DOCSLIB.ORG

Inflammation-Induced Plasticity of Micturition Reflex Pathways

Total Page：16

File Type：pdf, Size：1020Kb

Download full-text PDF Read full-text
Inflammation-Induced Plasticity of Micturition Reflex Pathways University of Vermont ScholarWorks @ UVM Graduate College Dissertations and Theses Dissertations and Theses 2011 Inflammation-Induced Plasticity of Micturition Reflex aP thways Lauren Arms University of Vermont Follow this and additional works at: https://scholarworks.uvm.edu/graddis Recommended Citation Arms, Lauren, "Inflammation-Induced Plasticity of Micturition Reflex aP thways" (2011). Graduate College Dissertations and Theses. 9. https://scholarworks.uvm.edu/graddis/9 This Dissertation is brought to you for free and open access by the Dissertations and Theses at ScholarWorks @ UVM. It has been accepted for inclusion in Graduate College Dissertations and Theses by an authorized administrator of ScholarWorks @ UVM. For more information, please contact [email protected]. INFLAMMATION-INDUCED PLASTICITY OF MICTURITION REFLEX PATHWAYS A Dissertation Presented by Lauren Arms to The Faculty of the Graduate College of The University of Vermont In Partial Fulfillment of the Requirements for the Degree of Doctor of Philosophy Specializing in Neuroscience January, 2011 Accepted by the Faculty ofthe Graduate College, The University ofVermont, in partial fulfillment ofthe requirements for the degree ofDoctor ofPhilosophy, specializing in Neuroscience. Dissertation Examination Committee: Advisor Q~JfiJ~ Deborah H. Damon, Ph.D. Chairperson Dean, Graduate College Date: December 7,2010 Abstract Although a seemingly basic and simple behavior, micturition necessitates precise integration and coordination of multiple divisions of the nervous system: visceral sensory, somatic motor, sympathetic, parasympathetic, as well as voluntary control from higher brain/ brainstem centers. When coordination of this circuitry falters, the consequences can be devastating and include severely decreased quality of life and substantial economic burden. This dissertation project investigates the potential role(s) of inflammatory mediators in bladder sensory physiology with the long term goal of elucidating potential targets for intervention. The overall hypothesis is that inflammatory-induced changes in the urinary bladder or afferent projections ultimately lead to dysfunctional micturition symptoms. Using a rodent model of cyclophosphamide (CYP)-induced bladder inflammation, we examined the expression and function of the chemokine/ receptor pair, CXCL12/CXCR4, and the activated (phosphorylated) form of ubiquitous signaling molecule, AKT using a multidisciplinary approach that includes: immunohistochemistry, protein and transcript quantification techniques, and in vivo bladder physiology studies combined with pharmacological tools. Peripheral chemokine levels are elevated in patients with various chronic pelvic inflammatory/ pain syndromes including interstitial cystitis/bladder pain syndrome (IC/BPS) and are implicated in numerous inflammatory and mechanical pain models in rodents. However studies had not previously shown a direct functional role for chemokine signaling in micturition. We hypothesized that CXCL12 and CXCR4 would increase in the urinary bladder with CYP-induced bladder inflammation and that CXCR4 receptor blockade with AMD3100 would reduce CYP-induced bladder hyperreflexia. ELISA, immunohistochemical and qRT-PCR experiments demonstrate duration- dependent increases in CXCL12 and CXCR4 protein and transcript expression in specific tissue compartments of the urinary bladder, mainly the urothelium. In vivo studies provide evidence of a role for chemokine signaling in the mediation of micturition function. Intravesical infusion with AMD3100, a CXCR4 receptor antagonist, significantly reduced CYP-induced bladder hyperreflexia as evidenced by increased bladder capacity, intercontraction interval and decreased voiding frequency. AKT is a putative cellular survival signal, however, recent studies also implicate the signaling molecule in the induction and maintenance of pain processes, development of long term plasticity (e.g. LTP and central sensitization) and visceral inflammation. Functional studies addressing the contribution of pAKT in micturition have not been performed. We hypothesized that increasing pAKT levels would contribute to CYP- induced bladder hyperreflexia. Western blot and immunohistochemical studies demonstrated that phosphorylation of AKT increases in the whole urinary bladder with CYP-induced bladder inflammation in a tissue compartment- and time-dependent manner. Intravesical infusion with inhibitors of AKT phosphorylation, AKT Inhibitor IV and deguelin, significantly improved symptoms of CYP-induced bladder hyperreflexia suggesting a functional role for pAKT in bladder physiology. These studies demonstrate the functional capacity of