Sexually transmitted infections (STIs) represent a public health problem due to their high prevalence worldwide and the emergence of multidrug resistance of responsible microorganisms. Medical laboratory diagnosis of ...Sexually transmitted infections (STIs) represent a public health problem due to their high prevalence worldwide and the emergence of multidrug resistance of responsible microorganisms. Medical laboratory diagnosis of sexually transmitted genital infections by traditional methods as culture remains extremely delicate, difficult or impossible (to find extremely fragile organisms that can be cultured). Thus, molecular techniques constitute an alternative to improve accurate diagnostic, personalized patient treatment, and public health. A total of 83 clinical samples including urethral discharge and urine samples from individual patients with symptoms of urethritis received were analyzed using traditional methods and a commercial real-time PCR (qPCR) method. Out of 83 urethritis patients, n = 55 (66.26%) were positive for at least one of the STI pathogens detected by qPCR. qPCR assay was more sensitive (50/83, positive cases) compared to culture (15/83, positive cases) and light microscopy (28/83, positive cases). The most prevalent NTD pathogen in the suspected patients was N. gonorrhoeae with 60.24% (50/83) based on real-time PCR diagnosis. Among the positive cases of STI pathogens, Neisseria gonorrhoeae had the highest frequency 49/55 (89.01%) followed by low frequencies of Trichomonas vaginalis 4/55 (7.27%) and Chlamydia trachomatis 1/55 (1.82%). This highlights the high prevalence of N. gonorrhoeae infection in male urethritis patients and a very important misdiagnosis using traditional routine methods in Burkina Faso by medical laboratories. Thus, this situation may negatively impact patients’ personalized treatment and care and public health with the possible rapid emergence of multidrug-resistant strains. This study also highlights the urgent need to optimize culture for the diagnosis of NTD pathogens in Burkina Faso and the usefulness and the need for the introduction of molecular diagnostic methods in routine diagnosis for the detection of NTD pathogens in the medical laboratories in Burkina Faso.展开更多
Introduction: Gonorrhoeae and antimicrobial resistance AMR of gonococci is a major health problem today, because emerged resistance to last line empirical treatment for gonorrhoeae cephalosporins in many countries is ...Introduction: Gonorrhoeae and antimicrobial resistance AMR of gonococci is a major health problem today, because emerged resistance to last line empirical treatment for gonorrhoeae cephalosporins in many countries is predictable to be untreatable disease in near future. WHO GASP, WHO GLASS and WHO’s global action plan on AMR recommends to expand nationally and internationally to collect data to monitor AMR of gonococci for public health policies. Objective: Our aim is to detect resistance of gonococci to Cepha- losporins and determine the most effective empirical treatment for un-com- plicated gonococcal urethritis in males in Egypt. Methods: We depended in our methodology on selected gonococci from male urethral discharge specimens on Thyer Martien medium;collected 33 isolates during three years from 2017 to 2020;used antibiotics with MIC according to international standards and measuring IZD according to antimicrobial susceptibility testing reference ranges in international standards. Results: By statistical studies, resistance to cephalosporins was as follows: Cephradine 97%, Cefaclor 87.9%, Cefoxitin 97%, Ceftriaxone 90.9% and 42.4% to Cefepime, that shows hetero-genecity in resistance inside cephalosporin group;while resistance to Macrolides group represented by Azithromycin and Tetracyclins group represented by Doxycycline was as follows: Azithromycin 39.4%, Doxycycilne 27.3%;finally fluoroquinolones, the most effective group, resistance, was as: Levofloxacin 15.2%, Ciprofloxacin 15.2% and Ofloxacin 24.2%. Conclusion: The most effective empirical treatment for uncomplicated gonococcal urethritis in males in EGYPT is Fluoroquinolone;especially Levofloxacin ranks first susceptibility as 78.8% and 15.2% resistance followed by Ciprofloxacin susceptibility as 69.7% and 15.2% resistance, finally Ofloxacin susceptibility as 66.7% and 24.2% resistance;for Ceftriaxone not more recommended in EGYPT as empirical treatment for uncomplicated gonococcal urethritis, it is susceptibility as 6.1% and 90.9% resistance;in addition, we can use combination therapy of Fluoroquinolones with Azithromycin or Doxycycline, whose susceptibility is 30.3% for Azithromycin and 42.4% for Doxycycycline, while resistance is 39.4% for Azithromycin and 27.3% for Doxycycline. It is worth noting that only Cefepime in Cephalosporins group represents 42.4% susceptibility and 42.4% resistance;in addition to the Carbapenems group, it represents as 42.4% susceptibility for Imipenem and 45.5% resistance, then 42.2% susceptibility for Meropenem and 48.5% resistance, which can play role in combination therapy.展开更多
Objective: To investigate the prevalence of myco-plasma infections and the sensitivity to antibiotics among patients with nongonococcal urethritis or cer-vicitis (NGU) in Chongqing. Methods: 387 NGU cases with mycopla...Objective: To investigate the prevalence of myco-plasma infections and the sensitivity to antibiotics among patients with nongonococcal urethritis or cer-vicitis (NGU) in Chongqing. Methods: 387 NGU cases with mycoplasma-positive results upon culture were analysed retrospectively. RESULTS: The majority of patients with mycoplasma infections were in the 20-40 year old age group. No significant difference was found between males and females. Ureaplasma urealyticum is the main pathogen of these NGU cases and no clear relationship between its concentration and pathogenic ability was noted. Drug sensitivity was tested against nine antibiotics; the sensitivity rates to josamycim, minocycline and doxycycline were 94.06%, 88.89% and 86.82% respectively, while the resistance rates to lincomycin, ofloxacin, azithromycin and roxthromycin were 74.94%, 42.12%, 41.60% and 40.31% in turn. Conclusions: Josamycin, minocycline and doxycycline could be used as the first choice to treat NGU with mycoplasma infections in Chongqing. It is important to select antibiotics for NGU treatment with mycoplasma infections based on the results of drug sensitivity tests.展开更多
