Urinary Tract Infection in Girls. I. A Computerized Analysis of Urethral Stenosis

Weiss, Jerome M.; Dykhuizen, Robert F.; Sargent, C.R.; Tandy, Roy W.

doi:10.1016/s0022-5347(17)62562-x

Cited by 13 publications

(3 citation statements)

References 12 publications

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“…The same is true regarding the high percentage of cure rate achieved by urethral dilatation and rupturing of the ring. It is evident that the calibre of the ring itself is not the determining factor, neither in severity of symptoms nor in cure rate (Graham et al, 1967;Weiss et al, 1968). Furthermore, the ring cannot be obstructive by itself; our studies (Tanagho and McCurry) well as those of others (Backman, 1968;Ritter et al, 1964) demonstrate that with normal voiding pressures (20 to 40 cm.…”

Section: Discussionmentioning

confidence: 45%

Spastic Striated External Sphincter and Urinary Tract Infection in Girls1

Tanagho¹,

Miller²,

Lyon³

et al. 1971

British Journal of Urology

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THE mechanism of function of distal urethral stenosis in relation to urinary tract infection is unclear. It is agreed that the calibre of the distal urethral ring is not obstructive in itself, yet its symptomatology and sequelae are, at least partly, of obstructive nature (Lyon and Smith, 1963;Lyon and Tanagho, 1965). Interest in the problem prompted us to do detailed physiological studies in order to define the obstructive mechanism.We studied 2 groups of patients: Group 1.-Girls with recurrent lower urinary tract infections (after failure to cure them)Group 1I.-Girls with distal urethral stenosis (studied both before and after treatment) Surprisingly, the findings in the 2 groups were very similar and incriminated a common -6 patients.-2 patients. aetiology.Material and Method of Study.-Group I.-Six girls were specifically selected because of persistence or recurrence of their urinary tract infections despite our repeated attempts with every known means of treatment. Urethral dilatation at least twice and adequate specific antibacterial therapy were tried. There was no demonstrable vesico-ureteral reflux.Group 11.-Two other girls who had presenting symptoms typical of distal urethral stenosis with urinary tract infection were also chosen for the present studies, which were done after clearance of their infections, yet before any diagnostic urethral calibration or endoscopic examination. Five to 6 months after urethral dilatation and treatment, the studies were repeated.The studies combined cineradiography with pressure measurements. Details of this technique have been reported before (Tanagho et al., 1966). In the present study, the following information was recorded:1. Intravesical pressure. 2. Proximal urethral pressure. 3. Midurethral pressure. 4. A profile of urethral pressure from the internal meatus to the external meatus. These 4 pressures were obtained with a specially constructed pressure-measuring catheter (modified from Enhorning) (Enhorning, 1961 ; Drouin and McCurry, 1969). 5. Rectal pressure indicating intra-abdominal pressure. 6. Anal sphincter pressure. The last 2 pressures were recorded using a special rectal catheter with one balloon at the end placed high in the rectum for recording intra-abdominal pressure. Another balloon in the anal sphincter region recorded its activity. This is also a measurement for the activity of the pelvic floor as a unit.7. Urine flow rate in C.C. per sec. and volume voided. 8. Cineradiographic image. 9. Measurements were timed and recorded with sound on video tape as well as o n motion

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Section: Discussionmentioning

confidence: 45%

Spastic Striated External Sphincter and Urinary Tract Infection in Girls1

Tanagho¹,

Miller²,

Lyon³

et al. 1971

British Journal of Urology

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“…Our statistics agree in principle with the experience of Weiss el al. [19] and focus attention of urologists and pediatricians on the age between 1.5 and 3.0 years in female children as the most endangered period of life from the urologic standpoint.…”

Section: Discussionmentioning

confidence: 99%

Significance of Urethral Obstruction in Girls

Hradec¹,

Simon²,

Hradcova³

et al. 1973

Urol Int

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A study of 220 young girls with chronic urinary infection and of 21 female children with pure enuresis is reported. Stenosis of the urethra was detected in 60%. The peak of onset of urinary infection was found in Internal urethrotomy the toilet-training period (age 1.5–3.0 years). No correlation could be found between the radiographic appearance of the urethra on cystourethrograms and the size of the urethra ascertained by bougie calibration. Internal urethrotomy using Otis urethrotome was the procedure of choice for treatment of stenosis of the urethral meatus and bladder neck obstruction. 15% of failures after urethrotomy were recorded in the group of less marked urethral stenosis, whereas no failure occurred in the group of more severe urethral stenosis. Less severe reflux secondary to urethral stenosis was present in 22 children. It was completely reversed in 18 patients and persisted in 3 after urethrotomy.

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“…By the next year, the McCarthy miniature and infant cystoscopes had become distinct assets for evaluating children with urinary tract infection (UTI) 2 . At this time, pediatric endoscopic examination of the lower urinary tract was vigorously performed to clarify the relationship between UTI and structural derangement of the urinary tract, and some authors actually detected distal urethral stenosis (as Lyon proposed) in up to 96% of children with recurrent UTI 3 . However, a similarity in the urethral calibration for groups of recurrently infected and normal children was found 4 .…”

Section: Introductionmentioning

confidence: 99%

Recent trends of genitourinary endoscopy in children

Nonomura

Κakizaki

2005

Int J of Urology

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Downsizing and refinement of the pediatric endoscope in video-monitoring systems have facilitated genitourinary endoscopy even in small children without any traumatic instrumentation. Indications for endoscopy in children with hematuria or tractable urinary tract infection have been tailored for the rareness of genitourinary malignancy or secondary vesicoureteral reflux (VUR) as a result of infravesical obstruction. Most mechanical outlet obstructions can be relieved endoscopically irrespective of sex and age. Endoscopic decompression by puncture or incision of both intravesical and ectopic ureteroceles can be an initial treatment similar to open surgery for an affected upper moiety. Endoscopy is necessary following urodynamic study to exclude minor infravesical obstruction only in children with unexplained dysfunctional voiding. Genitourinary endoscopy is helpful for structural abnormalities before and at the time of repairing congenital urogenital anomalies. Endoscopic injection therapy of VUR has been established as a less invasive surgical treatment. Pediatric endoscopy will play a greater role in the armamentarium for most pediatric urological diseases through the analysis of visual data and discussion on the indications for endoscopy throughout the world.

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Urinary Tract Infection in Girls. I. A Computerized Analysis of Urethral Stenosis

Cited by 13 publications

References 12 publications

Spastic Striated External Sphincter and Urinary Tract Infection in Girls1

Spastic Striated External Sphincter and Urinary Tract Infection in Girls1

Significance of Urethral Obstruction in Girls

Recent trends of genitourinary endoscopy in children

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