inflammatory mediators and inflammatory associated signaling pathways in micturition reflex pathways. Chemokine signaling via the CXCR4 receptor and upstream activators of AKT may provide therapeutic targets with respect to inflammatory-induced bladder sensory physiology dysfunction. Citations Material from this dissertation has been published in the following form: Arms, L., B.M. Girard, M.A. Vizzard (2010). Expression and function of CXCL12/CXCR4 in rat urinary bladder with cyclophosphamide-induced cystitis. American Journal of Physiology: Renal Physiology, 298: F589-F600. ii Dedication For my mother, Susan Arms. She is the epitome of strength and determination; she is my inspiration. iii Acknowledgements First and foremost I thank my parents, Susan and Roger Arms, for the solid foundation they have worked tirelessly to create and maintain in all aspects of my life. Their encouragement throughout the years has enabled me to believe that I can achieve anything. I owe the success of my academic career and happiness in life to their unyielding and selfless support. Graduate school has been an incredible learning and growing experience. I am immensely thankful to have worked with my advisor, Dr. Margaret Vizzard, who dedicated so much of her valuable time to me and my project. While working with Margaret, I gained invaluable skills that will help me undoubtedly throughout my career and personal life. Her unwavering kind and positive demeanor in the face of all situations, combined with her professional and personal ambitions make her an exceptional role model and a cultivating mentor. I would also like to thank members of the Vizzard lab, Susan Malley, Abbey Peterson, Kimberly Corrow and Dr. Beatrice Girard for all they have taught me, their willingness to always lend a helping hand, and their sincere friendship. I have had the fortunate opportunity to work with incredibly intelligent as well as caring and supportive faculty at UVM. My committee members, Dr. Deborah Damon, Dr. Cynthia Forehand, Dr. Gary Mawe and Dr. George Osol have offered valuable insight and taken sincere interest to help me achieve my goals, both present and future. I would also like to thank Dr. Jean Szilva, Dr. Ellen Cornbrooks, Laura Merriam, M.S and Leslie Hoffman, M.S. for making my teaching experiences at UVM incredibly fun, educational, motivational and memorable. My teaching experiences were truly rewarding and special, and I know that I will draw on these experiences for inspiration throughout my career. I extend a special thank you to Andre Zdunczyk for his continued love, support and devotion. He finds a way to keep my feet on positive ground during all the ups and downs experienced while chasing my dreams. iv Table of Contents Citations ........................................................................................................................ ii Dedication .................................................................................................................... iii Acknowledgements ...................................................................................................... iv List of Figures .............................................................................................................. ix List of Tables .................................................................................................................x Abbreviations ............................................................................................................... xi Chapter 1: Comprehensive Literature Review.............................................................1 I. Introduction ...................................................................................................................... 1 A. Anatomy of the Lower Urinary Tract ........................................................................ 3 B. Neural Control of Micturition .................................................................................... 7 C. Awakening of c-fiber Afferents ................................................................................ 13 D. Cystometry: Evaluation of Bladder Function in Humans and Animals ..................... 13 II. Micturition in Injury or Disease ...................................................................................... 16 A. Spinal Cord Injury ................................................................................................... 17 B. Multiple Sclerosis ................................................................................................... 18 C. Parkinson’s Disease ................................................................................................ 18 D. Interstitial Cystitis/ Painful Bladder Syndrome (IC/BPS) .......................................... 19 III. Inflammation and IC/BPS ...........................................................................................
