scholarly journals IATROGENIC URINARY TRACT TRAUMA IN OBSTETRICS AND GYNECOLOGIC SURGERIES AT H. ADAM MALIK GENERAL HOSPITAL MEDAN

2019 ◽  
Vol 26 (2) ◽  
Author(s):  
Teguh Risesa Djufri ◽  
Syah Mirsya Warli
Keyword(s):  
Urinary Tract ◽  
General Hospital ◽  
Patient Characteristics ◽  
Pelvic Surgery ◽  
Obstetrics And Gynecology ◽  
Common Procedure ◽  
Bladder Trauma ◽  
Included Patient ◽  
Common Diagnosis ◽  
Repair Procedure

Objective: Urinary tract iatrogenic trauma in abdominal or pelvic surgery may cause morbidity, mortality, or even medico-legal problems. The close embryonic, as well as anatomical relationship between urinary tract and genital organs, may be a predisposition for urinary tract trauma, especially ureter and bladder, in obstetrics and gynecology surgeries. This research aimed to evaluate the incidence of iatrogenic urinary tract trauma in obstetrics and gynecology surgeries. Material & Methods: This was a descriptive retrospective research. This research was conducted at Urology Division of Department of Surgery at H. Adam Malik General Hospital, Medan, from February to June 2016. Total sampling method was used. Data were collected from medical records of patients who had iatrogenic urinary tract trauma due to obstetrics and gynecology surgeries at H. Adam Malik General Hospital from January 2011 to December 2015. Parameters that were evaluated included patient characteristics, the type of obstetrics and gynecology procedure that was conducted, the type of urinary tract trauma, and the type of urologic procedure conducted. Data were registered and analyzed using statistical software SPSS version 22. Results: There were 25 patients with 28 incidences of iatrogenic urinary tract trauma, which consisted of 12 iatrogenic ureteral trauma and 16 iatrogenic bladder trauma, out of all patients who underwent obstetrics and gynecologic surgeries at H. Adam Malik General Hospital, Medan, from January 2011 to December 2016. The youngest patient was 19 years old, while the oldest patient was 78 years old. Mean age of patients was 46.48 years (SD ± 11.6). The age group with the most iatrogenic urinary tract trauma was between 26-45 years old, which consisted of 12 patients (48%). Gynecologic patients had the most iatrogenic urinary tract trauma, which was experienced by 23 patients (92%). The most common diagnosis was ovarian cancer. Hysterectomy was the most common procedure to cause iatrogenic urinary tract trauma, as was found in 23 patients (92%). All patients who were found with iatrogenic bladder trauma (15 patients; 60%) underwent bladder repair. Conclusion: Gynecologic procedure, especially hysterectomy, was the most common cause of iatrogenic urinary tract trauma. Bladder repair procedure was the most common procedure performed on patients who were found with iatrogenic urinary tract trauma. 

scholarly journals Avascular Spaces of the Female Pelvis—Clinical Applications in Obstetrics and Gynecology

2020 ◽  
Vol 9 (5) ◽  
pp. 1460
Author(s):  
Stoyan Kostov ◽  
Stanislav Slavchev ◽  
Deyan Dzhenkov ◽  
Dimitar Mitev ◽  
Angel Yordanov
Keyword(s):  
Pelvic Surgery ◽  
Gynecologic Surgery ◽  
Obstetrics And Gynecology ◽  
Nerve Sparing ◽  
Clinical Anatomy ◽  
Anatomical Landmarks ◽  
Female Pelvis ◽  
Precise Understanding ◽  
Significant Difference ◽  
Gynecological Diseases

The term “spaces” refers to the areas delimited by at least two independent fasciae and filled with areolar connective tissue. However, there is discrepancy regarding the spaces and their limits between clinical anatomy and gynecologic surgery, as not every avascular space described in literature is delimited by at least two fasciae. Moreover, new spaces and surgical planes have been developed after the adoption of laparoscopy and nerve-sparing gynecological procedures. Avascular spaces are useful anatomical landmarks in retroperitoneal anatomic and pelvic surgery for both malignant and benign conditions. A noteworthy fact is that for various gynecological diseases, there are different approaches to the avascular spaces of the female pelvis. This is a significant difference, which is best demonstrated by dissection of these spaces for gynecological, urogynecological, and oncogynecological operations. Thorough knowledge regarding pelvic anatomy of these spaces is vital to minimize morbidity and mortality. In this article, we defined nine avascular female pelvic spaces—their boundaries, different approaches, attention during dissection, and applications in obstetrics and gynecology. We described the fourth space and separate the paravesical and pararectal space, as nerve-sparing gynecological procedures request a precise understanding of retroperitoneal spaces.

