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Related Concept Videos

Urinary Tract Infection III: Diagnostic Studies and Interprofessional Care01:30

Urinary Tract Infection III: Diagnostic Studies and Interprofessional Care

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A healthcare provider can diagnose a urinary tract infection (UTI) through several methods:Medical History and Symptoms: The provider will take a detailed medical history and ask about symptoms such as frequent urination, burning sensation during urination, and lower abdominal pain.Urinalysis: A clean-catch urine sample is collected in a sterile container and tested for the presence of bacteria, white blood cells (leukocytes), nitrites, blood, and protein. The presence of leukocytes and...
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Urinary Tract Infection I: Introduction01:26

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Urinary tract infections (UTIs) impact various parts of the urinary system, including the kidneys, ureters, bladder, and urethra. These infections are generally bacterial, with Escherichia coli being the most common causative agent, often originating from the gastrointestinal tract. However, other bacteria, such as Staphylococcus saprophyticus, Klebsiella pneumoniae, and Proteus mirabilis, are also known to cause UTIs. The type, location, and underlying complexity of the UTI guide both...
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Imaging Studies V: Intravenous Urography and Retrograde Pyelography01:22

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IntroductionIntravenous Urography (IVU) and Retrograde Pyelography (RP) are important diagnostic imaging techniques used to evaluate the urinary system. These methods help identify structural abnormalities, obstructions, and functional issues in the kidneys, ureters, and bladder. Both procedures use iodine-based contrast media to enhance the visibility of urinary tract structures on X-ray images, though they differ in their methods and indications.1. Intravenous Urography (IVU)Intravenous...
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Urinary Tract Calculi I: Introduction01:28

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Renal calculi, or kidney stones, are solid deposits of minerals and salts formed inside the kidneys. In medical terminology, "calculus" refers to the stone itself, while "lithiasis" describes the process of stone formation. Depending on their location within the urinary system, these stones may be classified as either urolithiasis, when situated within the urinary tract, or nephrolithiasis, when located within the kidneys. Each term signifies the specific impact of the stone.Predisposition...
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Urinary Tract Calculi II: Pathophysiology and Clinical Manifestations01:26

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Renal calculi, commonly termed kidney stones, are crystalline solid masses that form in the kidneys but can occur at any point within the urinary system, encompassing the kidneys, ureters, bladder, and urethra.The pathophysiology of renal stones involves several key factors: supersaturation of the urine with stone-forming constituents, changes in urine pH, a decrease in urine volume, and the presence of substances that promote or inhibit stone formation.Supersaturation of Urine: This is the...
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Urinary Tract Infection II: Pathophysiology01:25

Urinary Tract Infection II: Pathophysiology

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The pathophysiology of urinary tract infections (UTIs) encompasses several progressive stages, beginning with bacterial colonization and culminating in potential systemic complications if untreated. UTIs are primarily initiated by bacteria, such as Escherichia coli, which often originate from the gastrointestinal tract and migrate to the urinary system through the periurethral area. This migration can occur via several routes, including improper hygiene practices, sexual activity, or...
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Upper Urinary Tract Carcinoma In Situ: Current Knowledge, Future Direction.

Grant P Redrow1, Charles C Guo2, Maurizio A Brausi3

  • 1Department of Urology, University of Texas MD Anderson Cancer Center, Houston, Texas; Division of Urology, University of Texas at Houston School of Medicine, Houston, Texas.

The Journal of Urology
|September 25, 2016
PubMed
Summary

Upper tract carcinoma in situ (CIS) is a rare urothelial cancer. Topical therapy shows promise for organ preservation, offering improved survival and lower recurrence rates compared to bladder CIS.

Keywords:
BCG vaccinecarcinoma in situurinary bladder neoplasmsurologic neoplasms

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Area of Science:

  • Uro-oncology
  • Nephrology
  • Systematic Review

Background:

  • Upper tract carcinoma in situ (CIS) is a high-grade, nonmuscle invasive urothelial cancer.
  • Understanding and management of upper tract CIS are limited by knowledge gaps.
  • This review addresses similarities and differences between bladder and upper tract CIS.

Purpose of the Study:

  • To review the literature on upper tract CIS.
  • To identify knowledge gaps in definition, diagnosis, and treatment.
  • To summarize current data on upper tract CIS management.

Main Methods:

  • Systematic review of PubMed and MEDLINE databases (1976-2014).
  • Utilized PRISMA guidelines for publication screening.
  • Developed a consensus definition of upper tract CIS.

Main Results:

  • 61 retrospective studies were included.
  • Upper tract CIS shows lower progression rates and better survival than bladder CIS.
  • Topical therapy is effective for upper tract CIS, with decreased recurrence.

Conclusions:

  • Organ-preserving topical therapy is a viable alternative to surgery for select upper tract CIS patients.
  • A paradigm shift in detection and treatment is needed for better renal preservation.
  • Knowledge gaps in definition, drug delivery, and treatment course require further research.