Load more

Recommended publications
  • Pediatric Hemorrhagic Cystitis
    CUA BEST PRACTICE REPORT Canadian Urological Association Best Practice Report: Pediatric hemorrhagic cystitis Jessica H. Hannick, MD, MSc1,2; Martin A. Koyle, MD, MSc2,3 1Division of Pediatric Urology, UH Rainbow Babies and Children’s Hospital, Cleveland, OH, United States; 2The Hospital for Sick Children, Toronto, ON, Canada; 3Division of Urology, Department of Surgery, University of Toronto, Toronto, ON, Canada Cite as: Can Urol Assoc J 2019;13(11):E325-34. http://dx.doi.org/10.5489/cuaj.5993 tem for guideline recommendations, as employed by the International Consultation on Urologic Disease (ICUD). Published online March 29, 2019 Definition HC is defined by the presence of hematuria and lower uri- Introduction nary tract symptoms, such as dysuria, frequency, or urgen- cy, in the absence of other potential contributing factors, This best practice report aims to provide the general practic- such as vaginal bleeding or bacterial or fungal urinary tract ing urologist with basic background information regarding infections.1 Multiple grading criteria have been published the pathophysiology and natural history of hemorrhagic cys- to distinguish the varied presentations of HC. Frequently titis (HC) in the pediatric population, as well as diagnostic referenced grading schema are Droller and Arthur’s, which and algorithmic therapeutic recommendations. Given that are used to aid the clinician in discerning potential treatment HC in the pediatric population is most frequently diagnosed options and inform the clinician about prognosis (Table 1).2,3 in the setting of bone marrow (BMT) or stem cell transplan- The European Organization for Research and Treatment of tation (SCT), discussion and recommendations will focus Cancer has combined similar grading criteria, along with largely on this population, but many of the diagnostic and quality of life parameters to further relay the morbidity and treatment options can be expanded to broader pediatric mortality implications of each grade.4 populations affected by HC.
    [Show full text]
  • 149 Treatment with Instillation of Hyaluronic
    149 Collado Serra A1, Lopez-Guerrero J A2, Dominguez-Escrig J2, Ramirez Backhaus M2, Gomez-Ferrez A2, Mir C3, Casanova J3, Iborra I3, Casaña M3, Solsona E3, Arribas L3, Rubio-Briones J3 1. Fundación IVO. Valencia.Spain, 2. Fundación IVO, Valencia, Spain, 3. Fundación IVO, Valencia,Spain. TREATMENT WITH INSTILLATION OF HYALURONIC ACID IN PATIENTS WITH A HISTORY OF PELVIC RADIATION THERAPY AND URINARY STORAGE SYMPTOMS Hypothesis / aims of study Pelvic radiotherapy for the treatment of tumours located in the pelvis is not free of the risk of secondary irradiation of the bladder, producing a certain histological changes and it can result in both acute and chronic bladder injuries. Of these, the most evident and studied is radiation-induced hemorrhagic cystitis, although other urinary symptoms like frequency, urgency, incontinence, dysuria or pelvic pain has been described. Therefore, the objective of our paper is to evaluate the clinical utility of bladder instillation of hyaluronic acid in patients with a history of pelvic radiation therapy and storage symptoms with failure of previous treatment with anticholinergic Study design, materials and methods We considered 39 consecutive patients with storage urinary symptoms (defined as urinary urgency, usually accompanied by frequency and nocturia, with or without urgency urinary incontinence) due to post radiation cystitis treated with bladder instillation of hyaluronic acid. Severe urgency episodes with or without incontinence was measured using the PPIUS (Patient Perception of Intensity of Urgency Scale). Eligible patients had ≥three severe urgency episodes with or without incontinence during the 3-day voiding diary period, defined as PPIUS grades 3 and 4, and ≥eight micturitions/24 hours (1).