Nghiên cứu sự kháng kháng sinh của các chủng vi khuẩn gây nhiễm khuẩn đường tiết niệu phân lập được tại Bệnh viện Hữu nghị Đa khoa Nghệ An

2021 ◽  
Author(s):  
Trâm Quế Anh
Keyword(s):  
Urinary Tract ◽  
General Hospital ◽  
Urinary Tract Infections ◽  
Resistant Bacteria ◽  
Antibiotics Resistance ◽  
Bacterial Strains ◽  
E Coli ◽  
Linezolid Resistance ◽  
Drug Resistant Bacteria ◽  
Tract Infections

TÓM TẮT Đặt vấn đề: Xác định đúng căn nguyên gây NKĐTN và mức độ kháng kháng sinh của các vi khuẩn sẽ giúp cho việc điều trị có hiệu quả, giảm được chi phí điều trị, hạn chế sự gia tăng vi khuẩn đề kháng kháng sinh. Đối tượng và phương pháp nghiên cứu: Các chủng VK gây nhiễm khuẩn đương tiết niệu phân lập được tại bệnh viện Hữu nghị Đa khoa Nghệ An từ 1/2020 đến 12/2020. Thiết kế nghiên cứu: Cắt ngang mô tả. Kết quả: Phân lập được 473 chủng vi khuẩn gây NKĐTN, trong đó, E. coli 38,48%; P. aeruginosa 14,15; Enterococcus sp 10,57; K. pneumoniae 13,32%. E. coli: kháng các kháng sinh Cephalosporine, Quinolones từ 56,7 - 63,8%, Carbapenem 4,5 - 6,2%, sinh ESBL 49,4%. P. aeruginosa: đã kháng các kháng sinh thử nghiệm từ 59,1 - 69,2%. Enterococcus sp: kháng với các kháng sinh nhóm Quinolone 73,5%, kháng Vancomycin 8,3%; Chưa ghi nhận đề kháng Linezolid. K. pneumoniae: kháng nhóm Cephalosporin, Quinolone từ 66,7 - 74,6%, đề kháng với Carbapenem từ 46,0 - 50,8%. Kết luận: Các vi khuẩn gây nhiễm khuẩn tiết niệu thường gặp là: E. coli, P. aeruginosa, Enterococcus sp. K. pneumoniae. Các vi khuẩn phân lập được đã đề kháng với nhiều kháng sinh thường dùng với các mức độ khác nhau. Xuất hiện các chủng vi khuẩn Gram âm kháng Carbapenem, Gram dương kháng Vancomycin. Từ khóa: Nhiễm khuẩn tiết niệu, E.coli, Klebsiella, P.aeruginosa, Enterococcus sp ABSTRACT RESEARCH OF ANTIBIOTICS RESISTANCE OF BACTERIA STRAINS CAUSING URINARY TRACT INFECTIONS ISOLATED AT NGHEAN FRIENDSHIP GENERAL HOSPITAL Background: The good identification of UTI microorganism and their antimicrobial susceptibility would promote the effective treatment, reduce the cost as well as the emergence of drug resistant bacteria. Methods: Bacterial strains causing urinary tract infections were isolated at Nghe An Friendship General Hospital from 1/2020 to 12/2020. Study design: Descriptive cross section. Results: 473 bacterial strains causing UTIs were isolated, in which, E. coli 38.48%; P. aeruginosa 14.15; Enterococcus sp 10.57; K. pneumoniae 13.32%. E. coli: resistant to Cephalosporin antibiotics, Quinolones from 56.7 - 63.8%, Carbapenem 4.5 - 6.2%, producing ESBL 49.4%. P. aeruginosa: was resistant to the tested antibiotics from 59.1 - 69.2%. Enterococcus sp: resistant to Quinolone antibiotics 73.5%, resistant to Vancomycin 8.3%; Linezolid resistance has not been recorded. K. pneumoniae: resistant to Cephalosporin, Quinolone from 66.7 - 74.6%, resistant to Carbapenem from 46.0 - 50.8%. Conclusion: Common bacteria causing urinary tract infections are: E. coli, P. aeruginosa, Enterococcus sp. K. pneumoniae. The isolates were resistant to many commonly used antibiotics to varying degrees. Occurrence of strains of Gram - negative bacteria resistant to Carbapenem, Gram - positive resistant to Vancomycin. Keywords: Urinary Tract infections, E. coli, Klebsiella, P. aeruginosa, Enterococcus sp.

