surgery. The study was conducted in 158 patients who came to our hospital for surgery. Clinical conditions were assessed by body mass index （BMI）, digital rectal examination, International Prostate Symptom Score （IPSS） and transrectal ultrasound （TRUS）. The levels of sex hormones （including total testosterone （TT）, estradiol （E2）, progesterone （P）, luteinizing hormone （LH）, follicle-stimulating hormone （FSH） and prolactin （PRL）） and prostate-specific antigen （PSA） were reviewed. Correlations were determined through statistical analysis. The mean age was 72.06 _＋ 8.68 years. The total IPSS was significantly associated with the TT level （r = -0.21, P = 0.01）. Other sex hormone levels were not correlated with total IPSS. However, some ratios such as E2/TT （r = 0.23, P = 0o00） and FSH/LH （r = -0.17, P = 0.04） were associated with total IPSS. Further analysis showed that the nocturia was associated with age （r = 0.16, P = 0.04）, BMI （r = 0.21, P = 0.01）, and TT （r = -0.19, P = 0.02）. Moreover, we divided the patients into two subgroups based on IPSS severity （〈20 or 〉20）. The mean TT level was in the normal range, but it was significantly related to the presence of severe LUTS. In summary, our study has shown that the severity of LUTS is associated with TT, EJTT and FSH/LH in men who underwent prostate surgery. Increasing nocturia was observed in lower testosterone patients. Additional larger studies are needed to elucidate the potential mechanisms.
基金supported by the China Postdoctoral Science Foundation,No.2015M581120
文摘TanshinoneⅡA,extracted from Salvia miltiorrhiza Bunge,exerts neuroprotective effects through its anti-inflammatory,anti-oxidative and anti-apoptotic properties.This study intravenously injected tanshinoneⅡA 20 mg/kg into rat models of spinal cord injury for 7 consecutive days.Results showed that tanshinoneⅡA could reduce the inflammation,edema as well as compensatory thickening of the bladder tissue,improve urodynamic parameters,attenuate secondary injury,and promote spinal cord regeneration.The number of hypertrophic and apoptotic dorsal root ganglion(L6–S1)cells was less after treatment with tanshinoneⅡA.The effects of tanshinoneⅡA were similar to intravenous injection of 30 mg/kg methylprednisolone.These findings suggested that tanshinoneⅡA improved functional recovery after spinal cord injury-induced lower urinary tract dysfunction by remodeling the spinal pathway involved in lower urinary tract control.
文摘Objective:To examine the relationship between benign prostatic hyperplasia(BPH)and the presence of lower urinary tract stones.Methods:We retrospectively reviewed the records of men with lower urinary tract stones who presented to three clinical centers in Korea over a 4-year period.We divided the patients into two groups based on the location of urinary stones:Group 1(bladder calculi)and Group 2(urethral calculi).We compared the characteristics of both groups and performed univariate and multivariate analyses with a logistic regression model to investigate the relationship between BPH and lower urinary tract stones.Results:Of 221 patients,194(87.8%)had bladder calculi and 27(12.2%)had urethral calculi.The mean age of Group 1 was higher than that of Group 2(68.9612.11 years vs.55.7414.20 years,p<0.001).The mean prostate volume of Group 1 was higher than that of Group 2(44.4727.14 mL vs.24.706.41 mL,respectively,p<0.001).Multivariate logistic regression showed that age(OR Z 1.075,95%CI:1.023e1.129)and prostate volume(OR Z 1.069,95%CI:1.017e1.123)were independently associated with increased risk for bladder calculi.Upper urinary tract stones and/or hydronephrosis conferred a 3-fold risk for urethral calculi(OR Z 3.468,95%CI:1.093e10.999).Conclusion:Age and prostate volume are independent risk factors for bladder calculi.In addition,men with upper urinary tract disease are at greater risk for urethral calculi,which may migrate from the upper urinary tract rather than from the bladder.