    [Show full text]
  • Hemorrhagic Cystitis with Giant Cells in Rheumatoid Arthritis Treating with Tacrolimus
    Journal of Rheumatic Diseases Vol. 21, No. 6, December, 2014 □ Case Report □ http://dx.doi.org/10.4078/jrd.2014.21.6.336 Hemorrhagic Cystitis with Giant Cells in Rheumatoid Arthritis Treating with Tacrolimus In Suk Min, YeonMi Ju, Hyun-young Kim, Yun Jung Choi, Won-Seok Lee, Wan-Hee Yoo Department of Rheumatology, Chonbuk National University Medical School and Research Institute of Clinical Medicine of Chonbuk National University Hospital-Chonbuk National University, Jeonju, Korea Hemorrhagic cystitis is a diffuse inflammation of the mu- hemorrhagic cystitis due to tacrolimus for the treatment cosa of the bladder, characterized by hematuria and burn- of rheumatoid arthritis. We describe a case of hemor- ing upon urination. This might be caused by a variety of rhagic cystitis with giant cells in a patient with rheumatoid reasons, including undergoing chemotherapy (such as cy- arthritis treating with tacrolimus. Hematuria resolved clophosphamide), radiation therapy, bladder cancer, cer- spontaneously with discontinuation of the drug. tain viruses, urinary infections, and thrombocytopenia. Key Words. Hemorrhagic cystitis, Rheumatoid arthritis, There are no previous reports of hemorrhagic cystitis asso- Tacrolimus ciated with the use of tacrolimus. This is the first case of Introduction with an occasional small clot. She was initially treated, em- Hemorrhagic cystitis (HC) is a diffuse inflammation of the pirically, with sulfamethoxazole/trimethoprim for a presumed mucosa of the bladder. It is characterized by gross hematuria urinary tract infection, but showed no change in symptoms. and irritating voiding symptoms such as dysuria, with fre- She was referred for further urologic evaluation. The patient quency and urgency (1). The reasons behind this may include denied any prior urologic history, and did not have a history undergoing chemotherapy (such as cyclophosphamide), using of smoking.
    [Show full text]
  • Native Kidney Cytomegalovirus Nephritis and Cytomegalovirus Prostatitis in a Kidney Transplant Recipient
    Received: 23 July 2018 | Revised: 20 August 2018 | Accepted: 2 September 2018 DOI: 10.1111/tid.12998 CASE REPORT Native kidney cytomegalovirus nephritis and cytomegalovirus prostatitis in a kidney transplant recipient Susanna K. Tan1 | Xingxing S. Cheng2 | Chia‐Sui Kao3 | Jenna Weber3 | Benjamin A. Pinsky1,3 | Harcharan S. Gill4 | Stephan Busque5 | Aruna K. Subramanian1 | Jane C. Tan2 1Department of Medicine, Division of Infectious Diseases and Geographic Abstract Medicine, Stanford University School of We present a case of cytomegalovirus (CMV) native kidney nephritis and prostatitis Medicine, Stanford, California in a CMV D+/R‐ kidney transplant recipient who had completed six months of CMV 2Department of Medicine, Division of Nephrology, Stanford University School of prophylaxis four weeks prior to the diagnosis of genitourinary CMV disease. The Medicine, Stanford, California patient had a history of benign prostatic hypertrophy and urinary retention that re‐ 3Department of Pathology, Stanford quired self‐catheterization to relieve high post‐voiding residual volumes. At 7 months University School of Medicine, Stanford, California post‐transplant, he was found to have a urinary tract infection, moderate hydrone‐ 4Department of Urology, Stanford University phrosis of the transplanted kidney, and severe hydroureteronephrosis of the native School of Medicine, Stanford, California left kidney and ureter, and underwent native left nephrectomy and transurethral re‐ 5Department of Surgery, Division of Abdominal Transplantation, Stanford section of the prostate. Histopathologic examination of kidney and prostate tissue University School of Medicine, Stanford, revealed CMV inclusions consistent with invasive CMV disease. This case highlights California that CMV may extend beyond the kidney allograft to involve other parts of the geni‐ Correspondence tourinary tract, including the native kidneys and prostate.