Background: The incidence of sexually transmittedHIV infections is rapidly increasing in China, and theprevalence of AIDS-associated mycoplasmas (includingMycoplasma genitalium, Mycoplasma penetrans, Myco-plasma pirum...Background: The incidence of sexually transmittedHIV infections is rapidly increasing in China, and theprevalence of AIDS-associated mycoplasmas (includingMycoplasma genitalium, Mycoplasma penetrans, Myco-plasma pirum and Mycoplasma fermentans) infections isunknown in patients with sexually transmitted diseases.Objective: To investigate the prevalence of these 4species of AIDS-associated mycoplasmas infections inpatients with nongonococcal urethritis (NGU) andmucopurulent cervicitis (MPC).Methods: In 65 patients with NGU/MPC, detection ofM. genitalium, M. penetrans, M. pirum and M. fermentansin genital and pharyngeal specimens was performed byculture and nested polymerase chain reaction.Results: M. genitalium, M. penetrans, M. pirum and M.fermentans were identified in genital specimens from23.1% (15/65), 12.3% (8/65), 1.5% (1/65) and 0% ofpatients, respectively, and from pharyngeal samples in26.2% (17/65), 15.4% (10/65), 1.5% (1/65) and 0% ofpatients, respectively. M. genitalium was detected in bothgenital and pharyngeal samples in 10.8% (7/65) ofpatients, and M. penetrans in 4.6% (3/65) of patients. M.pirum was found in only 2 cases, and no M. fermentanswas discovered.Conclusions: This study suggests that M. genitaliumand M. penetrans infections are common in patients withNGU/MPC. M. genitalium and M. penetrans may be trans-mitted by genital-genital or oral-genital sex, and maycause urethritis and cervicitis.展开更多
Objective： To analyze the efficacy of six antibiotic methods for treating non- gonococcal urethritis /cervicitis and the factors influencing efficacy. Methods： Retrospective analysis of 878 nongonococcal urethritis ...Objective： To analyze the efficacy of six antibiotic methods for treating non- gonococcal urethritis /cervicitis and the factors influencing efficacy. Methods： Retrospective analysis of 878 nongonococcal urethritis / cervicitis cases which received regular treatment and follow-up in our institute from 1st Jan. 2001 to 31st Aug. 2003. Results： The mean cure rate of six methods for Chlamydia trachamatis （Ct） was 57.116%. There were distinct differences among these methods for Ct treatment.The mean cure rate of six methods for Ureaplasma urealyticum （Uu） was 69.556% and there was no difference among these methods for Uu treatment. Coinfection with Ct and Uu dramatically reduced the elimination rate of these two pathogens. Conclusion： The effectiveness of treatment of these antibodies for non-gonococcal urethritis / cervicitis is not currently satisfactory. Importantly, there were many antibiotic-resistant Ct and Uu strains. The factors influencing antibiotic efficacy and mechanisms need further study.展开更多
Objective: To study the prevalence of Trichomonas vaginalis (TV) infection in Chinese male patients with nongonococcalurethritis (NGU), to evaluate the sensitivity and specificity ofurine-based and urethral swab polym...Objective: To study the prevalence of Trichomonas vaginalis (TV) infection in Chinese male patients with nongonococcalurethritis (NGU), to evaluate the sensitivity and specificity ofurine-based and urethral swab polymerase chain reaction(PCR) detection, to set up a method for non-invasive detectionof male TV infection. Method: One hundred and five male NGU patients wereselected from a Beijing STD clinic. Two urethral swabs wereobtained from each patient, one for the InPouch TV culturesystem and the other for PCR. In addition, one first void urinespecimen was collected for PCR detection. Culture wasconsidered the 'gold standard'. The sensitivity, specificity,positive predictive value (PPV) and negative predictive value(NPV) of the two PCR detections were compared to cultureresults. Results: The prevalence of urine-based PCR and urethralswab PCR detection was 3.81% (4/105) and 4.76% (5/105)respectively. Compared to culture, the sensitivity, specificity,PPV and NPV were 80%, 100%, 100% and 99% for urinbased PCR and 80%, 99%, 80% and 99% for urethral swab PCR. Conclusion: TV is one of the etiological agents in male NGU,with a 4.76% prevalence of infection in our study. The urine-based PCR detection has higher sensitivity and specificity andprovides a noninvasive method more feasible in practice.展开更多
1.Patient's conditionsA 29-year-old man,was infected with nongonococcal urethritis(NGU).He complained that he had dysuria and discomfort in the urethra and mucopurulent discharge,which appeared one week after inte...1.Patient's conditionsA 29-year-old man,was infected with nongonococcal urethritis(NGU).He complained that he had dysuria and discomfort in the urethra and mucopurulent discharge,which appeared one week after intercourse.展开更多
Urethritis glanduris is a rare benign inflammatory lesion and has a tendency to malignant transformation. We described here a case of urethritis glandularis with the extensive lesions in the anterior urethra and the s...Urethritis glanduris is a rare benign inflammatory lesion and has a tendency to malignant transformation. We described here a case of urethritis glandularis with the extensive lesions in the anterior urethra and the special outward appearance; no similar case has been reported previously.展开更多
This study developed an animal model with internal and external urethral sphincter insufficiency by bypassing the sphincter without major damage so that the animal under study can return to normal life after the study...This study developed an animal model with internal and external urethral sphincter insufficiency by bypassing the sphincter without major damage so that the animal under study can return to normal life after the study.There is a need for a reliable,applicable,and reproducible animal model for studying urinary incontinency disease due to incorrect sphincter function.Seven adult male dogs were used for this study.The urethral sphincter was bypassed by inserting a catheter between the bladder neck and the distal sphincter.The animals'physical condition was closely monitored for 9 weeks,and standard urodynamic and radiologic studies were performed before and 1–2 months after surgery.The animals were killed at 9 weeks after surgery for pathological assessment.Catheter placement caused complete incontinence in the animal,with urodynamic assessments indicating that the animal was unable to control urination and radiological assessments indicating an empty bladder with a residual volume of 50±10 cc.Tissue analysis did not show significant histological damage and inflammation.The study shows that by bypassing the urethral sphincter,which is a reliable and reproducible method,an animal model of urinary incontinence can be developed,which can be used in various studies such as assessing the adequacy of artificial sphincter function.The animals under study did not have any permanent defect,so they were able to return to their normal life.展开更多
