Experimental urinary tract infection with Pseudomonas aeruginosa in mice.
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Urinary tract infection with Pseudomonas aeruginosa was induced in mice by transurethral inoculation of the organism into the bladder, followed by urethral obstruction for 6 h. The infection was mostly localized in the urinary organs. P. aeruginosa P9 was selected as the challenge organism from 10 laboratory strains of P. aeruginosa. After the inoculation of 10(7) colony-forming units of P. aeruginosa P9, transient bacteremia was observed in some of the mice from 6 h to 1 day after the inoculation. The number of organisms in the bladder tissue gradually decreased, whereas that in the kidneys increased to levels of 10(6) to 10(7) colony-forming units in 3 days, and these levels remained up to 2 weeks after the inoculation. The organisms gradually disappeared thereafter, and spontaneous recovery took place. The organisms could be recovered from the kidneys of 95% of the mice, and the gross lesions in the kidneys were observed in 77% of the mice 1 week after inoculation. The method developed here is simple and may be useful in the study of urinary tract infections due to P. aeruginosa and other species of bacteria.20 (+info)
Neurological disorders of micturition and their treatment.
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An overview of the current concepts of the neurological control of the bladder is given, based on laboratory experiments and PET scanning studies in human subjects. This is followed by a description of the various causes of the neurogenic bladder, discussed in a hierarchical order starting with cortical lesions and descending through the basal ganglia and brainstem, spinal cord, conus and cauda equina to disorders of peripheral innervation. Then follows a description of the condition of isolated urinary retention in young women. The article concludes with a review of the methods available for treating neurogenic bladder disorders. These are largely medical but brief mention of appropriate surgical procedures is made. (+info)
Effects of ZD6169, a K(ATP) channel opener, on the micturition reflex in the rat.
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The effects of ZD6169, a new ATP-sensitive potassium channel opener, on reflex urinary bladder activity were evaluated in urethane-anesthetized female Wistar rats. Continuous transvesical slow infusion cystometrograms (0.04 ml/min) were performed in untreated, capsaicin-pretreated (125 mg/kg s.c., 4 days before experiments) and capsaicin vehicle-pretreated rats. Intravesical infusion of ZD6169 in concentrations of 6, 15, 30, and 300 nM for 2 h at each concentration increased the intercontraction interval and pressure threshold for voiding in a concentration-dependent manner in untreated and vehicle-pretreated rats but not in capsaicin-pretreated animals. The effects appeared within 30 min after administration. ZD6169 did not alter baseline bladder pressure, duration of contractions, or the peak pressure during voiding. Glibenclamide (20 mg/kg i.v.) reversed the effects of ZD6169 (30 nM). During transvesical cystometrograms performed at a fast rate (0.21 ml/min), ZD6169 in concentrations between 6 and 300 nM did not alter the intercontraction interval or pressure threshold for voiding. ZD6169 produced smaller and more variable effects during slow transurethral cystometrograms. Capsaicin, a C-fiber afferent neurotoxin, administered s.c. 4 days before the experiment, produced similar changes and also eliminated the effect of ZD6169. These data suggest that ZD6169 raises the threshold for activation of C-fiber mechanoreceptors in the bladder wall and thereby increases the bladder volume for inducing reflex voiding. (+info)
Two cases of metastatic bladder cancers showing diffuse thickening of the bladder wall.
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Metastatic bladder cancer showing diffuse thickening of the bladder wall is very rare. We report two cases of metastatic bladder cancer arising from a stomach cancer and acute lymphocytic leukemia. Hydronephrosis and diffuse thickening of the bladder wall were revealed by ultrasonography and computed tomography. Transurethral biopsy and percutaneous whole wall needle biopsy of the bladder were useful for diagnosis. The possibility of metastasis or recurrence of prior and other malignancies should therefore be considered when the clinical features described here are encountered. (+info)
Biodistribution of an adenoviral vector carrying the luciferase reporter gene following intravesical or intravenous administration to a mouse.
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The biodistribution and resulting pattern of transgene expression were determined following intravesical administration of an adenoviral vector carrying the luciferase reporter gene (AdLuc). Female BALB/c mice were subjected to intravesical instillation of 1 x 10(9) or 5 x 10(9) plaque-forming units of AdLuc. After sacrifice, transgene expression was detected in tissues using luciferase assays; vector DNA was detected by vector-specific polymerase chain reaction. These experiments showed very little vector dissemination outside of the bladder by this route of administration. High-level expression of the vector transgene in the bladder was found to diminish by severalfold after 3 days. In a supporting study, vector dissemination and resulting transgene expression were determined following tail vein injection of 5 x 10(9) plaque-forming units of AdLuc. Vector was distributed to and expressed in every organ analyzed, with the highest concentration and level of expression observed in the liver. (+info)
Management of bladder function after outpatient surgery.