    [Show full text]
  • Neuroplasticity of Micturition Reflex Pathways with Cyclophosphamide-Induced Cystitis
    University of Vermont ScholarWorks @ UVM Graduate College Dissertations and Theses Dissertations and Theses 2008 Neuroplasticity of Micturition Reflex aP thways with Cyclophosphamide-Induced Cystitis Mary Beth Klinger University of Vermont Follow this and additional works at: https://scholarworks.uvm.edu/graddis Recommended Citation Klinger, Mary Beth, "Neuroplasticity of Micturition Reflex aP thways with Cyclophosphamide-Induced Cystitis" (2008). Graduate College Dissertations and Theses. 123. https://scholarworks.uvm.edu/graddis/123 This Dissertation is brought to you for free and open access by the Dissertations and Theses at ScholarWorks @ UVM. It has been accepted for inclusion in Graduate College Dissertations and Theses by an authorized administrator of ScholarWorks @ UVM. For more information, please contact [email protected]. NEUROPLASTICITY OF MICTURITION REFLEX PATHWAYS WITH CYCLOPHOSPHAMIDE-INDUCED CYSTITIS A Dissertation Presented by Mary Beth Klinger to The Faculty of the Graduate College of The University of Vermont In Partial Fulfillment of the Requirements for the Degree of Doctor of Philosophy Specializing in Anatomy and Neurobiology October, 2008 Accepted by the Faculty of the Graduate College, The University of Vermont, in partial fulfillment of the requirements for the degree of Doctor of Philosophy, specializing in Anatomy and Neurobiology. Dissertation Examination Committee: Advisor ~a>~detA. vizard &.D. awe, Ph.D. r ;; 2'':l'"X ChailpersOn Mark T. Nelson, Ph.D. Vice President for Research and Dean of Graduate Studies Date: July 14,2008 Abstract Micturition requires the precise reciprocal function of the urinary bladder and urethral outlet. Perhaps due to this degree of precision, micturition is prone to dysfunction with injury or disease. One such disease, interstitial cystitis (IC)/painful bladder syndrome (PBS), is characterized by urinary urgency, frequency and pelvic pain.
    [Show full text]
  • Urinary Bladder, Renal Pelvis & Urethra John F
    Urinary Tract Pathology: Urinary Bladder, Renal Pelvis & Urethra John F. Madden, M.D., Ph.D. Spring 2010 Cystitis Infectious cystitis •“Ascending” infection due to enteric bacteria • >95% of cases due to E. coli • Klebsiella, Proteus, etc. in predisposed pts • Yeast, viruses (CMV, polyoma, adenovirus) with immunosuppression •Favored by obstruction •Prostatism, congenital anomalies, stones Urethral colonization Asymptomati c bacteriuria (<104/ml) “Urethral syndrome” (104–105/ml) Cystitis (≥105/ml) Pyelonephritis Interstitial (“Hunner’s”) cystitis • Idiopathic (? autoimmune, mast cell dysfunction) cystitis • Typically, women in later adulthood • Hematuria, pain • Extensive ulceration, often transmural, with fibrosis • dDx: infection, cancer Hemorrhagic cystitis • Complication of chemo-therapy or therapeutic pelvic irradiation • Cyclophosphamide, others • Can cause severe hemorrhage Malakoplakia & Xanthogranulomatous pyelonephritis •Chronic bacterial infection with ineffective clearance of organisms • Proteus often involved •“Pseudotumor” •Sheets of histiocytes packed lysosomes •Malakoplakia has Michaelis-Gutmann bodies Urothelial metaplasia • Urothelium takes on characteristics of some other type of epithelium • Often a response to chronic inflammation • Benign Normal urothelium Cystitis cystica Normal submucosal nests of urothelium (“von Brunn’s nests”) develop central cystic change Cystitis glandularis Transitional cells convert to mucinous columnar type Squamous metaplasia Transitional cells convert to squamous cells under chronic irritation