Objective:The management of urethral stricture disease depends on the location,length of stricture,and associated urethral pathology.These parameters are obtained from preoperative imaging,with conventional urethrogra...Objective:The management of urethral stricture disease depends on the location,length of stricture,and associated urethral pathology.These parameters are obtained from preoperative imaging,with conventional urethrogram(retrograde urethrogram and micturating cystourethrogram[RGU/MCU])being the diagnostic tool of choice despite its many shortcomings.Sono-urethrogram(SUG)is an alternative that addresses most issues of RGU/MCU.Studies comparing RGU/MCU with SUG are limited.With the objective of comparing these two imaging modalities in the evaluation of urethral stricture disease,a prospective study was conducted.Methods:Fifty-six patients suspected of urethral stricture disease on clinical evaluation and confirmed either on RGU/MCU or urethro-cystoscopy were included in the study.SUG was performed by the experienced consultant radiologist who was blinded to the report of RGU/MCU.Findings of RGU/MCU and SUG were compared to intraoperative findings,which served as the reference standard.Results:The median length of the stricture determined intraoperatively was 16.5 mm,by RGU/MCU was 5.8 mm,and by SUG was 13.5 mm.The diagnostic accuracy for determination of the stricture location was 93%for RGU/MCU and 98%for SUG.SUG identified spongiofibrosis in 90%of patients with higher accuracy for the severe degree of spongiofibrosis.Conclusion:SUG has been shown to be more accurate than RGU/MCU in estimating stricture length(both short and intermediate)and localizing the stricture location.Use of SUG in conjunction with RGU/MCU helps in better guidance of stricture management by improving preoperative assessment.Further studies with larger sample sizes are warranted.展开更多
Introduction: Urethral prolapse, a rare benign lesion of the female urethra, is considered unusual in children, but it is far from exceptional in girls aged 18 to 24. African origin. The diagnosis is clinical but can ...Introduction: Urethral prolapse, a rare benign lesion of the female urethra, is considered unusual in children, but it is far from exceptional in girls aged 18 to 24. African origin. The diagnosis is clinical but can be overlooked or confused with other pathologies. Treatment remains controversial. The aim of this work is to study the epidemiological, clinical and therapeutic data of urethral mucosal prolapse in young girls in our department. Materials and methods: Retrospective and descriptive study on urethral mucosal prolapse in little girls identified from the hospitalization records of the Sino-Guinean Friendship Hospital in Conakry. The study period was 5 years. Patients were selected randomly. Outcome assessment focused on the occurrence of recurrences and urinary incontinence. The mean follow-up duration was 24 months. The parameters studied were: Age, clinical and histological findings, therapeutic data and patient outcomes. Results: The incidence of urethral mucosal prolapse in girls in the urology department was 2.2 cases/year. The mean age of the patients was 6.7 years (with extremes of 5 months and 10 years). The age group of 7 to 10 years was the most represented, observed in 63.63% of patients. The most frequent reason for consultation was vulvar bleeding in 7 patients, or 63.63%. Malpighian hyperplasia with a congested chorion was the most observed histological type, in 4 patients. Surgical treatment consisting of complete excision of the prolapsed part had given excellent results. Conclusion: Urethral prolapse is a rare pathology, observed mainly in young black girls. Its diagnosis is based mainly on clinical examination. Surgical treatment gives satisfactory results, both clinically and aesthetically.展开更多
Urethral catheterization is an important skill to develop as consultations for“difficult catheterization”are common in practice.Developing a broad approach to difficult urethral catheterization is crucial to improve...Urethral catheterization is an important skill to develop as consultations for“difficult catheterization”are common in practice.Developing a broad approach to difficult urethral catheterization is crucial to improve trainee success rates.Strategies and techniques to improve catheterization success are often passed down and shared between trainees without formal documentation or dissemination of techniques.Herein,we present a framework for difficult urethral catheterization based on clinical history and patient examination,while also providing additional techniques and troubleshooting to overcome common challenges with urethral catheterization in adult and pediatric patients.展开更多
We report a case involving an 85-year-old man who underwent laparoscopic radical prostatectomy for prostate cancer in 2011.During follow-up,he required long-term use of a penile clamp to manage urination due to perman...We report a case involving an 85-year-old man who underwent laparoscopic radical prostatectomy for prostate cancer in 2011.During follow-up,he required long-term use of a penile clamp to manage urination due to permanent severe stress incontinence.In February 2023,he presented with a painless cystic mass in the scrotum.Upon pressing the mass with hand,fluid drained from the external urethral orifice,causing the mass to shrink in size,although it returned to its original size a few hours later.Urography and cystoscopy showed a globular urethral diverticulum located anteriorly.The patient underwent surgical excision of the diverticulum along with urethroplasty.Postoperatively,the urinary stress incontinence persisted,but he declined any further surgical intervention.An artificial urinary sphincter is currently the first-line treatment for male urinary incontinence.However,devices such as penile clamps can serve as an alternative when considering surgical suitability or cost.It is important to note that these devices can lead to serious complications such as urethral erosion,stricture,or diverticulum.Therefore,caution is advised when using such devices,and they should be removed periodically at short intervals.展开更多
ECharles Osterberg。Dr.Osterberg is a board-certified urologist with fellowship training in male genitourinary reconstruction.He moved to Austin(TX,USA)in 2016 to join the University of Texas-Dell Medical School as As...ECharles Osterberg。Dr.Osterberg is a board-certified urologist with fellowship training in male genitourinary reconstruction.He moved to Austin(TX,USA)in 2016 to join the University of Texas-Dell Medical School as Associate Professor of Surgery.Dr.Osterberg specializes in reconstructive urology,genitourinary trauma,prosthetics,and robotic surgery.After serving as the Chief of Urology at Dell-Seton Medical Center-the main teaching hospital for Dell Medical School for 7 years,Dr.Osterberg transitioned his practice to Urology Austin,an affiliate of Urology America.At his new practice,he and his team have performed hundreds of complex urologic reconstructions and urethral stricture surgeries.展开更多
