Purpose To determine prevalence and risk factors for renal scar in children referred for urologic assessment of febrile UTI and/or VUR. Methods Pre-determined risk factors for renal scar were prospectively recorded in consecutive patients referred for UTI/VUR. Age, gender, VUR grade, and reported number of febrile and non-febrile UTIs were analyzed with logistic regression to determine risk for focal cortical defects on non-acute DMSA. Results Of 565 consecutive children, 24 (4%) had congenital renal dysplasia and 84 (15.5%) had focal defect(s). VUR, especially grades IV–V, recurrent febrile UTI, and older age increased risk. For any age child with the same number of UTIs, VUR increased odds of renal defect 5.4-fold (OR = 5.4, 95% CI = 2.7–10.6, AUC = 0.759). Conclusions Focal DMSA defects were present in 15.5% of 565 consecutive children referred for febrile UTI and/or VUR; 4% had presumed congenital reflux nephropathy without cortical defect. All VUR grades increased risk for these defects, as did recurrent febrile UTIs and older age. However, 43% with grades IV–V VUR and 76% with recurrent UTI had normal DMSA.
OBJECTIVE Polyethylene glycol (PEG) is common first-line therapy for urinary symptoms despite minimal evidence-based support. We performed a randomized, double-blind, placebo-controlled study of PEG for initial treatment of urinary urge symptoms. PATIENTS AND METHODS Patients aged >3 years underwent baseline urinary symptom questionnaire (USQ, scored 0-16), bowel symptom questionnaire (scored 0-20) and abdominal x-ray (KUB). Patients were randomized to placebo/PEG regardless of parent’s perception of constipation. After 1 month, patients completed follow-up questionnaires and KUB. Improvement was defined as decrease in USQ (ΔUSQ)≥3points. Secondary analyses compared urinary and bowel symptoms to KUB. RESULTS Of 138 enrolled patients, 71 (51.4%) completed 1 month of therapy. Analyses of those randomized to placebo versus PEG and non-completers demonstrated similar demographics, baseline symptoms, and KUB. Patients treated with placebo and PEG both had significant improvement in USQ scores(p<0.0001). Patients treated with PEG responded similar to placebo (ΔUSQ 3.7 vs. 3.4, p=0.773), with improvement in nearly half (48.5% PEG vs. 44.7% placebo). There was no correlation between KUB and urinary or bowel symptoms. CONCLUSIONS Nearly 50% of patients with urinary urge symptoms treated with either placebo or PEG for 1 month had improvement in urinary symptoms. KUB did not correlate with baseline or follow-up urinary or bowel symptoms.
Background: The data pertaining to the lower urinary tract disorders in dogs in India is very merge. This retrospective analysis presents a retrospective analysis of incidence of affections of lower urinary tract in dogs. Methods: The cases of different affections of lower urinary tract presented at the Veterinary Clinical Complex, Veterinary College, Anand Agricultural University, Anand during April-2012 to March-2017 were screened and detailed information regarding age, sex and breed were collected and analysed to calculate percentage of incidence of different affections of lower urinary tract viz., surgical affections and non-surgical affection. Conclusions: Total 24319 cases of lower urinary tract affections in dogs were registered. Among them 5854 (24.07 %) surgical cases comprising urolithiasis (81, 76.42 %), bladder neoplasia (25, 23.58 %) and 18465 (75.93 %) non-surgical affections with cystitis (176, 0.95 %) cases. The highest incidence of urolithiasis was 25.93 per cent in the year 2014-15 and in 7 to 9 years aged dogs (35.80 %). The sex wise per cent incidence was higher in male (72.84) than female (27.16). The urinary bladder calculi was the highest (72.84 %) followed by the urethra (16.05 %) and both the locations (11.11 %). The year wise highest per cent incidence of cystitis was recorded for the year 2015-16 (52.27). The age wise per cent incidence of cystitis was equally higher 28.98 in the age groups of 7 to 9 and 10 to 12 years, each. The year wise the highest per cent incidence of neoplasia of urinary bladder (TCC) in dogs was 52.00 for the year 2015-2016. The age wise percent incidence of neoplasia of urinary bladder was the highest in 7 to 9 years age groups (36.00). The sex wise per cent incidence for neoplasia in urinary bladder was higher in male (64.00) than female (36.00). The breed wise highest per cent incidence of urolithiasis was in Pomeranian (25.93), cystitis in Pug (28.41) and neoplasia of bladder (TCC) Labrador and Pug (20.00, each).
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