    [Show full text]
  • Evaluation of Dysuria & Hematuria
    Evaluation of dysuria & hematuria Editing link Done by : Abdulrahman Almizel Nada alamri OVERVIEW: Dysuria : pain, burning, or discomfort during or immediately after urination The most common causes are infection or inflammation of the bladder or urethra Voiding symptoms: symptoms that occur at the time of urination: dysuria, hesitancy, dribbling, poor stream Storage symptoms: symptoms that occur during bladder storage and filing: urgency, frequency, nocturia, incontinence Infection Differential Diagnosis: ★ UTI → Frequency/urgency, suprapubic pain, hx of previous UTI,sexual activity, BPH in men. ★ Urethritis → Common in young patient,Urethral discharge, frequency and urgency are frequently absent ★ Pyelonephritis → Fever, rigors, Flank pain costovertebral angle tenderness ★ Prostatitis → Perineal or rectal pain, urinary frequency, urgency, tender prostate ★ Epididymitis → Unilateral scrotal pain and swelling of gradual onset with hematuria ★ Cystitis → Suprapubic pain frequency urgency voiding of small urine volumes, hx of previous UTI,common in young female, uncommon and always complicated in young male . Inflammatory ★ Atrophic vaginitis → Postmenopausal women, vaginal discharge,external irritation/pruritus, dyspareunia ★ Behcet’s syndrome→ Frequency, urgency, painful oral and genital ulcers, uveitis,arthralgia ★ Reactive arthritis → Cant pee, cant see, cant climb a tree :D ★ Interstitial cystitis → Urgency. Frequency, dyspareunia, pain is exacerbated by specific foods and emotional or physical stress ★ Valvudenya ★ Drugs or radiation
    [Show full text]
  • Aua Update Series Index Volumes 1–38
    AUA UPDATE SERIES INDEX VOLUMES 1–38 ACID-BASE EQUILIBRIUM: Anatomy of the Penis and Male Perineum Part II. Fluid, Electrolyte and Acid-Base Abnormalities in Angermeier KW and Devine CJ, Vol. XIII, Lesson 3, Urological Practice. Tanrikut C and McDougal WS, Vol. 1994 25, Lesson 19, 2006 Anatomy, Physiology and Diseases of the Epididymis. Tracy C and Steers W, Vol. 26, Lesson 12, 2007 ADRENAL GLAND DISEASE: Anatomy, Physiology and Pharmacology of Bladder The Adrenal: Diagnosis and Medical Management. Stewart Urothelium. Birder LA, Vol. 24, Lesson 25, 2005 BH, Vol. II, Lesson 14, 1983 Anatomy of the Testis: A Clinically Relevant Review. Adrenal Incidentalomas. Mandeville J and Moinzadeh A, Tadros N, Hecht S, Ostrowski KA and Hedges JC, Vol. Vol. 29, Lesson 4, 2010 34, Lesson 9, 2015 The Adrenal: Surgical Therapy. Stewart BH, Vol. II, Lesson Applied Anatomy of the Groin Part I. Redman JE, Vol. 15, 1983 VIII, Lesson 9, 1989 Anatomy and Physiology of the Adrenal. Bravo EL and Applied Anatomy of the Groin Part II. Redman JE, Vol. Stewart BH, Vol. II, Lesson 13, 1983 VIII, Lesson 10, 1989 Assessment and Management of an Adrenal Mass in Evaluation and Management of Posterior Vaginal Wall Urological Practice. Kutikov A, Mehrazin R and Uzzo Prolapse. Sherman ND and Amundsen CL, Vol. 25, RG, Vol. 33, Lesson 19, 2014 Lesson 31, 2006 Contemporary Surgical Approaches to the Adrenal Gland. Neuroanatomy of the Retroperitoneum and the Pelvis: Du K and Bishoff JT, Vol. 35, Lesson 32, 2016 Operative Implications Part I. Strasser H, Stenzel A, Diagnosis and Management of Adrenogenital Syndrome Hobisch A, Bartsch G and Poisel S, Vol.