Objective:The aim of this study was to find the optimal force that should be applied to control urine leakage using a non-hydraulic cuff design,and to investigate the relationship between the number of cuffs used in u...Objective:The aim of this study was to find the optimal force that should be applied to control urine leakage using a non-hydraulic cuff design,and to investigate the relationship between the number of cuffs used in urinary control and the change in demand force.Method:In this study,five sheep bladders were used to design and build a biomechanical evaluation system.The biomechanical system included the bladder,pressure gauge,pressure regulator system of the bladder,and force application system by the cuff.In this study,we increased the fluid pressure inside the bladder from 0 cmH_(2)O to 200 cmH_(2)O(1 cmH_(2)O=0.098 kPa),and at each point,the force applied by the cuff to prevent fluid leakage was measured and recorded.Results:The study revealed that a mean tensile force of 2.81(standard deviation 0.23)N for a single cuff and 1.63(standard deviation 0.16)N for double cuffs with symmetrical pressure effectively prevented bladder fluid leakage in the pressure range from 75 cmH_(2)O to 100 cmH_(2)O(p<0.001).However,there were no significant differences in results when comparing the applied tensile force required by double cuffs with asymmetric tensile force to that of the single cuff use.Furthermore,using three cuffs instead of two did not yield significantly different outcomes.Conclusion:Using double cuffs with symmetrical pressure had a greater effect compared with a single cuff with the same tensile force.Although multiple cuffs with varying tensile forces were not found to be useful in controlling urine leakage in this study,it is suggested that applying variable forces alternately and rotationally among several cuffs may reduce long-term risks such as atrophy and necrosis.Future in vivo studies are recommended to further evaluate efficiency.展开更多
BACKGROUND Primary signet ring cell carcinoma of the urethra in women is an exceedingly rare malignancy.It was first reported in postmenopausal women in 1987,and only five patients have been reported to date.CASE SUMM...BACKGROUND Primary signet ring cell carcinoma of the urethra in women is an exceedingly rare malignancy.It was first reported in postmenopausal women in 1987,and only five patients have been reported to date.CASE SUMMARY A 61-year-old woman presented with irregular vaginal bleeding,and subsequent evaluation identified a tumor located in the distal urethra.Upon diagnosis of primary urethral carcinoma,she underwent a distal urethrectomy.Histopathological analysis demonstrated that the tumor consisted of a combination of intestinal adenocarcinoma and signet ring cell carcinoma.At the 12-month postoperative follow-up,there was no evidence of disease recurrence.CONCLUSION This case report highlights the exceptional rarity of female urethral signet ring cell carcinoma,emphasizing the importance of early clinical detection and the necessity for precise and conservative surgical intervention.展开更多
Background:Bladder augmentation is often necessary to address poorly compliant and low-capacity bladders which can result from Posterior Urethral Valve.Traditional techniques are limited by complications from using bo...Background:Bladder augmentation is often necessary to address poorly compliant and low-capacity bladders which can result from Posterior Urethral Valve.Traditional techniques are limited by complications from using bowel tissue,thus in the setting of a megaureter,ureterocystoplasty is favorable.Methods:We present a case of Teapot ureterocystoplasty,which improves vascular protection of the ureter by leaving the distal 3 cm of the ureter tubularized.Cystograms demonstrated bladder capacity improvement from 50 mL to 180 mL post-operatively.Additionally,Creatinine stabilized after a peak of 250 umol/L.Result and Conclusion:This patient is doing well at 4.5-year surveillance and has avoided renal transplant,a common fate for these children.展开更多
Objective:Radical prostatectomy(RP)is considered the gold standard treatment for patients with localized prostate cancer(PCa).All patients undergoing RP,either open,laparoscopic,or robotic,are at risk of developing ur...Objective:Radical prostatectomy(RP)is considered the gold standard treatment for patients with localized prostate cancer(PCa).All patients undergoing RP,either open,laparoscopic,or robotic,are at risk of developing urinary incontinence after RP.Our study aimed to analyze possible predictors of early postoperative(within 3 months)urinary continence(UC)outcomes following extraperitoneal single-site robot-assisted RP(ss-RARP)for localized PCa.Methods:We retrospectively reviewed data from 113 patients with localized PCa who were operated on by a highly experienced surgeon between September 2022 and December 2023.Patient characteristics(age,body mass index,prostate volume,prostate dimensions,preoperative and postoperative membranous urethral length,and percentage of membranous urethra removed)were analyzed using logistic regression to determine the independent factors contributing to short-term UC recovery after extraperitoneal ss-RARP.From the time of urinary catheter removal after surgery,the recovery of UC was followed up every month,and UC was defined as using≤1 safety pad daily,known as social continence.Results:The proportions of continent patients immediately after urinary catheter removal,1 month,and 3 months after extraperitoneal ss-RARP were 22%,49%,and 82%,respectively.The multivariate logistic regression analysis showed that the percentage of membranous urethra removed(p=0.016)and prostate volume(p=0.049)were associated with social UC recovery immediately after urinary catheter removal,and craniocaudal dimension of the prostate(p=0.042)and age(p=0.014)were associated with social UC recovery 1 month and 3 months after extraperitoneal ss-RARP,respectively.Conclusion:The percentage of membranous urethra removed,prostate volume,craniocaudal dimension of the prostate,and age are independent risk factors for social UC early after extraperitoneal ss-RARP.展开更多
Introduction Urethritis, a common presentation of several sexually transmitted infections, results from infectious and noninfectious conditions. Urethritis accounts for a significant burden of disease in young individ...Introduction Urethritis, a common presentation of several sexually transmitted infections, results from infectious and noninfectious conditions. Urethritis accounts for a significant burden of disease in young individuals over 2.8 million cases in the United States each year[1], and is associated with complications including acute epididymitis, orchitic, and prostatitis. Symptoms of urethritis include discharge of mucopurulent or purulent material, dysuria, or urethral frequency, pruritus. The most common infectious etiologies of urethritis are gonorrhea and chlamydia[2].展开更多
