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Urinary Bladder

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The urinary bladder is a hollow, muscular sac that temporarily stores urine before it is expelled from the body. It can hold approximately 600 mL of urine prior to micturition. The bladder is retroperitoneal and located behind the pubic symphysis in the pelvic floor.
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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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Urinary Tract Infection II: Pathophysiology01:25

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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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Urinary Tract Infection IV: Nursing Management01:17

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In managing urinary tract infections (UTIs) in nursing, a comprehensive assessment is essential. Begin by gathering subjective data, such as the patient’s complaints of dysuria (painful urination), urinary frequency, urgency, suprapubic pain, and any lower abdominal discomfort. This information can be complemented by questions regarding previous UTIs, sexual activity, and personal hygiene practices, which can provide insight into risk factors. Objective assessment should focus on signs...
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Anatomy of the Genitourinary System II: Bladder and Urethra01:19

Anatomy of the Genitourinary System II: Bladder and Urethra

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The lower urinary system consists of the urinary bladder and urethra, which are essential in storing and expelling urine from the body. Together with the internal and external sphincters, these structures work together to regulate urination effectively.Anatomy of the BladderThe urinary bladder is a muscular, stretchable organ behind the pubic bone and in front of the rectum. In females, the bladder is positioned anterior to the vagina and inferior to the uterus, while in males, it is located...
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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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An In Vitro Bladder Model of Catheter-Associated Urinary Tract Infection
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Gentamicin bladder instillations decrease symptomatic urinary tract infections in neurogenic bladder patients on

Lindsey Cox1, Chang He1, Jack Bevins2

  • 1Department of Urology; University of Michigan, Ann Arbor, MI, United States.

Canadian Urological Association Journal = Journal De L'Association Des Urologues Du Canada
|February 1, 2018
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Summary
This summary is machine-generated.

Gentamicin bladder instillations significantly reduce symptomatic urinary tract infections (UTIs) and oral antibiotic use in neurogenic bladder patients undergoing intermittent self-catheterization. This treatment also decreased antibiotic resistance patterns.

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Area of Science:

  • Urology
  • Infectious Diseases
  • Nephrology

Background:

  • Neurogenic bladder (NGB) patients using intermittent self-catheterization (ISC) frequently experience recurrent symptomatic urinary tract infections (UTIs).
  • Managing recurrent UTIs in NGB patients often involves significant antibiotic use, raising concerns about resistance.

Purpose of the Study:

  • To evaluate the efficacy of prophylactic intravesical gentamicin instillations in reducing symptomatic UTIs in NGB patients on ISC.
  • To assess the impact of intravesical gentamicin on antibiotic resistance patterns in these patients.

Main Methods:

  • Retrospective review of a prospective NGB database.
  • Inclusion of NGB patients on ISC with at least six months of data before and after initiating prophylactic intravesical gentamicin.
  • Definition of symptomatic UTIs as clinical symptoms requiring antibiotic treatment.

Main Results:

  • A significant reduction in symptomatic UTIs (median 4 to 1 episode) and oral antibiotic courses (median 3.5 to 1) was observed.
  • Telephone encounters for UTI concerns decreased significantly (median 3 to 0).
  • The proportion of multi-drug-resistant organisms decreased from 58.3% to 47.1%, with no increase in gentamicin resistance.

Conclusions:

  • Intravesical gentamicin instillations are effective in decreasing symptomatic UTIs and oral antibiotic requirements in NGB patients with recurrent UTIs on ISC.
  • This prophylactic approach also led to a reduction in antibiotic resistance.
  • Adverse events associated with gentamicin instillations were infrequent and mild.