    [Show full text]
  • Urinary Tract Infections
    Lecture Two + Three Pathology of upper and lower Urinary Tract Infections 432 Pathology Team Done By: Rana Al-Ohaly and Abrar Al-Faifi Reviewed By: Malak Al-Sanie and Ibrahim Abunohaiah Renal Block NOTE: female-side notes are written in purple. Red is important. Orange is explanation. 432 PathologyTeam LECTURE TWO&THREE: UTI Pathology of upper and lower Urinary Tract Infections Lecture Objectives: At the end of this lecture the student should be capable of: Definition Distinguish types of infections of urinary tract- pyelonephritis urethritis, cystitis, and ureteritis. Recognize the pathophysiology of the most common infections of the kidney and urinary tract Complications of infections of the urinary tract Mind Map: Papillary Acute Necrosis Upper Urinary Pyelonephritis Tract Chronic Tubulointerstitial Lower Urinary Cystitis nephritis Tract Intersitial Drug induced interstitial nephritis nephritis Calcium stones Struvite stones Renal Stones Uric acid stones Cystine stones P a g e | 1 432 PathologyTeam LECTURE TWO&THREE: UTI General Considerations in Urinary Tract Infections Infections of the Kidney and Urinary Tract Routes of Infections: 1- Ascending: by external entry of organisms through the urethra into the bladder then ureters (vesicoureteral reflux) then kidney. (Depending on the case) REMEMBER: Bacteria that can cause ascending urinary tract infections: KEEPS Klebsiella Escherichia Coli (E.Coli) (It is the normal flora of the colon) Enterobacter Proteus Vulgaris Serratia 2- Hematogenous: (very dangerous) from another focus of infection (endocarditis, septic emboli.) through the blood the bacteria will reach the kidney. Usually by Staphylococcus Aureus Predisposing Factors: 1. Female Gender because of: a. Short urethra. b. Urethra is close to the anus (source of gram negative bacilli like E.Coli) as well as vagina.
    [Show full text]
  • Pseudomembranous Cystitis: an Uncommon Ultrasound Appearance of Cystitis in Cats and Dogs
    veterinary sciences Article Pseudomembranous Cystitis: An Uncommon Ultrasound Appearance of Cystitis in Cats and Dogs Caterina Puccinelli , Ilaria Lippi, Tina Pelligra, Tommaso Mannucci, Francesca Perondi , Mirko Mattolini and Simonetta Citi * Department of Veterinary Sciences, University of Pisa, Via Livornese Lato Monte, 56121 Pisa, Italy; [email protected] (C.P.); [email protected] (I.L.); [email protected] (T.P.); [email protected] (T.M.); [email protected] (F.P.); [email protected] (M.M.) * Correspondence: [email protected] Abstract: In veterinary medicine, pseudomembranous cystitis (PC) is a rare condition described only in cats. The purposes of this retrospective study were to describe ultrasound features of PC in cats and dogs, predisposing factors, comorbidities and outcomes. Cats and dogs with an ultrasonographic diagnosis of PC were included in the study. The bladder ultrasound findings that were recorded were: pseudomembranes’ characteristics, abnormalities of the bladder’s wall and content and anomalies of the pericystic peritoneal space. Ten cats and four dogs met the inclusion criteria. Four pseudomembrane adhesion patterns were described. The presence of pseudomembrane acoustic shadowing was observed in the 60% of cats. A total of 80% of the cats included were presented for urethral obstruction (UO) and/or had at least one episode of UO in the previous 2 months. Thirteen patients out of fourteen received only medical therapy, and all of them survived. PC is a rare disorder in cats and dogs and there are some ultrasonographic differences between the two species, suggesting Citation: Puccinelli, C.; Lippi, I.; a greater severity of the pathology in cats.
