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Related Concept Videos

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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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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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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Inflammatory Bowel Disease II: Crohn's Disease01:30

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Introduction
Inflammatory bowel disease, commonly known as IBD, refers to a collection of disorders that lead to persistent inflammation of the gastrointestinal tract. The two types of IBD are ulcerative colitis, which impacts the colon, and Crohn's disease, which can involve any part of the gastrointestinal segment.
Crohn's disease
Crohn's disease is a chronic, systemic inflammatory bowel disease (IBD) that predominantly affects the gastrointestinal tract. It is marked by...
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Acute Pyelonephritis I: Introduction01:27

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Pyelonephritis is a bacterial infection that primarily affects the renal parenchyma and collecting system, including the renal pelvis, tubules, and interstitial tissue of one or both kidneys. It can be classified as either acute—a sudden, severe infection—or chronic, which refers to long-term or recurrent kidney infections.The primary cause of acute pyelonephritis (APN) is bacterial infection, with Escherichia coli accounting for approximately 70-80% of cases. Other bacteria, such...
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Destroyed bladders: Characterization of progressive inflammatory cystitis.

Anna Faris1, Giulia I Lane1, Rohit Mehra2

  • 1Department of Urology, University of Michigan, Ann Arbor, Michigan, USA.

Neurourology and Urodynamics
|May 1, 2023
PubMed
Summary

Progressive inflammatory cystitis (PIC) is a severe noninfectious bladder condition causing reduced capacity and urinary issues. Many patients require urinary diversion due to rapid disease progression.

Keywords:
Cystitishydronephrosislower urinary tract symptomsurinary bladder diseasesurinary tract infectionsvesicoureteral reflux

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Area of Science:

  • Urology
  • Pathology
  • Inflammatory Diseases

Background:

  • Noninfectious cystitis can present with severe, refractory symptoms.
  • A subset of patients exhibits diffuse inflammation, reduced bladder capacity, and vesicoureteral reflux (VUR).
  • This distinct clinical entity is termed progressive inflammatory cystitis (PIC).

Purpose of the Study:

  • To describe the clinical phenotype of PIC.
  • To report disease outcomes in patients with PIC.
  • To detail the pathologic findings associated with PIC.

Main Methods:

  • Retrospective cohort study of 46 patients with PIC.
  • Exclusion criteria: pelvic radiation, urologic malignancy, neurogenic bladder.
  • Bivariate analyses and Kaplan-Meier methods were used.

Main Results:

  • Median age at symptom onset was 63 years; common symptoms included urgency/frequency and incontinence.
  • Urodynamics revealed a median bladder capacity of 80 mL, with frequent VUR (68%) and hydronephrosis (59%).
  • Pathology showed ulceration, acute/chronic inflammation (80% eosinophils), lymphoid follicles, and mast cells.

Conclusions:

  • PIC is a distinct entity with diminished bladder capacity and upper tract changes, progressing to urinary diversion.
  • Further prospective studies are needed to characterize this severe phenotype.
  • Earlier diagnosis and management strategies for PIC require further investigation.