Objective:To conduct a systematic literature review on urethral calculi in a contemporary cohort describing etiology,investigation,and management patterns.Methods:A systematic search of MEDLINE and Cochrane Central Re...Objective:To conduct a systematic literature review on urethral calculi in a contemporary cohort describing etiology,investigation,and management patterns.Methods:A systematic search of MEDLINE and Cochrane Central Register of Controlled Trials(CENTRAL)databases was performed.Articles,including case reports and case series on urethral calculi published between January 2000 and December 2019,were included.Full-text manuscripts were reviewed for clinical parameters including symptomatology,etiology,medical history,investigations,treatment,and outcomes.Data were collated and analyzed with univariate methods.Results:Seventy-four publications met inclusion criteria,reporting on 95 cases.Voiding symptoms(41.1%),pain(40.0%),and acute urinary retention(32.6%)were common presenting features.Urethral calculi were most often initially investigated using plain X-ray(63.2%),with almost all radio-opaque(98.3%).Urethral calculi were frequently associated with coexistent bladder or upper urinary tract calculi(16.8%)and underlying urethral pathology(53.7%)including diverticulum(33.7%)or stricture(13.7%).Urethral calculi were most commonly managed with external urethrolithotomy(31.6%),retrograde manipulation(22.1%),and endoscopic in situ lithotripsy(17.9%).Conclusion:This unique systematic review of urethral calculi provided a summary of clinical features and treatment trends with a suggested treatment algorithm.Management in contemporary urological practice should be according to calculus size,shape,anatomical location,and presence of urethral pathology.展开更多
文摘Sexually transmitted infections (STIs) represent a public health problem due to their high prevalence worldwide and the emergence of multidrug resistance of responsible microorganisms. Medical laboratory diagnosis of sexually transmitted genital infections by traditional methods as culture remains extremely delicate, difficult or impossible (to find extremely fragile organisms that can be cultured). Thus, molecular techniques constitute an alternative to improve accurate diagnostic, personalized patient treatment, and public health. A total of 83 clinical samples including urethral discharge and urine samples from individual patients with symptoms of urethritis received were analyzed using traditional methods and a commercial real-time PCR (qPCR) method. Out of 83 urethritis patients, n = 55 (66.26%) were positive for at least one of the STI pathogens detected by qPCR. qPCR assay was more sensitive (50/83, positive cases) compared to culture (15/83, positive cases) and light microscopy (28/83, positive cases). The most prevalent NTD pathogen in the suspected patients was N. gonorrhoeae with 60.24% (50/83) based on real-time PCR diagnosis. Among the positive cases of STI pathogens, Neisseria gonorrhoeae had the highest frequency 49/55 (89.01%) followed by low frequencies of Trichomonas vaginalis 4/55 (7.27%) and Chlamydia trachomatis 1/55 (1.82%). This highlights the high prevalence of N. gonorrhoeae infection in male urethritis patients and a very important misdiagnosis using traditional routine methods in Burkina Faso by medical laboratories. Thus, this situation may negatively impact patients’ personalized treatment and care and public health with the possible rapid emergence of multidrug-resistant strains. This study also highlights the urgent need to optimize culture for the diagnosis of NTD pathogens in Burkina Faso and the usefulness and the need for the introduction of molecular diagnostic methods in routine diagnosis for the detection of NTD pathogens in the medical laboratories in Burkina Faso.
文摘Introduction: Gonorrhoeae and antimicrobial resistance AMR of gonococci is a major health problem today, because emerged resistance to last line empirical treatment for gonorrhoeae cephalosporins in many countries is predictable to be untreatable disease in near future. WHO GASP, WHO GLASS and WHO’s global action plan on AMR recommends to expand nationally and internationally to collect data to monitor AMR of gonococci for public health policies. Objective: Our aim is to detect resistance of gonococci to Cepha- losporins and determine the most effective empirical treatment for un-com- plicated gonococcal urethritis in males in Egypt. Methods: We depended in our methodology on selected gonococci from male urethral discharge specimens on Thyer Martien medium;collected 33 isolates during three years from 2017 to 2020;used antibiotics with MIC according to international standards and measuring IZD according to antimicrobial susceptibility testing reference ranges in international standards. Results: By statistical studies, resistance to cephalosporins was as follows: Cephradine 97%, Cefaclor 87.9%, Cefoxitin 97%, Ceftriaxone 90.9% and 42.4% to Cefepime, that shows hetero-genecity in resistance inside cephalosporin group;while resistance to Macrolides group represented by Azithromycin and Tetracyclins group represented by Doxycycline was as follows: Azithromycin 39.4%, Doxycycilne 27.3%;finally fluoroquinolones, the most effective group, resistance, was as: Levofloxacin 15.2%, Ciprofloxacin 15.2% and Ofloxacin 24.2%. Conclusion: The most effective empirical treatment for uncomplicated gonococcal urethritis in males in EGYPT is Fluoroquinolone;especially Levofloxacin ranks first susceptibility as 78.8% and 15.2% resistance followed by Ciprofloxacin susceptibility as 69.7% and 15.2% resistance, finally Ofloxacin susceptibility as 66.7% and 24.2% resistance;for Ceftriaxone not more recommended in EGYPT as empirical treatment for uncomplicated gonococcal urethritis, it is susceptibility as 6.1% and 90.9% resistance;in addition, we can use combination therapy of Fluoroquinolones with Azithromycin or Doxycycline, whose susceptibility is 30.3% for Azithromycin and 42.4% for Doxycycycline, while resistance is 39.4% for Azithromycin and 27.3% for Doxycycline. It is worth noting that only Cefepime in Cephalosporins group represents 42.4% susceptibility and 42.4% resistance;in addition to the Carbapenems group, it represents as 42.4% susceptibility for Imipenem and 45.5% resistance, then 42.2% susceptibility for Meropenem and 48.5% resistance, which can play role in combination therapy.