Assessment of Fosfomycin for Complicated or Multidrug-Resistant Urinary Tract Infections: Patient Characteristics and Outcomes

Chemotherapy ◽  
2016 ◽  
Vol 62 (2) ◽  
pp. 100-104 ◽  
Author(s):  
Stephanie E. Giancola ◽  
Monica V. Mahoney ◽  
Michael D. Hogan ◽  
Brian R. Raux ◽  
Christopher McCoy ◽  
...  
Keyword(s):  
Urinary Tract ◽  
Urinary Tract Infections ◽  
Bacterial Resistance ◽  
Clinical Success ◽  
Patient Characteristics ◽  
Multidrug Resistant ◽  
Enterococcus Spp ◽  
Tract Infections ◽  
Microbiological Cure

Background: Bacterial resistance among uropathogens is on the rise and has led to a decreased effectiveness of oral therapies. Fosfomycin tromethamine (fosfomycin) is indicated for uncomplicated urinary tract infections (UTIs) and displays in vitro activity against multidrug-resistant (MDR) isolates; however, clinical data assessing fosfomycin for the treatment of complicated or MDR UTIs are limited. Methods: We conducted a retrospective evaluation of patients who received ≥1 dose of fosfomycin between January 2009 and September 2015 for treatment of a UTI. Patients were included if they had a positive urine culture and documented signs/symptoms of a UTI. Results: Fifty-seven patients were included; 44 (77.2%) had complicated UTIs, 36 (63.2%) had MDR UTIs, and a total of 23 (40.4%) patients had a UTI that was both complicated and MDR. The majority of patients were female (66.7%) and elderly (median age, 79 years). Overall, the most common pathogens isolated were Escherichia coli (n = 28), Enterococcus spp. (n = 22), and Pseudomonas aeruginosa (n = 8). Twenty-eight patients (49.1%) were clinically evaluable; the preponderance achieved clinical success (96.4%). Fifteen out of 20 (75%) patients with repeat urine cultures had a microbiological cure. Conclusions: This retrospective study adds to the limited literature exploring alternative therapies for complicated and MDR UTIs with results providing additional evidence that fosfomycin may be an effective oral option.

scholarly journals INFECTIOUS RISKS AND COMPLICATIONS IN ADULT LEUKEMIC PATIENTS RECEIVING BLINATUMOMAB

2018 ◽  
Vol 10 (1) ◽  
pp. 2018029 ◽  
Author(s):  
Wonhee So ◽  
Shuchi Pandya ◽  
Rod Quilitz ◽  
Rod Quilitz ◽  
John Greene
Keyword(s):  
Lymphoblastic Leukemia ◽  
Patient Characteristics ◽  
Underlying Disease ◽  
Mucosal Barrier ◽  
Cancer Center ◽  
Antibacterial Prophylaxis ◽  
Lower Baseline ◽  
Included Patient ◽  
Mucosal Barrier Injury ◽  
Cell Acute Lymphoblastic Leukemia