基金supported by the National Key Research and Development Plan of China(Technology helps Economy 2020)the Fundamental Research Funds for the Central Universities(2042020kf1081)+2 种基金the Nature Science Foundation of Hubei Province(2019CFB760)the Translational Medicine and Interdisciplinary Research Joint Fund of Zhongnan Hospital of Wuhan University(ZNJC201917)the Health Commission of the Hubei Province Scientific Research Project(WJ2019H035)。
文摘Background:Urinary tract infections(UTI),urolithiasis,and benign prostatic hyperplasia(BPH)are three of the most common nonmalignant conditions in urology.However,there is still a lack of comprehensive and updated epidemiological data.This study aimed to investigate the disease burden of UTI,urolithiasis,and BPH in 203 countries and territories from 1990 to 2019.Methods:Data were extracted from the Global Burden of Disease 2019,including incident cases,deaths,disabilityadjusted life-years(DALYs)and corresponding age-standardized rate(ASR)from 1990 to 2019.Estimated annual percentage changes(EAPC)were calculated to evaluate the trends of ASR.The associations between disease burden and social development degrees were analyzed using a sociodemographic index(SDI).Results:Compared with 1990,the incident cases of UTI,urolithiasis,and BPH increased by 60.40%,48.57%,and 105.70%in 2019,respectively.The age-standardized incidence rate(ASIR)of UTI increased(EAPC=0.08),while urolithiasis(EAPC=–0.83)and BPH(EAPC=–0.03)decreased from 1990 to 2019.In 2019,the age-standardized mortality rate(ASMR)of UTI and urolithiasis were 3.13/100,000 and 0.17/100,000,respectively.BPH had the largest increase(110.56%)in DALYs in the past three decades,followed by UTI(68.89%)and urolithiasis(16.95%).The burden of UTI was mainly concentrated in South Asia and Tropical Latin America,while the burden of urolithiasis and BPH was recorded in Asia and Eastern Europe.Moreover,the ASIR and SDI of urolithiasis in high-SDI regions from 1990to 2019 were negatively correlated,while the opposite trend was seen in low-SDI regions.In 2019,the ASIR of UTI in females was 3.59 times that of males,while the ASIR of urolithiasis in males was 1.96 times higher than that in females.The incidence was highest in the 30–34,55–59,and 65–69 age groups among the UTI,urolithiasis,and BPH groups,respectively.Conclusions:Over the past three decades,the disease burden has increased for UTI but decreased for urolithiasis and BPH.The allocation of medical resources should be based more on the epidemiological characteristics and geographical distribution of diseases.
文摘Summary: In order to study the association between lower urinary tract infection and cystitis glandularis (CG), 120 cases of CG were diagnosed by cystoscopic biopsy in the suspicious foci of the bladder. Among them, 72 cases were subjected to bacterial counting culture of urine and microscopic examination of urinary sediment, and 60 cases to fluorescence quantitative polymerase chain reaction (FQ-PCR) assay to detect HPV, CMV and HSV DNA in urine samples. In the 72 cases of CG, the positive rate of bacterial counting culture of urine was 15.3 % (11/72), and gray zone rate was 18.1 % (13/72). 31.9 % (23/72) patients were positive in bacterioscopy of urinary sediment. There was statistically significant difference as compared with the control group (P<0.01). Only 4 of 60 urine samples were positive by FQ-PCR in detection of the three viruses mentioned above with the positive rate being 6.67 %. Compared with the control group, there was no significant difference (P>0.05). It was concluded that the genesis of CG was closely correlated with the chronic lower urinary tract infection, especially caused by Esch coli.