文摘Objective: To investigate the prevalence of myco-plasma infections and the sensitivity to antibiotics among patients with nongonococcal urethritis or cer-vicitis (NGU) in Chongqing. Methods: 387 NGU cases with mycoplasma-positive results upon culture were analysed retrospectively. RESULTS: The majority of patients with mycoplasma infections were in the 20-40 year old age group. No significant difference was found between males and females. Ureaplasma urealyticum is the main pathogen of these NGU cases and no clear relationship between its concentration and pathogenic ability was noted. Drug sensitivity was tested against nine antibiotics; the sensitivity rates to josamycim, minocycline and doxycycline were 94.06%, 88.89% and 86.82% respectively, while the resistance rates to lincomycin, ofloxacin, azithromycin and roxthromycin were 74.94%, 42.12%, 41.60% and 40.31% in turn. Conclusions: Josamycin, minocycline and doxycycline could be used as the first choice to treat NGU with mycoplasma infections in Chongqing. It is important to select antibiotics for NGU treatment with mycoplasma infections based on the results of drug sensitivity tests.
文摘Background: The incidence of sexually transmittedHIV infections is rapidly increasing in China, and theprevalence of AIDS-associated mycoplasmas (includingMycoplasma genitalium, Mycoplasma penetrans, Myco-plasma pirum and Mycoplasma fermentans) infections isunknown in patients with sexually transmitted diseases.Objective: To investigate the prevalence of these 4species of AIDS-associated mycoplasmas infections inpatients with nongonococcal urethritis (NGU) andmucopurulent cervicitis (MPC).Methods: In 65 patients with NGU/MPC, detection ofM. genitalium, M. penetrans, M. pirum and M. fermentansin genital and pharyngeal specimens was performed byculture and nested polymerase chain reaction.Results: M. genitalium, M. penetrans, M. pirum and M.fermentans were identified in genital specimens from23.1% (15/65), 12.3% (8/65), 1.5% (1/65) and 0% ofpatients, respectively, and from pharyngeal samples in26.2% (17/65), 15.4% (10/65), 1.5% (1/65) and 0% ofpatients, respectively. M. genitalium was detected in bothgenital and pharyngeal samples in 10.8% (7/65) ofpatients, and M. penetrans in 4.6% (3/65) of patients. M.pirum was found in only 2 cases, and no M. fermentanswas discovered.Conclusions: This study suggests that M. genitaliumand M. penetrans infections are common in patients withNGU/MPC. M. genitalium and M. penetrans may be trans-mitted by genital-genital or oral-genital sex, and maycause urethritis and cervicitis.
文摘Objective： To analyze the efficacy of six antibiotic methods for treating non- gonococcal urethritis /cervicitis and the factors influencing efficacy. Methods： Retrospective analysis of 878 nongonococcal urethritis / cervicitis cases which received regular treatment and follow-up in our institute from 1st Jan. 2001 to 31st Aug. 2003. Results： The mean cure rate of six methods for Chlamydia trachamatis （Ct） was 57.116%. There were distinct differences among these methods for Ct treatment.The mean cure rate of six methods for Ureaplasma urealyticum （Uu） was 69.556% and there was no difference among these methods for Uu treatment. Coinfection with Ct and Uu dramatically reduced the elimination rate of these two pathogens. Conclusion： The effectiveness of treatment of these antibodies for non-gonococcal urethritis / cervicitis is not currently satisfactory. Importantly, there were many antibiotic-resistant Ct and Uu strains. The factors influencing antibiotic efficacy and mechanisms need further study.
文摘Objective: To study the prevalence of Trichomonas vaginalis (TV) infection in Chinese male patients with nongonococcalurethritis (NGU), to evaluate the sensitivity and specificity ofurine-based and urethral swab polymerase chain reaction(PCR) detection, to set up a method for non-invasive detectionof male TV infection. Method: One hundred and five male NGU patients wereselected from a Beijing STD clinic. Two urethral swabs wereobtained from each patient, one for the InPouch TV culturesystem and the other for PCR. In addition, one first void urinespecimen was collected for PCR detection. Culture wasconsidered the 'gold standard'. The sensitivity, specificity,positive predictive value (PPV) and negative predictive value(NPV) of the two PCR detections were compared to cultureresults. Results: The prevalence of urine-based PCR and urethralswab PCR detection was 3.81% (4/105) and 4.76% (5/105)respectively. Compared to culture, the sensitivity, specificity,PPV and NPV were 80%, 100%, 100% and 99% for urinbased PCR and 80%, 99%, 80% and 99% for urethral swab PCR. Conclusion: TV is one of the etiological agents in male NGU,with a 4.76% prevalence of infection in our study. The urine-based PCR detection has higher sensitivity and specificity andprovides a noninvasive method more feasible in practice.
文摘1.Patient's conditionsA 29-year-old man,was infected with nongonococcal urethritis(NGU).He complained that he had dysuria and discomfort in the urethra and mucopurulent discharge,which appeared one week after intercourse.
文摘Urethritis glanduris is a rare benign inflammatory lesion and has a tendency to malignant transformation. We described here a case of urethritis glandularis with the extensive lesions in the anterior urethra and the special outward appearance; no similar case has been reported previously.
文摘This study developed an animal model with internal and external urethral sphincter insufficiency by bypassing the sphincter without major damage so that the animal under study can return to normal life after the study.There is a need for a reliable,applicable,and reproducible animal model for studying urinary incontinency disease due to incorrect sphincter function.Seven adult male dogs were used for this study.The urethral sphincter was bypassed by inserting a catheter between the bladder neck and the distal sphincter.The animals'physical condition was closely monitored for 9 weeks,and standard urodynamic and radiologic studies were performed before and 1–2 months after surgery.The animals were killed at 9 weeks after surgery for pathological assessment.Catheter placement caused complete incontinence in the animal,with urodynamic assessments indicating that the animal was unable to control urination and radiological assessments indicating an empty bladder with a residual volume of 50±10 cc.Tissue analysis did not show significant histological damage and inflammation.The study shows that by bypassing the urethral sphincter,which is a reliable and reproducible method,an animal model of urinary incontinence can be developed,which can be used in various studies such as assessing the adequacy of artificial sphincter function.The animals under study did not have any permanent defect,so they were able to return to their normal life.
