Factors Associated with Urethral and Bladder Neck Stricture After Transurethral Resection of the Prostate.

Introduction: Urethral and bladder neck stricture (U/BNS) is a complication that occurs in up to 9% of patients following transurethral resection of the prostate (TURP). The most relevant risk factors reported are prolonged surgical duration and prostatic volume. The purpose of this study is to analyze risk factors associated with the development of U/BNS following TURP. Materials and Methods: Case-control study. Population: patients who underwent TURP. Cases: patients with U/BNS following TURP, diagnosed between January 2010 and December 2018. We included patients with obstructive symptoms after TURP with clinical or radiographical evidence of U/BNS. Controls were patients who underwent TURP between January 2016 and December 2017, without evidence of stricture. Patients with history of pelvic fracture and previous U/BNS were excluded. We analyzed as risk factors age, prostatic volume, diabetes mellitus, previous use of transurethral catheter, urinary tract infection, bladder calculi, prostate cancer, previous TURP, resection time, resected volume during TURP, transoperative complications, and number of surgical procedures performed during the same event. We used chi-square or Mann-Whitney's U test for between-group comparison; association was established by odds ratios (ORs) and 95% confidence interval (CI), variables with p < 0.05 were included in the logistic regression. Results: We included 101 cases and 207 controls. Cases had lower incidence of prostate cancer, smaller prostates, less resection time during TURP, lower grams resected and prostate-specific antigen values than controls. History of transurethral catheter was more frequent in controls than cases (46% vs 29%, p = 0.004); there were no differences between groups in the other factors analyzed. On multivariate analysis, the use of a transurethral catheter was a protective factor against U/BNS (OR 0.16, 95% CI 0.064-0.442, p < 0.001). Conclusions: In this study, the use of urethral catheter before TURP is a protective factor against U/BNS.

[Cerebral palsy associated urological pathologies. Nurse´s role.] / Patologias urologicas asociadas a paralisis cerebral. El rol de la enfermera.

OBJECTIVES: The objectives of this study were: To analyze the causes of urological consultation of the child with CP, to analyze the role of nursing in the urological care of children with CP referred to Urology, and to know the relationship between the child's urinary tract infection and CP and its degree of independence. METHOD: Retrospective analytical observational study based on the review of the clinical records of patients diagnosed with cerebral palsy. Forty-seven patients selected by simple randomization in an age range of 2 to 16 years were included in the study in an outpatient clinic for CP patients located in a town in northern Mexico. RESULTS: The causes of urological consultation of the child with CP, referred by nursing were: urinary infection, phimosis, retractable testicle, cryptorchidism, hypogonadism, overactive bladder, and hypospadias. The relationship between the urinary infection of the child with CP and its degree of independence was established with the level of urinary sphincter control. CONCLUSIONS: The nursing staff is a key and decisive factor in the diagnosis, early reference for treatment and monitoring of the evolution of urinary disorders in children with CP. It is not indicated to start a toilet training program in children with CP, without having previously ruled out a urinary tract infection.

OBJETIVOS: Los objetivos de este estudio fueron: analizar las causas de consulta urológica del niño con Parálisis Cerebral (PC), analizar el rol de enfermería en el cuidado urológico de niños con PC referidos a Urología, y conocer la relación entre la infección urinaria del niño con PC y su grado de independencia. MATERIAL Y METODO: Estudio observacional analítico retrospectivo en base a la revisión del expediente clínico de pacientes con diagnóstico de parálisis cerebral. Se incluyeron en el estudio a 47 pacientes seleccionados mediante aleatorización simple en un rango de edad de 2 a 16 años en una clínica de atención ambulatoria para pacientes con PC, ubicada en una población del norte de México. RESULTADOS: Las causas de consulta urológica del niño con PC, referidos por enfermería fueron: infección urinaria, fimosis, testículo retráctil, criptorquidia, hipogonadismo, vejiga hiperactiva, e hipospadias. La relación entre la infección urinaria del niño con PC y su grado de independencia se estableció con el nivel de control de esfínter urinario. CONCLUSIONES: El personal de enfermería es factor clave y decisivo en el diagnóstico, referencia temprana para tratamiento y vigilancia de la evolución de los trastornos urinarios en niños con PC. No está indicado iniciar un programa de control de esfínteres en niños con PC, sin haber descartado antes una infección urinaria.

