Submit to Special Issue Submit Abstract to Special Issue Review for Healthcare Propose a Special Issue

Journal Browser

► Journal Browser

Urinary Tract Health and Care

Print Special Issue Flyer
Special Issue Editors
Special Issue Information
Keywords
Published Papers

A special issue of Healthcare (ISSN 2227-9032). This special issue belongs to the section "Women's Health Care".

Deadline for manuscript submissions: 31 May 2024 | Viewed by 21243

Share This Special Issue

Special Issue Editors

Dr. Matteo Frigerio

E-Mail Website
Guest Editor

Gynecology Department, San Gerardo Hospital, Milano Bicocca University, ASST Monza—Via Pergolesi 33, 20900 Monza, Italy
Interests: urogynecology, pelvic floor, prolapse, incontinence; pelvic organ prolapse; pelvic floor surgery; stress incontinence; recurrent urinary tract infection, pelvic pain
Special Issues, Collections and Topics in MDPI journals

Dr. Stefano Manodoro

E-Mail Website
Guest Editor

Department of Obstetrics and Gynecology, ASST Santi Paolo e Carlo, San Paolo Hospital, 20122 Milano, Italy
Interests: urogynecology; pelvic floor; prolapse; incontinence; pelvic organ prolapse; stress incontinence; chronic pelvic pain; vulvodynia

Special Issue Information

Dear Colleagues,

Lower urinary tract symptoms are common in women of all ages, with different causes and expressions according to patient age and condition. Most of the time the symptoms are transitory and recover with no or simple therapy. Nevertheless, for some women the symptoms are ongoing and interfere with normal routine, impacting quality of life.

Urinary tract dysfunctions range from infective disorders to impaired continence physiology, with urinary incontinence and or urinary outlet obstruction, as well as chronic pelvic pain of unknown origin and dyspareunia. Frequently these aspects combine with each other, leading to complex clinical presentations.

Many women never tell anyone about their symptoms and are reticent even with their gynecologist. Referral to a pelvic floor center is not usually required. On the other hand, the management of these conditions is never fulfilled by one single specialist, but by a team of specialists who work together to ensure pelvic floor and urinary tract health.

This Special Issue of Healthcare is dedicated to offering an overview of female urinary tract health and care. Groups from all specialties are encouraged to submit original research articles, project reports, short reports, reviews, and opinion papers.

Dr. Matteo Frigerio
Dr. Stefano Manodoro
Guest Editors

Manuscript Submission Information

Manuscripts should be submitted online at www.mdpi.com by registering and logging in to this website. Once you are registered, click here to go to the submission form. Manuscripts can be submitted until the deadline. All submissions that pass pre-check are peer-reviewed. Accepted papers will be published continuously in the journal (as soon as accepted) and will be listed together on the special issue website. Research articles, review articles as well as short communications are invited. For planned papers, a title and short abstract (about 100 words) can be sent to the Editorial Office for announcement on this website.

Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a single-blind peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. Healthcare is an international peer-reviewed open access semimonthly journal published by MDPI.

Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 2700 CHF (Swiss Francs). Submitted papers should be well formatted and use good English. Authors may use MDPI's English editing service prior to publication or during author revisions.

Keywords

urinary tract
incontinence
pelvic floor
pelvic floor prolapse
chronic pelvic pain
urinary infections
pelvic surgery

Published Papers (13 papers)

Download All Papers

Research

Jump to: Review, Other

11 pages, 233 KiB

Open AccessArticle

Minimally Invasive Treatment of Stress Urinary Incontinence in Women: A Prospective Comparative Analysis between Bulking Agent and Single-Incision Sling

by Lorenzo Campanella, Gianluca Gabrielli, Erika Chiodo, Vitaliana Stefanachi, Ermelinda Pennacchini, Debora Grilli, Giovanni Grossi, Pietro Cignini, Andrea Morciano, Marzio Angelo Zullo, Pierluigi Palazzetti, Carlo Rappa, Marco Calcagno, Vincenzo Spina, Mauro Cervigni and Michele Carlo Schiavi