    [Show full text]
  • The Inflammatory Contracted Bladder
    Cantu, H., Maarof, S. N. M., & Hashim, H. (2019). The Inflammatory Contracted Bladder. Current Bladder Dysfunction Reports, 14(2), 67- 74. https://doi.org/10.1007/s11884-019-00507-w Publisher's PDF, also known as Version of record License (if available): CC BY Link to published version (if available): 10.1007/s11884-019-00507-w Link to publication record in Explore Bristol Research PDF-document This is the final published version of the article (version of record). It first appeared online via Springer Link at https://doi.org/10.1007/s11884-019-00507-w . Please refer to any applicable terms of use of the publisher. University of Bristol - Explore Bristol Research General rights This document is made available in accordance with publisher policies. Please cite only the published version using the reference above. Full terms of use are available: http://www.bristol.ac.uk/red/research-policy/pure/user-guides/ebr-terms/ Current Bladder Dysfunction Reports (2019) 14:67–74 https://doi.org/10.1007/s11884-019-00507-w INFLAMMATORY/INFECTIOUS BLADDER DISORDERS (MS MOURAD, SECTION EDITOR) The Inflammatory Contracted Bladder Hector Cantu1 & Siti Nur Masyithah Maarof1 & Hashim Hashim1,2,3 Published online: 22 April 2019 # The Author(s) 2019 Abstract Purpose of Review This review will present the inflammatory contracted bladder as a clinical entity and will address its pathophysiology, diagnosis and treatment. Recent Findings The inflammatory contracted bladder is relevant since it is not a recognised urological condition and it can be found in several affections to the urinary tract. Its medical management depends on its aetiology and severity.
    [Show full text]
  • Bladder Pain Syndrome International Consultation on Incontinence
    Committee 19 Bladder Pain Syndrome International Consultation on Incontinence Chairman P. H ANNO (USA) Members A. LIN (Taiwan), J. NORDLING (Denamark), L. NYBERG (USA), A. VAN OPHOVEN (Germany), T. UEDA (Japon) 1459 CONTENTS INTRODUCTION X. NEUROMODULATION I. NOMENCLATURE/ HISTORY/ XI. PAIN EVALUATION AND TAXONOMY TREATMENT II. EPIDEMIOLOGY XII. SURGICAL THERAPY III. AETIOLOGY XIII. CLINICAL SYMPTOM SCALES IV. PATHOLOGY XIV. OUTCOME ASSESSMENT V. DIAGNOSIS XV. PRINCIPLES OF MANAGEMENT VI. CLASSIFICATION XVI. FUTURE DIRECTIONS IN RESEARCH VII. CONSERVATIVE TREATMENT XVII. SUMMARY (figure 10) VIII. ORAL THERAPY REFERENCES IX. INTRAVESICAL / INTRAMURAL THERAPY (Table 5) 1460 Bladder Pain Syndrome International Consultation on Incontinence P. H ANNO, A. LIN, J. NORDLING, L. NYBERG, A. VAN OPHOVEN, T. UEDA 2. DEFINITION INTRODUCTION Bladder Pain Syndrome (BPS) is a clinical diagnosis that relies on symptoms of pain in the bladder and or 1. EVIDENCE ACQUISITION pelvis and other urinary symptoms like urgency and The unrestricted, fully exploded Medical Subject frequency. Based on the evolving consensus that Heading (MeSH) ‘‘interstitial cystitis’’ (including all BPS probably is strongly related to other pain related terms as ‘‘painful bladder syndrome,’’ “bladder syndromes like Irritable Bowel Syndrome, Fibromyalgia pain syndrome”, or different terms such as ‘‘chronic and Chronic Fatigue Syndrome, the European Society interstitial cystitis,’’ etc.) were used to thoroughly for the Study of Bladder Pain Syndrome/ Interstitial search the PubMed database (http://www.ncbi. Cystitis (ESSIC) recently published a comprehensive nlm.nih.gov/PubMed/) of the US National Library of paper on definition and diagnosis of BPS [1]. Medicine of the National Institutes of Health; 1795 BPS was defined as chronic (>6 months) pelvic pain, hits were retrieved.
    [Show full text]