肾移植术后60例女性尿路感染的临床分析

目的:探讨肾移植术后女性尿路感染(UTI)的相关影响因素。方法:调查2012年1月~2012年12月在上海长征医院肾移植康复病房收治的肾移植术后UTI女性患者60例,依据年龄段分为低年组和高年组,比较两组患者UTI的临床资料,分析其临床特点,并探讨相关影响因素。结果:78.33%(47/60)患者至少出现UTI1例次;51.67%(31/60)患者UTI临床症状不典型;38.33%(23/60)患者尿标本以大肠埃希菌感染为主,但36.67%(22/60)患者却难以找到致病菌。其中高年组(占78.33%,47/60)比低年组(占21.67%,13/60)UTI发生率高,差异有统计学意义(P0.05)。进一步分析发现,在高年组UTI中,糖尿病和移植肾失功发生率均高于低年组患者(P0.05)。结论:年龄、糖尿病是肾移植术后女性UTI的重要影响因素,高年组UTI患者易增加移植肾失功的风险。     

雌激素佐治老年绝经女性复发性尿路感染疗效分析

目的:本文探讨研究雌激素辅助治疗老年女性反复发作性下尿路感染的疗效.方法:48例年龄50～75岁女性,绝经期后复发性下尿路感染患者,病史均有半年以上,随机分为2组,观察组采用雌激素联合抗生素,对照组则只采用抗生素治疗.随访观察治疗后6月内的情况.结果:采用雌激素联合抗生素治疗后3个月及6个月的有效率明显高于对照组;复发率明显下降,差异显著(P＜0.05).结论:雌激素辅助抗生素能提高治疗有效率,有效降低老年女性尿路感染的复发率,值得临床推广.     

不同生理阶段女性下尿路感染治疗的研究

目的：研究不同生理阶段女性下尿路感染的特点，采用不同方法进行治疗，比较治疗效果。方法：按不同生理阶段分为绝经组、青春期及生殖期妇女组、青春前期组。绝经组又分为单独使用抗生素及抗生素加雌激素制剂组，比较两组治疗效果。青春期及生殖期妇女组分为单独使用抗生素组及根据检查结果行阴道用药同时治疗泌尿系感染组，比较两组治疗效果。青春前期组针对病因进行治疗。结果：绝经期组中加用雌激素制剂的治疗效果(96．2％)明显优于单独使用抗生素组(76．0％)。青春期及生殖期妇女组中阴道用药同时治疗泌尿系感染组的效果(98．4％)明显优于单独使用抗生素组(67．4％)。青春前期组90．3％治愈。结论：不同生理段的女性下尿路感染病因不同，针对病因采用不同的治疗方法，有助于提高治疗效果。     

保定市六家医院女性反复尿路感染及相关因素的调查分析

目的:以提高女性健康为目的,探讨女性反复尿路感染的相关因素。方法:对保定市六家医院360例女性尿路感染患者进行问卷调查,确定有效调查310例,分析反复尿路感染与卫生习惯、受教育程度、对医嘱依从性三方面的关系,卡方检验为主要手段,分析反复尿路感染的相关因素。结果:缺乏良好的卫生习惯、受教育程度低、对医嘱的依从性差都与尿路感染反复发生密切相关。结论:通过有效的卫生宣教,使妇女保持良好的卫生习惯,做到对医嘱的高依从性,更多关注受教育低的女性可有效预防尿路感染的反复发生。     

老年人尿路感染124例临床分析

感染是老年人最常见的疾病之一 ,而尿路感染又是其中较常见的。我院近 1 1年来收治 60岁以上尿路感染患者 1 2 4例 ,现根据其临床特点作如下分析 ,为临床诊治提供有益的参考。1　资料与方法1 .1 　 临床资料本组 1 2 4例 ,为我院于 1 990～ 2 0 0 0年收治的住院患者 ,男 42例 ,女 82例。年龄 60～ 83岁 ,平均 65 .5岁 ,其中 60～ 69岁者 77例 ,70岁以上者 47例。1 .2 　 分析方法按有尿路感染症状和 (或 )白细胞尿、清洁中段尿细菌培养≥ 1 0 5 ｍｌ进行尿路感染临床统计和分析。2 　 结果1 1年中 ,60岁以上住院人数为 2 1 30例 ,其中尿路感…     