Background: Blinatumomab is an anti-CD19 immunotherapy approved for relapsed/refractory B-cell acute lymphoblastic leukemia (ALL) with significantly increased survival rate. While blinatumomab showed lower rates of infection, neutropenia and mucosal barrier injury versus chemotherapy, its infection risks are not well described. Methods: All patients who received blinatumomab for ≥ 7 days at an academic cancer center from May 2015 to April 2017 were included. Patient characteristics pertinent to infectious risks and complications were examined.Results: Twenty patients with refractory (25%), relapsed (70%), or remitted (5%) B-ALL who received a total of 35 cycles were included. Ten of the 35 cycles were interrupted, none of which were due to infections. Twenty six infections (n) were observed with lower respiratory (9), gastrointestinal (6) and bacteremia (5) being most common. Compared to patients without nodular, possible mold pneumonia (n=16), patients with nodular pneumonia (n=4) had significantly lower baseline absolute neutrophil count (ANC) (2319 v. 208/µL, p=0.011). There were no differences in baseline characteristics including ANC between bacteremic and non-bacteremic patients. One patient was discharged with no antibacterial prophylaxis since ANC recovered to >500cells/µL, but developed Pseudomonal bacteremia within a week with ANC ~100cells/µL. Conclusion: Despite blinatumomab’s relatively modest myelosuppression and the lack of mucotoxicity, host factors (e.g., duration and degree of neutropenia/lymphopenia) play a key role and should be considered when choosing anti-microbial prophylaxis. In relapsed/refractory disease, the ANC should be monitored closely post blinatumomab since neutropenia can unexpectedly develop after treatment which may be compounded by the underlying disease and recent chemotherapy effects.

scholarly journals Antibacterial data synthesis challenges: a systematic review of treatments for complicated gram-negative urinary tract infections

2021 ◽  
Author(s):  
Ryan Dillon ◽  
Jennifer Uyei ◽  
Rajpal Singh ◽  
Eilish McCann
Keyword(s):  
Urinary Tract Infection ◽  
Urinary Tract ◽  
Tract Infection ◽  
Meta Analysis ◽  
Complicated Urinary Tract Infection ◽  
Clinical Trial Data ◽  
Patient Characteristics ◽  
Heterogeneous Data ◽  
Eligibility Criteria ◽  
Tract Infections

Aim: To determine the suitability of network meta-analysis (NMA) using antibacterial treatment evidence in complicated urinary tract infection. Materials & methods: We conducted a systematic literature review to identify published clinical trial data for complicated urinary tract infection treatments. We performed a feasibility assessment to determine whether the available evidence would support the creation of a robust NMA, considering key assumptions of homogeneity, similarity and consistency. Results: Twenty-five trials met eligibility criteria. Risk of bias was low, and individual studies met their primary end point(s). Assumptions central to the conduct of a robust NMA were not met. Heterogeneity was ubiquitous, including baseline pathogen, treatment and patient characteristics. Conclusion: Limited and heterogeneous data identified make the use of NMA to compare novel antibacterial agents impractical and likely unreliable.

scholarly journals Post colonoscopic acute bacterial prostatitis: a case report

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

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

Approach to Management of Iatrogenic Foreign Bodies of the Lower Urinary Tract Following Reconstructive Pelvic Surgery

2012 ◽  
Vol 187 (5) ◽  
pp. 1685-1690 ◽  
Author(s):  
Priya Padmanabhan ◽  
Ryan C. Hutchinson ◽  
W. Stuart Reynolds ◽  
Melissa Kaufman ◽  
Harriette M. Scarpero ◽  
...  
Keyword(s):  
Urinary Tract ◽  
Lower Urinary Tract ◽  
Foreign Bodies ◽  
Pelvic Surgery ◽  
Reconstructive Pelvic Surgery ◽  
Lower Urinary

scholarly journals Lower urinary tract dysfunction - a common diagnosis in the pediatrics practice

2013 ◽  
Vol 35 (1) ◽  
pp. 57-64 ◽  
Author(s):  
Monica Maria de Almeida Vasconcelos ◽  
Eleonora Moreira Lima ◽  
Giovana Branco Vaz ◽  
Thamara H. S. Silva
Keyword(s):  
Urinary Tract ◽  
Lower Urinary Tract ◽  
Lower Urinary Tract Dysfunction ◽  
Common Diagnosis ◽  
Lower Urinary
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