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

Urinary Tract Infection III: Diagnostic Studies and Interprofessional Care

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...
Acute Pyelonephritis II: Diagnostic Studies and Management01:28

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Introduction:For diagnosing acute pyelonephritis, a comprehensive patient history is collected to identify symptoms such as dysuria, frequent or urgent urination, flank pain, or costovertebral angle (CVA) tenderness that may suggest a kidney infection.Physical ExaminationDuring the physical examination, CVA tenderness is assessed. This involves gentle percussion over the costovertebral angle, where tenderness often indicates a kidney infection.Diagnostic TestsUrinalysis: Used to identify white...
Imaging Studies V: Intravenous Urography and Retrograde Pyelography01:22

Imaging Studies V: Intravenous Urography and Retrograde Pyelography

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...
Imaging Studies VI: Voiding Cystourethrography and Cystography01:22

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Voiding Cystourethrography (VCUG) and Cystography are specialized radiographic procedures used to examine the structure and function of the bladder and urethra.Voiding Cystourethrography (VCUG)A Voiding Cystourethrogram (VCUG) is a diagnostic imaging procedure that assesses the anatomy and function of the lower urinary tract. It focuses on the bladder, bladder neck, and urethra, helping detect abnormalities such as vesicoureteral reflux (VUR)—the backward or reverse flow of urine into the...
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Meaning of Cystoscopic Examination:Cystoscopy is an essential diagnostic tool in urology that is used to assess the structure and function of the genitourinary system. It provides a direct view of the urethra, bladder, and, in some cases, the ureteral openings. This procedure helps detect structural abnormalities, infections, cancers, and blockages in the urinary tract. There are two types of cystoscopy:Flexible cystoscopy is commonly performed in outpatient settings due to its less invasive...
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Urine Studies II: Urine Culture and Sensitivity Test

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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In Vivo Luminal Measurement of Distension-Evoked Urothelial ATP Release in Rodents
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Suprapubic catheterisation: a study of 1000 elective procedures.

Catherine Hobbs1, Sarah Howles1, Fadel Derry2

  • 1Department of Urology, Churchill Hospital, Oxford University NHS Foundation Trust, Oxford, UK.

BJU International
|March 13, 2022
PubMed
Summary

Suprapubic catheter (SPC) insertion carries a low risk of major complications, even in spinal cord injury patients. Minor issues are common long-term but generally well-tolerated, supporting SPC safety.

Keywords:
intestinal perforationneurogenic bladdersepsissuprapubic cystostomyurinary catheters

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Area of Science:

  • Urology
  • Neurosurgery
  • Medical Devices

Background:

  • Suprapubic catheter (SPC) insertion is a common procedure for urinary management.
  • Patients with spinal cord injury (SCI) often require long-term catheterization, necessitating evaluation of SPC risks and outcomes in this population.

Purpose of the Study:

  • To investigate the risks and long-term outcomes associated with suprapubic catheter (SPC) insertion.
  • To assess the safety and tolerability of SPCs in a cohort predominantly comprising individuals with spinal cord injuries.

Main Methods:

  • Retrospective analysis of 1000 consecutive SPC insertions from 1998 to 2015 at the National Spinal Injuries Centre.
  • Utilized theatre database records for patient data, with follow-up ranging from 4 weeks to 16.45 years (median 3.3 years).
  • Procedures included cystoscopy-guided suprapubic puncture or direct incision with cystoscopy.

Main Results:

  • Major complications (Clavien-Dindo IIIb or higher) occurred in 0.6% of patients; 0.4% required return to theatre.
  • No bowel injuries were reported; one death within 30 days was attributed to pulmonary embolism.
  • Long-term tolerance of SPCs was high, with 59% experiencing minor complications, often related to tract issues or antibiotic prescribing.

Conclusions:

  • SPC insertion demonstrates a lower risk of major complications than previously suggested.
  • While minor complications are frequent in long-term SPC use, they are generally well-tolerated by patients.
  • Educational development in catheter care and antibiotic stewardship could further enhance patient outcomes.