泌宁方治疗老年尿路感染46例临床观察

笔者自2003年4月以来,采用泌宁方结合抗生素治疗老年性尿路感染46例,疗效较好,现报告如下。     

89例真菌性尿路感染的临床分析

目的了解真菌性尿路感染的临床特点、病原菌及药敏。方法回顾性分析真菌性尿路感染有关的临床资料。结果共398例尿路感染患者，其中剀例诊断真菌性尿路感染（占22．36％）；念珠菌85株（占95．50％）；重症监护室（ICU）患者57例（占64．04％）。结论真菌性尿路感染多发生在ICU病房，发病诱因与抗生素使用及留置尿管等有关，以念珠菌为主，耐药率低。     

女性下尿路症状的尿动力学分析(附283报告)

目的 研究以下尿路症状为主诉的女性患者的尿动力学变化及其临床意义。方法女性患者．年龄6-89岁，临床表现为储尿期（刺激性）和（或）排尿期（梗阻性）症状，采用尿动力学方法检查尿流率、同步膀胱压力容积流率及肛门括约肌肌电图测定、部分同步透视下行影像尿动力学检查。结果 以排尿症状为主者86例，以储尿症状为主者197例。不稳定膀胱57例，感觉性尿急30例。神经原性膀胱尿道功能障碍32例，其中逼尿肌反射低下26例。逼尿肌反射亢进7例。逼尿肌收缩力低下26例。逼尿肌外括约肌协同失调1例。下尿路梗阻30例，其中膀胱颈梗阻6例，尿道远端狭窄11例，非神经原件逼尿肌外括约肌协同失调13例。压力性尿失禁68例，其中Ⅰ型19例，Ⅱ型12例。Ⅲ型14例，Ⅱ／Ⅲ型23例；TF常40例。结论 尿动力学检查能了解膀胱的功能状况和膀胱出口梗阻的部位，为临床治疗的选择提供了可靠的依据。     

尿流动力学在女性下尿路症候群诊治中的应用

目的评估尿流动力学在女性下尿路症候群（LUTS）分类和治疗中的作用。方法采用尿动力测定仪对127例女性下尿路症候群患者进行尿流动力学检查,并根据检查结果进行分类及相关治疗,治疗后观察临床症状变化并复查尿流动力学各项参数进行对照。结栗不稳定膀胱30例（26．8％）,低顺应性膀胱10例（8．9％）,逼尿肌无力12例（10．7％）,尿道压增高89例（79．5％）,尿动力学无明显异常15例（11．8％）。112例尿动力学异常患者经相应治疗后有效97例,有效率为86．6％。结论尿流动力学检查在女性LUTS的诊断分型及指导治疗上具有重要意义。     

女性护士无尿意排尿行为与下尿路症状的关系

目的探讨女性护士的无尿意排尿行为现状,分析其与下尿路症状的关系。方法采用方便抽样的方法,调查江苏省2家医院578名女性在职护士。使用无尿意排尿行为量表和中文版国际尿失禁咨询委员会女性下尿路症状量表调查女性护士的无尿意排尿行为和下尿路症状情况。采用Pearson相关分析和多元线性回归分析女性护士无尿意排尿行为与下尿路症状的关系。结果女性护士无尿意排尿量表平均得分为(9.17±3.67)分,45.67%的护士在离开家之前没有尿意也会排尿,有61.24%的护士在临睡前没有尿意也会排尿;多元线性回归显示,无尿意排尿行为是储尿期症状(β=0.214,P0.01)和排尿期症状(β=0.181,P0.01)的影响因素。结论女性护士群体中存在频繁的无尿意排尿行为,且对行为的认知程度不高。无尿意排尿行为与下尿路症状中储尿期症状和排尿期症状的发生有关,应制定针对护士无尿意排尿行为的相关措施来预防女性护士下尿路症状的发生。     