文摘Objective:The management of urethral stricture disease depends on the location,length of stricture,and associated urethral pathology.These parameters are obtained from preoperative imaging,with conventional urethrogram(retrograde urethrogram and micturating cystourethrogram[RGU/MCU])being the diagnostic tool of choice despite its many shortcomings.Sono-urethrogram(SUG)is an alternative that addresses most issues of RGU/MCU.Studies comparing RGU/MCU with SUG are limited.With the objective of comparing these two imaging modalities in the evaluation of urethral stricture disease,a prospective study was conducted.Methods:Fifty-six patients suspected of urethral stricture disease on clinical evaluation and confirmed either on RGU/MCU or urethro-cystoscopy were included in the study.SUG was performed by the experienced consultant radiologist who was blinded to the report of RGU/MCU.Findings of RGU/MCU and SUG were compared to intraoperative findings,which served as the reference standard.Results:The median length of the stricture determined intraoperatively was 16.5 mm,by RGU/MCU was 5.8 mm,and by SUG was 13.5 mm.The diagnostic accuracy for determination of the stricture location was 93%for RGU/MCU and 98%for SUG.SUG identified spongiofibrosis in 90%of patients with higher accuracy for the severe degree of spongiofibrosis.Conclusion:SUG has been shown to be more accurate than RGU/MCU in estimating stricture length(both short and intermediate)and localizing the stricture location.Use of SUG in conjunction with RGU/MCU helps in better guidance of stricture management by improving preoperative assessment.Further studies with larger sample sizes are warranted.
文摘Introduction: Urethral prolapse, a rare benign lesion of the female urethra, is considered unusual in children, but it is far from exceptional in girls aged 18 to 24. African origin. The diagnosis is clinical but can be overlooked or confused with other pathologies. Treatment remains controversial. The aim of this work is to study the epidemiological, clinical and therapeutic data of urethral mucosal prolapse in young girls in our department. Materials and methods: Retrospective and descriptive study on urethral mucosal prolapse in little girls identified from the hospitalization records of the Sino-Guinean Friendship Hospital in Conakry. The study period was 5 years. Patients were selected randomly. Outcome assessment focused on the occurrence of recurrences and urinary incontinence. The mean follow-up duration was 24 months. The parameters studied were: Age, clinical and histological findings, therapeutic data and patient outcomes. Results: The incidence of urethral mucosal prolapse in girls in the urology department was 2.2 cases/year. The mean age of the patients was 6.7 years (with extremes of 5 months and 10 years). The age group of 7 to 10 years was the most represented, observed in 63.63% of patients. The most frequent reason for consultation was vulvar bleeding in 7 patients, or 63.63%. Malpighian hyperplasia with a congested chorion was the most observed histological type, in 4 patients. Surgical treatment consisting of complete excision of the prolapsed part had given excellent results. Conclusion: Urethral prolapse is a rare pathology, observed mainly in young black girls. Its diagnosis is based mainly on clinical examination. Surgical treatment gives satisfactory results, both clinically and aesthetically.
文摘Urethral catheterization is an important skill to develop as consultations for“difficult catheterization”are common in practice.Developing a broad approach to difficult urethral catheterization is crucial to improve trainee success rates.Strategies and techniques to improve catheterization success are often passed down and shared between trainees without formal documentation or dissemination of techniques.Herein,we present a framework for difficult urethral catheterization based on clinical history and patient examination,while also providing additional techniques and troubleshooting to overcome common challenges with urethral catheterization in adult and pediatric patients.
文摘We report a case involving an 85-year-old man who underwent laparoscopic radical prostatectomy for prostate cancer in 2011.During follow-up,he required long-term use of a penile clamp to manage urination due to permanent severe stress incontinence.In February 2023,he presented with a painless cystic mass in the scrotum.Upon pressing the mass with hand,fluid drained from the external urethral orifice,causing the mass to shrink in size,although it returned to its original size a few hours later.Urography and cystoscopy showed a globular urethral diverticulum located anteriorly.The patient underwent surgical excision of the diverticulum along with urethroplasty.Postoperatively,the urinary stress incontinence persisted,but he declined any further surgical intervention.An artificial urinary sphincter is currently the first-line treatment for male urinary incontinence.However,devices such as penile clamps can serve as an alternative when considering surgical suitability or cost.It is important to note that these devices can lead to serious complications such as urethral erosion,stricture,or diverticulum.Therefore,caution is advised when using such devices,and they should be removed periodically at short intervals.
文摘ECharles Osterberg。Dr.Osterberg is a board-certified urologist with fellowship training in male genitourinary reconstruction.He moved to Austin(TX,USA)in 2016 to join the University of Texas-Dell Medical School as Associate Professor of Surgery.Dr.Osterberg specializes in reconstructive urology,genitourinary trauma,prosthetics,and robotic surgery.After serving as the Chief of Urology at Dell-Seton Medical Center-the main teaching hospital for Dell Medical School for 7 years,Dr.Osterberg transitioned his practice to Urology Austin,an affiliate of Urology America.At his new practice,he and his team have performed hundreds of complex urologic reconstructions and urethral stricture surgeries.