文摘The present paper serves as a review of the associations between lower urinary tract symptoms （LUTS） and erectile dysfunction （ED）, with a focus on common and combined pathways for treatment. LUTS and ED are common conditions seen in general urologic practice. Research has started to establish epidemiologic and pathophysiologic links between the two conditions and a strong association confirmed across multiple studies. Men seeking care for one condition should always be interviewed for complaints of the other condition. Proposed common pathways include α-1 adrenergic receptor imbalance, Rho-kinase overactivity, endothelial cell dysfunction and atherosclerosis-induced ischemia. Medical therapy has replaced surgery as the first-line treatment for LUTS in most patients, with the incorporation of α-adrenergic receptor antagonists （α-ARAs） and 5-α-reductase inhibitors （5-ARIs） into everyday practice. Treatment with α-ARAs contributes to some improvement in ED, whereas use of 5-ARIs results in worsened sexual function in some patients. Phosphodiesterase-5 （PDE-5） inhibitors have revolutionized the treatment of ED with a simple oral regimen, and new insights demonstrate a benefit of combined use of PDE-5 inhibitors and α-ARAs. The mechanisms of action of these medications support these observed benefits, and they are being studied in the basic science and clinical settings. In addition, novel mechanisms for therapy have been proposed based on clinical and research observations. The minimally invasive and surgical treatments for LUTS are known to have adverse effects on ejaculatory function, while their effects on erectile function are still debated. Much remains to be investigated, but it is clear that the associations between LUTS and ED lay the foundation for future therapies and possible preventative strategies.
基金This work was supported by the Natural Science Foundation of China(No.81871147 and No.81671453)Sichuan Science and Technology Program(2018TJPT0018)Chengdu Science and Technology Program(No.2019-YFYF-00087-SN).
文摘Lower urinary tract symptoms suggestive of benign prostate hyperplasia(LUTS/BPH)and depression are both increasing in Chinese aging males.However,the relationship still remains unknown.To explore their relationship,a retrospective cohort study based on propensity score matching(PSM)was conducted by analyzing the China Health and Retirement Longitudinal Study dataset.After data cleaning,a total of 5125 participants were enrolled and subjected to PSM;1351 pairs were matched and followed for 2 years.Further logistic regression and restricted cubic spline(RCS)were performed to evaluate,model and visualize the relationship between depression and LUTS/BPH.Moreover,subgroup analyses and sensitivity analyses were adopted to verify the robustness of the conclusions.Before PSM,depressive patients showed higher odds of LUTS/BPH in all three models adjusting for different covariates(P<0.001).After PSM,univariate logistic regression revealed that depressive patients had higher risks for LUTS/BPH than participants in the control group(odds ratio[OR]=2.10,P<0.001).The RCS results indicated a nonlinear(P<0.05)and inverted U-shaped relationship between depression and LUTS/BPH.In the subgroup analyses,no increased risks were found among participants who were not married or cohabitating,received an education,had an abnormal body mass index(<18.5 kg m−2 and≥28 kg m−2),slept more than 6 h,did not smoke,and drank less than once a month(all P>0.05).The results of sensitivity analyses indicated identical increased risks of LUTS/BPH in all four models(all P<0.001).In conclusion,depression enhances the risks of LUTS/BPH in aging males.
文摘We analyzed the effects of obesity on lower urinary tract symptoms （LUTSs） in Korean benign prostatic hyperplasia （BPH） patients. This is a multicenter, cross-sectional, prospective study conducted in four centers in Korea. A total of 602 men with LUTSs secondary to BPH were included. BPH/LUTSs cases were men aged ≥ 40 years with intemational prostate symptom scores （IPSS） ≥ 8 points. Height, weight and waist circumference were measured. Among the 602 patients, 156 patients had a waist circumference above 90 cm, representing central obesity, and 215 patients had a body mass index above 25 kg m2. Waist circumference was positively correlated with prostate volume （P = 0.034）. Men with waist circumference 〉 90 cm experienced a 1.36-fold increased risk of severe LUTSs （95% CI 0.82-2.41） compared with men with waist circumference ≤ 90 cm. Prostate volume was positively correlated with urgency and nocturia in men with central obesity. In this population of Korean men diagnosed with BPH, central obesity rather than overall obesity seems to be the more important predictor of LUTSs correlated with BPH.