女性下尿路症状患者的尿动力学分析

目的　探讨女性下尿路症状原因及临床意义。　方法　 72例下尿路症状女性患者 ,年龄 8～ 86岁 ,平均 4 8岁。其中排尿困难 4 6例 ,尿失禁 14例 ,尿频 10例 ,夜间遗尿 2例。患者均行尿动力学检测。　结果　 4 6例排尿困难者膀胱容量 6 0～ 80 0ml,其中 2 0例膀胱逼尿肌收缩力为 0 ,2 6例9～ 16 0cmH2 O(1cmH2 O =0 .0 98kPa)。Linp URR图示为Ⅲ级以上梗阻者 19例。尿道静态分布阻力2 5～ 130cmH2 O。膀胱逼尿肌与尿道外括约肌协调性良好者 5例 ,协同失调者 33例。 10例尿频患者膀胱容量 97～ 4 5 0ml,2例排尿期膀胱逼尿肌收缩力为 0 ,8例 31～ 110cmH2 O。Linp URR图示显示Ⅲ级以上梗阻者 2例。 1例急迫性尿失禁者膀胱过度敏感。 6例压力性尿失禁者腹压漏尿点压力 4 4～76cmH2 O。 3例充盈性尿失禁者排尿期膀胱逼尿肌压力为 0 ,尿道静态分布阻力 32～ 4 2cmH2 O。真性尿失禁 4例尿道外括约肌压力 0～ 16cmH2 O ,平均 (8.5± 5 .7)cmH2 O。 2例遗尿患者存在不稳定性膀胱表现 ,排尿期膀胱收缩乏力。　结论　尿动力学检查对女性下尿路症状疾病诊断、治疗、预后判断具有重要指导意义。     

Cystoscopy in women with recurrent urinary tract infection

OBJECTIVE: To investigate if women with recurrent urinary tract infection (UTI) warrant cystoscopy to exclude an abnormality of the lower urinary tract. This is particularly relevant given that non-invasive imaging has often been performed to exclude abnormality. Our further aims were to correlate imaging and risk factors with cystoscopic findings to determine their predictive value in finding pathology. PATIENTS AND METHODS: A database of women undergoing cystoscopy with recurrent UTI has been maintained at our institution for 10 years. We retrospectively examined this and patient records for patient demographics, and investigative and operative data. RESULTS: A total of 118 patients (mean 55 years) having recurrent UTI (mean 4.7 infections/year) were available. There were nine patients (8%) with significant abnormalities at cystoscopy: urethral stricture (six), bladder calculus (one), bladder diverticulum (one) and colovesical fistula (one). The negative predictive value (NPV) of imaging was 99% and significant (P < 0.01). Women with no risk factors for UTI had a NPV of 93% for normal cystoscopy (P > 0.05). The positive predictive value was low for imaging and risk factors in predicting cystoscopy findings. CONCLUSIONS: In our study, 8% of women had significant abnormalities detected during cystoscopy with most over 50 years. Women without risk factors for recurrent UTI and with normal imaging could have a cystoscopy omitted. Younger women are less likely to have pathology and this must be factored into decisions to perform cystoscopy.     

Usefulness of classical homeopathy for the prophylaxis of recurrent urinary tract infections in individuals with chronic neurogenic lower urinary tract dysfunction

Context/Objective: to investigate the usefulness of classical homeopathy for the prevention of recurrent urinary tract infections (UTI) in patients with spinal cord injury (SCI).

Design: prospective study.

Setting: rehabilitation center in Switzerland.

Participants: patients with chronic SCI and ≥3 UTI/year.

Interventions: Participants were treated either with a standardized prophylaxis alone or in combination with homeopathy.

Outcome measures: The number of UTI, general and specific quality of life (QoL), and satisfaction with homeopathic treatment were assessed prospectively for one year.

Results: Ten patients were in the control group; 25 patients received adjunctive homeopathic treatment. The median number of self-reported UTI in the homeopathy group decreased significantly, whereas it remained unchanged in the control group. The domain incontinence impact of the KHQ improved significantly (P?=?0.035), whereas the general QoL did not change. The satisfaction with homeopathic care was high.