Patologias urologicas asociadas a paralisis cerebral. El rol de la enfermera / Cerebral palsy associated urological pathologies. Nurse's role

Objetivos: Los objetivos de este estudio fueron: analizar las causas de consulta urológica del niño con Parálisis Cerebral (PC), analizar el rol de enfermería en el cuidado urológico de niños con PC referidos a Urología, y conocer la relación entre la infección urinaria del niño con PC y su grado de independencia. Material y método: Estudio observacional analítico retrospectivo en base a la revisión del expediente clínico de pacientes con diagnóstico de parálisis cerebral. Se incluyeron en el estudio a 47 pacientes seleccionados mediante aleatorización simple en un rango de edad de 2 a 16 años en una clínica de atención ambulatoria para pacientes con PC, ubicada en una población del norte de México. Resultados: Las causas de consulta urológica del niño con PC, referidos por enfermería fueron: infección urinaria, fimosis, testículo retráctil, criptorquidia, hipogonadismo, vejiga hiperactiva, e hipospadias. La relación entre la infección urinaria del niño con PC y su grado de independencia se estableció con el nivel de control de esfínter urinario. Conclusiones: El personal de enfermería es factor clave y decisivo en el diagnóstico, referencia temprana para tratamiento y vigilancia de la evolución de los trastornos urinarios en niños con PC. No está indicado iniciar un programa de control de esfínteres en niños con PC, sin haber descartado antes una infección urinaria

Objectives: The objectives of this study were: To analyze the causes of urological consultation of the child with CP, to analyze the role of nursing in the urological care of children with CP referred to Urology, and to know the relationship between the child’s urinary tract infection and CP and its degree of independence. Method: Retrospective analytical observational study based on the review of the clinical records of patients diagnosed with cerebral palsy. Forty-seven patients selected by simple randomization in an age range of 2 to 16 years were included in the study in an outpatient clinic for CP patients located in a town in northern Mexico. Results: The causes of urological consultation of the child with CP, referred by nursing were: urinary infection, phimosis, retractable testicle, cryptorchidism, hypogonadism, overactive bladder, and hypospadias. The relationship between the urinary infection of the child with CP and its degree of independence was established with the level of urinary sphincter control. Conclusions: The nursing staff is a key and decisive factor in the diagnosis, early reference for treatment and monitoring of the evolution of urinary disorders in children with CP. It is not indicated to start a toilet training program in children with CP, without having previously ruled out a urinary tract infection

Comorbidities and antimicrobial resistance in urological outpatients with positive urine culture / Resistencia bacteriana y comorbilidades presentes en pacientes urológicos ambulatorios con urocultivos positivos

Background: The urinary tract infections are the third cause of infections in Mexico. The inappropriate use of antibiotic has generated the presence of multidrugresistant bacteria. Objective: To identify the bacterial resistance patterns of the hospital and to detect the present comorbidities that can modify the evolution of urinary tract infection for proper empirical management. Methods: Non-comparative cross-sectional study, positive urine cultures were reviewed in the period from December 2015 to May 2016, in outpatients of urology in the hospital. The obtained growth, bacterial resistance and the comorbidities of each patient were analyzed. Results: 190 urine cultures were included. The most frequent bacterium was Escherichia coli. Greater general antibiotic resistance was detected to ceftazidime (91.5%), quinolones (> 65%) and trimethoprim / sulfamethoxazole (58%). The general multiresistance was 66.3%. The antibiotics that showed greater sensitivity were: amikacin, imipenem, nitrofurantoin, meropenem and piperacillin / tazobactam. The most frequent comorbidities were diabetes mellitus, previous use of antibiotics for urinary tract infection and prostatic hyperplasia. Conclusion: In patients with urinary tract infection in the hospital, the empirical use of nitrofurantoin and amikacin is recommended. Quinolones and trimethoprim / sulfamethoxazole have a high resistance index.

Introducción: las infecciones de vías urinarias son la tercera causa de morbilidad por infecciones en México. El uso indiscriminado de antibióticos ha generado la aparición de bacterias multiresistentes. Objetivo: identificar los patrones de resistencia bacteriana del hospital y detectar las comorbilidades presentes que pueden alterar el curso de una infección urinaria, para el manejo empírico adecuado. Métodos: estudio transversal no comparativo, se revisaron los urocultivos positivos en el período diciembre de 2015 a mayo de 2016, en pacientes ambulatorios de urología del hospital. Se analizó crecimiento obtenido, resistencia bacteriana y las comorbilidades de cada paciente. Resultados: se incluyeron 190 urocultivos. La bacteria más frecuente fue Escherichia coli. Se detectó mayor resistencia antibiótica general a ceftazidima (91.5%), quinolonas (> 65%) y trimetoprim/sulfametoxazol (58%). La multirresistencia general fue de 66.3%. Los antibióticos que demostraron mayor sensibilidad fueron: amikacina, imipenem, nitrofurantoína, meropenem y piperacilina/tazobactam. Las comorbilidades más frecuentes fueron diabetes mellitus, uso previo de antibióticos para infección de vías urinarias e hiperplasia prostática. Conclusiones: en los pacientes con infección de vías urinarias del hospital, se recomienda el uso empírico de nitrofurantoína y amikacina. Las quinolonas y el trimetoprim/sulfametoxazol tienen un alto índice de resistencia.