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BACKGROUND: This study was designed to test a treatment algorithm for management of bladder function after outpatient general or local anesthesia. METHODS: Three hundred twenty-four outpatients, stratified into risk categories for urinary retention, were studied. Patients in category 1 were low-risk patients (n = 227) having non-pelvic surgery and randomly assigned to receive 10 ml/kg or 2 ml/kg of intravenous fluid intraoperatively. They were discharged when otherwise ready, without being required to void. Patients in category 2 (n = 40), also presumed to be low risk, had gynecologic surgery. High-risk patients included 31 patients having hernia or anal surgery (category 3), and 31 patients with a history of retention (category 4). Bladder volumes were monitored by ultrasound in those in categories 2-4, and patients were required to void (or be catheterized) before discharge. The incidence of retention and urinary tract symptoms after surgery were determined for all categories. RESULT: Urinary retention affected 0.5% of category 1 patients and none of category 2 patients. Median time to void after discharge was 75 min (interquartile range 120) in category 1 patients (n = 27) discharged without voiding. Fluids administered did not alter incidence of retention or time to void. Retention occurred in 5% of high-risk patients before discharge and recurred in 25% after discharge. CONCLUSION: In reliable patients at low risk for retention, voiding before discharge appears unnecessary. In high-risk patients, continued observation until the bladder is emptied is indicated to avoid prolonged overdistention of the bladder. (+info)
Evaluation of the upper uterine cervix by the location of the vesicocervical fold of the urinary bladder to rule out cervical shortening during pregnancy with and without premature contractions.
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OBJECTIVES: To measure the length of the upper and lower cervix, as demarcated anatomically by the lowermost edge of the urinary bladder, in second- and third-trimester pregnancies with and without premature contractions. We hypothesized that patients with active premature contractions have a shorter upper cervix, placing them at greater risk of preterm delivery. METHODS: The lengths of the total cervix and of the upper and lower cervix, separately, and funnelling of the internal os, were assessed by endovaginal ultrasonography. In 120 women with normal pregnancy (43 of which with premature contractions), cervical dilatation and effacement were determined by digital examination. The correlation of cervical variables with the course of pregnancy was analyzed by the Wilcoxon test. RESULTS: The mean lengths of the upper and lower cervix were 15.9 +/- 1.7 mm (median 16.0 mm) and 26.4 +/- 3.7 mm (median 27.0 mm), respectively, in patients without premature contractions and 6.9 +/- 3.7 mm (median 6.0 mm) and 24.7 +/- 4.7 mm (median 25.0 mm), respectively, in patients with premature contractions. In the latter subgroup, the upper cervix was significantly shorter (p = 0.0001) but the lower cervix remained almost unchanged. Digital palpation was less accurate than transvaginal sonography for evaluating total cervical length. CONCLUSIONS: Transvaginal sonography is the method of choice for assessing cervical changes during pregnancy. In this prospective study, upper cervical length was the best predictor of preterm labor of all cervical parameters studied. Its length could be accurately determined by the location of the lowermost edge of the urinary bladder (vesicocervical fold of the bladder). (+info)
Hormonal replacement therapy and urinary problems as evaluated by ultrasound and color Doppler.
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OBJECTIVE: To determine how hormone replacement therapy modifies bladder vascularization and urinary symptoms. STUDY DESIGN: Twenty-eight postmenopausal women with urinary symptoms (day-time frequency > 8; nocturia > 1; urgency and/or dysuria) were analyzed before and after 1, 3 and 6 months of hormone replacement therapy. The patients underwent transvaginal ultrasound evaluation of the pelvic organs and endometrial and bladder wall thickness. Transvaginal color Doppler analysis of blood flow impedance of the uterine and intramural bladder wall arteries was performed in all cases. RESULTS: Hormone replacement therapy significantly increased bladder wall and endometrial thickness. This result was associated with significant improvements in uterine and bladder wall vascularization. Urinary symptoms also improved during therapy. CONCLUSION: The study of bladder wall thickness and vascularization provides additional information regarding the beneficial effect of hormone replacement therapy on lower urinary tract symptoms in postmenopausal women. (+info)