Conclusions: Adjunctive homeopathic treatment lead to a significant decrease of UTI in SCI patients. Therefore, classical homeopathy could be considered in SCI patients with recurrent UTI.

Trial registration: ClinicalTrials.gov. (NCT01477502).     

Examining lower urinary tract symptom constellations using cluster analysis

OBJECTIVE

To gain a better understanding of how patients experience lower urinary tract symptoms (LUTS) and to determine whether particular symptoms cluster together, as LUTS seldom occur alone.

SUBJECTS AND METHODS

A secondary analysis of a cross‐sectional, population‐based survey of adults in Sweden, Italy, Germany, UK and Canada was undertaken to examine the presence of LUTS groups. Of the 19 165 telephone surveys, 13 519 respondents reported at least one LUTS and were included in the analysis. All respondents were asked about the presence of 14 LUTS (International Prostate Symptom Score plus seven additional LUTS). K‐means cluster analyses, a statistical method for sorting objects into groups so that similar objects are grouped together, was used to identify groups of people based on their symptoms. Men and women were analysed separately. A split‐half random sample was selected from the dataset so that exploratory analyses could be conducted in one half and confirmed in the second. On model confirmation, the sample was analysed in its entirety.

RESULTS

Included in this analysis were 5014 men (mean age 49.8 years; 95% white) and 8505 women (mean age 50.4 years; 96% white). Among both men and women, six distinct symptom cluster groups were identified and the symptom patterns of each cluster were examined. For both, the largest cluster consisted of respondents with minimal symptoms (i.e. reporting essentially one symptom), 56% of men and 57% of women. The remaining five clusters for men and women were labelled based on their predominant symptoms. For men, the clusters were nocturia of twice or more per night (12%); terminal dribble (11%); urgency (10%); multiple symptoms (9%); and postvoid incontinence (5%). For women, the clusters were nocturia of twice or more per night (12%); terminal dribble (10%); urgency (8%); stress incontinence (8%); and multiple symptoms (5%). The multiple‐symptom groups had several and varied LUTS, were older, and had more comorbidities. Clusters of terminal dribble and male postvoid incontinence had a lower prevalence of all other LUTS, but were fairly common (11% and 5% of men).

CONCLUSIONS

This analysis provides an empirical approach to examining the presentation of multiple LUTS and suggests it is possible to identify subgroups of patients with LUTS based on their symptom presentation. These analyses need to be replicated to evaluate the clinical relevance of these findings.     

Core lower urinary tract symptom score (CLSS) for the assessment of female lower urinary tract symptoms: a comparative study

Objective: We have recently developed the core lower urinary tract symptom score (CLSS) questionnaire to readily address 10 important lower urinary tract symptoms (LUTS). The aim of the present study was to evaluate the performance of the CLSS in women compared with the International Prostate Symptom Score (IPSS) and Overactive Bladder Symptom Score (OABSS). Methods: Three hundred and eighteen treatment‐naïve consecutive female patients, including 48 controls, completed the three questionnaires. Quality of life (QOL) was determined as per the IPSS QOL Index. The clinical diagnoses were overactive bladder (n = 69), mixed incontinence (n = 42), stress incontinence (n = 17), pelvic organ prolapse (n = 56), interstitial cystitis (n = 31), bacterial cystitis (n = 16), underactive bladder (n = 16), and “other” (n = 23). Simple statistics and the relationship between symptom scores and poor QOL (QOL Index ≥4) were examined. Results: All symptom scores were significantly increased in symptomatic women. The CLSS described the symptom profiles of patients with distinct conditions. The scores of corresponding symptoms on the three questionnaires were significantly correlated (r = 0.51–0.85; all P < 0.0001). Multivariate logistic regression modeling proved five CLSS symptoms (daytime frequency, nocturia, urgency incontinence, straining, and urethral pain) as independent predictors of poor QOL, with hazard ratios ranging from 2.0 to 4.2. The IPSS included only two (urgency and straining) significant symptoms. Conclusions: The IPSS alone does not fully evaluate female LUTS, with a possible negative impact on QOL. Using the CLSS questionnaire would enable a simple and comprehensive assessment of female LUTS.