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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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Urine Studies II: Urine Culture and Sensitivity Test01:26

Urine Studies II: Urine Culture and Sensitivity Test

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A urine culture and sensitivity test is a diagnostic procedure used to identify urinary tract bacterial infections and determine the most effective antibiotics for treatment. This test is generally preferred when a patient shows manifestations of a urinary tract infection, such as frequent or painful urination, cloudy or foul-smelling urine, or lower abdominal pain.Purpose of the TestThe primary goals of a urine culture and sensitivity test are to:Determine the specific bacteria causing the...
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Urinary Tract Infection IV: Nursing Management01:17

Urinary Tract Infection IV: Nursing Management

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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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Urinary Tract Calculi VI: Surgical Management01:25

Urinary Tract Calculi VI: Surgical Management

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Procedures for Kidney StonesMedical intervention is necessary when kidney stones or renal calculi are too large to pass spontaneously (typically greater than 5 millimeters) when stones are accompanied by symptomatic infection (such as fever or pyelonephritis), when they impair kidney function, or when they cause persistent symptoms like severe pain, nausea, or urinary retention. Additionally, patients with only one kidney or those who cannot be treated with medical management also require...
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Urinary Tract Calculi III: Medical Management01:30

Urinary Tract Calculi III: Medical Management

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The diagnosis of renal calculi involves several imaging techniques, including non-contrast CT scans and ultrasound. These methods help visualize kidney stones, assess their size and location, and detect possible obstructions. Additionally, Measuring urine pH is useful for diagnosing specific stone types, such as struvite (alkaline pH) and uric acid stones (acidic pH). Cystine stones are primarily linked to cystinuria, a genetic condition. A urinalysis helps detect blood in the urine (hematuria)...
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Kidney Transplant II: Surgical Procedure01:26

Kidney Transplant II: Surgical Procedure

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Preoperative ManagementThe primary goals of preoperative management in kidney transplantation are to optimize the patient’s metabolic state and prepare them for surgery through diet adjustments, necessary dialysis, and tailored medical treatment. This phase also involves comprehensive infection screening and patient education about the surgical procedure and postoperative care to improve outcomes and adherence.Medical ManagementA comprehensive evaluation is required for both the living...
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Vessel-sparing Excision and Primary Anastomosis
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Minimizing Antibiotic Use in Urethral Reconstruction.

Sunchin Kim1, Katherine C Cheng2, Nejd F Alsikafi3

  • 1University of California San Diego, San Diego, California.

The Journal of Urology
|February 25, 2022
PubMed
Summary

Prolonged antibiotic use after urethral reconstruction does not reduce infection rates. A standardized protocol minimized antibiotic exposure without increasing complications, suggesting shorter antibiotic courses are sufficient.

Keywords:
anti-bacterial agentsurethral strictureurethroplasty

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Area of Science:

  • Urology
  • Infectious Disease
  • Surgical Management

Background:

  • No established guidelines exist for antibiotic management in urethral reconstruction.
  • Concerns regarding antibiotic over-prescription necessitate standardized protocols.

Purpose of the Study:

  • To evaluate the efficacy of a standardized protocol for antibiotic use in urethral reconstruction.
  • To determine if prolonged postoperative antibiotics prevent infection after urethroplasty.

Main Methods:

  • Prospective study of 900 patients undergoing urethral reconstruction across 11 centers.
  • Comparison of two cohorts: one receiving prolonged postoperative antibiotics, the other not.
  • Adherence to American Urological Association guidelines for perioperative antibiotics.

Main Results:

  • Overall 30-day postoperative infection rate was 5.1% (UTI) and 3.9% (wound infection).
  • Infection rates were not significantly different between cohorts receiving prolonged antibiotics versus those who did not (p=0.064 for UTI, p=0.772 for wound infection).
  • Multivariate analysis identified no predictive factors for postoperative infections.

Conclusions:

  • A standardized protocol effectively minimizes antibiotic use in urethral reconstruction.
  • Prolonged postoperative antibiotic administration offers no additional benefit in preventing infections.
  • Recommendations are against prolonged antibiotic use post-urethral reconstruction due to concerns of over-prescription.