Experimental supratrigonal cystectomy: evaluation of long-term complications

Abstract

Objective: The present study aims at assessing the occurrence of pyelonephritis and long-term complications in rats submitted to surgical reduction of bladder capacity. Materials and Methods: Sprague-Dawley rats were submitted to supratrigonal cystectomy (29 animals) or sham operation (15 animals) and sacrificed 2, 4 and 6 months after the surgical procedure. The arterial blood pressure and serum creatinine levels were assessed before the surgery and at the time of the sacrifice. After the sacrifice a careful inspection of the urinary apparatus was performed to the characterization of the hydronephrosis and for the detection of the presence of calculi. With sterile technique, the urine was aspirated from the bladder and the kidneys removed and sent to a microbiologic study. Results: Pyelonephritis was frequent in animals submitted to supratrigonal cystectomy. The most frequent and isolated microorganisms were Staphylococcus sp. and E. coli. The presence of urinary calculi was correlated significantly to the presence of urinary tract infection (p < 0.003). Arterial hypertension was frequent amongst animals submitted to supratrigonal cystectomy. Serum creatinine was high in 72.4% of the animals in the group submitted to supratrigonal cystectomy. The presence of calculi and pyelonephritis were frequent in rats presenting renal insufficiency and in hypertensive rats. Conclusions:The long-term course of urinary infection in rats submitted to supratrigonal cystectomy was characterized by a high incidence of renal insufficiency and arterial hypertension that seem to be related to dysfunction and bladder obstruction induced by an extensive surgical procedure and the presence of urolithiasis and pyelonephritis.

Experimental supratrigonal cystectomy: II—evaluation of urinary calculi, infection, and bladder dysfunction in the pathogenesis of renal failure

“…Although it has been suggested that the renal failure may be related to the presence of urolithiasis and pyelonephritis, the actual cause of kidney damage was not investigated [5]. In the current study the same experimental model of cystectomy was used with the addition of a second series of experiments in which animals subjected to supratrigonal cystectomy, as already described, also received 0.5 mL of a suspension containing 10 2 cfu of Proteus mirabilis, which was slowly injected into the stump of the bladder in order to stimulate lithogenesis [7,8].…”

“…The presence of urinary calculi was documented in all the animals that were inoculated with Proteus mirabilis and in 50% of the animals subjected to cystectomy without bacterial Table 1 Mean systolic blood pressure and mean levels of serum creatinine and blood urea prior to surgery and at sacrifice in rats subjected to supratrigonal cystectomy and sham surgery n Systolic blood pressure (mmHg) Serum creatinine (mg dL -1 ) Blood urea (mg dL -1 ) inoculation, which were analyzed as a separate group. As already noted, there was a strong association between the presence of calculi and pyelonephritis/ urinary tract infection [5]. The association between infection, the formation of urinary calculi, and their presence as a contributing factor towards the maintenance of urinary tract infection are well-known [9].…”

“…One half of each kidney was homogenized separately in 5 mL sterile normal saline solution (TRI-instruments). Dilutions (10 -1 , 10 -3 , 10 -5 ) of the tissue homogenates were cultured on plates and the number of bacteria were determined after correction for the dilution factor [5,6]. Standard microbiological techniques were used.…”

“…In previous laboratory studies a high incidence of hydronephrosis, lithiasis, and pyelonephritis associated with renal failure and hypertension was found. It was suggested that the renal failure and hypertension were related to bladder dysfunction induced by the cystectomy and the presence of urolithiasis and pyelonephritis [5].…”

Efficacy of Tigecycline and Rifampin Alone and in Combination against Enterococcus faecalis Biofilm Infection in a Rat Model of Ureteral Stent

“…The catheterized urinary tract provides ideal conditions for biofilm development inducing complications in patients' care [1][2][3][4]. Biofilm is a structured community of microorganisms irreversibly encapsulated within a self-developed polymeric matrix and adherent to various biotic and abiotic surfaces [5][6][7].…”