文摘Objective:The aim of this study was to find the optimal force that should be applied to control urine leakage using a non-hydraulic cuff design,and to investigate the relationship between the number of cuffs used in urinary control and the change in demand force.Method:In this study,five sheep bladders were used to design and build a biomechanical evaluation system.The biomechanical system included the bladder,pressure gauge,pressure regulator system of the bladder,and force application system by the cuff.In this study,we increased the fluid pressure inside the bladder from 0 cmH_(2)O to 200 cmH_(2)O(1 cmH_(2)O=0.098 kPa),and at each point,the force applied by the cuff to prevent fluid leakage was measured and recorded.Results:The study revealed that a mean tensile force of 2.81(standard deviation 0.23)N for a single cuff and 1.63(standard deviation 0.16)N for double cuffs with symmetrical pressure effectively prevented bladder fluid leakage in the pressure range from 75 cmH_(2)O to 100 cmH_(2)O(p<0.001).However,there were no significant differences in results when comparing the applied tensile force required by double cuffs with asymmetric tensile force to that of the single cuff use.Furthermore,using three cuffs instead of two did not yield significantly different outcomes.Conclusion:Using double cuffs with symmetrical pressure had a greater effect compared with a single cuff with the same tensile force.Although multiple cuffs with varying tensile forces were not found to be useful in controlling urine leakage in this study,it is suggested that applying variable forces alternately and rotationally among several cuffs may reduce long-term risks such as atrophy and necrosis.Future in vivo studies are recommended to further evaluate efficiency.
基金Supported by the Science and Technology Bureau Foundation of Jinhua,No.2021-4-300 and No.2020-3-062The Zhejiang Provincial Medical and Health Science and Technology Plan,No.2025KY1752。
文摘BACKGROUND Primary signet ring cell carcinoma of the urethra in women is an exceedingly rare malignancy.It was first reported in postmenopausal women in 1987,and only five patients have been reported to date.CASE SUMMARY A 61-year-old woman presented with irregular vaginal bleeding,and subsequent evaluation identified a tumor located in the distal urethra.Upon diagnosis of primary urethral carcinoma,she underwent a distal urethrectomy.Histopathological analysis demonstrated that the tumor consisted of a combination of intestinal adenocarcinoma and signet ring cell carcinoma.At the 12-month postoperative follow-up,there was no evidence of disease recurrence.CONCLUSION This case report highlights the exceptional rarity of female urethral signet ring cell carcinoma,emphasizing the importance of early clinical detection and the necessity for precise and conservative surgical intervention.
文摘Background:Bladder augmentation is often necessary to address poorly compliant and low-capacity bladders which can result from Posterior Urethral Valve.Traditional techniques are limited by complications from using bowel tissue,thus in the setting of a megaureter,ureterocystoplasty is favorable.Methods:We present a case of Teapot ureterocystoplasty,which improves vascular protection of the ureter by leaving the distal 3 cm of the ureter tubularized.Cystograms demonstrated bladder capacity improvement from 50 mL to 180 mL post-operatively.Additionally,Creatinine stabilized after a peak of 250 umol/L.Result and Conclusion:This patient is doing well at 4.5-year surveillance and has avoided renal transplant,a common fate for these children.
文摘Objective:Radical prostatectomy(RP)is considered the gold standard treatment for patients with localized prostate cancer(PCa).All patients undergoing RP,either open,laparoscopic,or robotic,are at risk of developing urinary incontinence after RP.Our study aimed to analyze possible predictors of early postoperative(within 3 months)urinary continence(UC)outcomes following extraperitoneal single-site robot-assisted RP(ss-RARP)for localized PCa.Methods:We retrospectively reviewed data from 113 patients with localized PCa who were operated on by a highly experienced surgeon between September 2022 and December 2023.Patient characteristics(age,body mass index,prostate volume,prostate dimensions,preoperative and postoperative membranous urethral length,and percentage of membranous urethra removed)were analyzed using logistic regression to determine the independent factors contributing to short-term UC recovery after extraperitoneal ss-RARP.From the time of urinary catheter removal after surgery,the recovery of UC was followed up every month,and UC was defined as using≤1 safety pad daily,known as social continence.Results:The proportions of continent patients immediately after urinary catheter removal,1 month,and 3 months after extraperitoneal ss-RARP were 22%,49%,and 82%,respectively.The multivariate logistic regression analysis showed that the percentage of membranous urethra removed(p=0.016)and prostate volume(p=0.049)were associated with social UC recovery immediately after urinary catheter removal,and craniocaudal dimension of the prostate(p=0.042)and age(p=0.014)were associated with social UC recovery 1 month and 3 months after extraperitoneal ss-RARP,respectively.Conclusion:The percentage of membranous urethra removed,prostate volume,craniocaudal dimension of the prostate,and age are independent risk factors for social UC early after extraperitoneal ss-RARP.
文摘Introduction Urethritis, a common presentation of several sexually transmitted infections, results from infectious and noninfectious conditions. Urethritis accounts for a significant burden of disease in young individuals over 2.8 million cases in the United States each year[1], and is associated with complications including acute epididymitis, orchitic, and prostatitis. Symptoms of urethritis include discharge of mucopurulent or purulent material, dysuria, or urethral frequency, pruritus. The most common infectious etiologies of urethritis are gonorrhea and chlamydia[2].
文摘Objective:To conduct a systematic literature review on urethral calculi in a contemporary cohort describing etiology,investigation,and management patterns.Methods:A systematic search of MEDLINE and Cochrane Central Register of Controlled Trials(CENTRAL)databases was performed.Articles,including case reports and case series on urethral calculi published between January 2000 and December 2019,were included.Full-text manuscripts were reviewed for clinical parameters including symptomatology,etiology,medical history,investigations,treatment,and outcomes.Data were collated and analyzed with univariate methods.Results:Seventy-four publications met inclusion criteria,reporting on 95 cases.Voiding symptoms(41.1%),pain(40.0%),and acute urinary retention(32.6%)were common presenting features.Urethral calculi were most often initially investigated using plain X-ray(63.2%),with almost all radio-opaque(98.3%).Urethral calculi were frequently associated with coexistent bladder or upper urinary tract calculi(16.8%)and underlying urethral pathology(53.7%)including diverticulum(33.7%)or stricture(13.7%).Urethral calculi were most commonly managed with external urethrolithotomy(31.6%),retrograde manipulation(22.1%),and endoscopic in situ lithotripsy(17.9%).Conclusion:This unique systematic review of urethral calculi provided a summary of clinical features and treatment trends with a suggested treatment algorithm.Management in contemporary urological practice should be according to calculus size,shape,anatomical location,and presence of urethral pathology.