Healthcare 2024, 12(7), 751; https://doi.org/10.3390/healthcare12070751 - 29 Mar 2024

Viewed by 496

Abstract

Introduction: The study aims to compare the efficacy and safety of bulking agents and single-incision slings in the treatment of urinary incontinence in 159 patients during a 29-month follow-up period. Material and methods: Of the 159 patients suffering from stress urinary incontinence, 64 were treated with bulking agents (PAHG Bulkamid^®) and 75 with a single-incision sling (Altis^®). The ICIQ-UI-SF (Incontinence Questionnaire-Urine Incontinence-Short Form), PISQ-12 (Pelvic Organ Prolapse/Urinary Incontinence Sexual Questionnaires short form), FSFI (Female Sexual Function Index), FSDS (Female Sexual Distress Scale), and PGI-I (Patient Global Improvement Index) were used to assess efficiency and quality of life. Results: The bulking agents showed high efficacy and safety during the 29-month follow-up. Post-operative complications were recorded in both groups, with only two significant differences. The Bulkamid group experienced no pain, while 10.8% of the ALTIS group experienced groin pain and 5% experienced de novo urgency. Furthermore, patients treated with bulking agents experienced reduced nicturia (0.78 vs. 0.92 in patients treated with single-incision slings.). In both groups, we noticed a significant improvement in QoL (quality of life), with a halved ICIQ-UI-SF (International Consultation on Incontinence Questionnaire-Urine Incontinence-Short Form) score which was completed to assess the impact of urine symptoms. After 24 months of therapy, the Bulkamid group saw a decrease from 14.58 ± 5.11 at baseline to 5.67 ± 1.90 (p < 0.0001), whereas the ALTIS group experience a decrease from 13.75 ± 5.89 to 5.83 ± 1.78. Similarly, we observed an improvement in sexual function, with the number of sexually active patients increasing from 29 to 44 (56.4%) in the Bulkamid group (p = 0.041) and from 31 to 51 (61.7%) in the ALTIS group (p = 0.034). According to the most recent statistics, the PISQ-12, FSFI, and FSDS scores all demonstrated an improvement in women’s sexual function. Conclusions: In terms of efficacy and safety, bulking agents had notable results over the 29-month follow-up period. Furthermore, the patients treated with bulking agents reported a lower incidence of postoperative complications and a no discernible difference in terms of quality of life and sexual activity compared to the ones treated with single-incision slings. Bulking agents can be considered a very reliable therapeutic option based on accurate patient selection. Full article

(This article belongs to the Special Issue Urinary Tract Health and Care)

12 pages, 1485 KiB

Open AccessArticle

Pelvic Floor Dysfunction among Reproductive-Age Women in Israel: Prevalence and Attitudes—A Cross-Sectional Study

by Tehila Fisher-Yosef, Dina Lidsky Sachs, Shiri Sacha Edel, Hanan Nammouz, Abd Ellatif Zoabi and Limor Adler

Healthcare 2024, 12(3), 390; https://doi.org/10.3390/healthcare12030390 - 02 Feb 2024

Viewed by 1119

Abstract

Objectives: Our study aimed to investigate the prevalence of female pelvic floor dysfunction (PFD) in Israeli women who experienced vaginal delivery and are in their reproductive years (premenopausal), as well as to understand their attitudes and health-seeking behavior and barriers towards treating this problem. Methods: In this cross-sectional study, we conducted a questionnaire-based Internet survey. The surveys were sent to Israeli women in their fertile years (18–50 years old). We asked the women about their PFD symptoms, attitudes, and help-seeking behaviors. We used two validated questionnaires, including the USIQ and the PFDI-20. The combined questionnaire was submitted in both Hebrew and Arabic. We assessed the prevalence of PFD symptoms in the study population. Symptomatic women were asked about their help-seeking behaviors and their beliefs, desires, and barriers regarding the clinical management of symptoms. Results: Between July and September 2020, 524 women completed the questionnaire (response rate 44%). In total, 95% reported at least one symptom (mostly urinary-related) at any grade of severeness in at least one category, and 66.8% suffered from at least one moderate to severe symptom in at least one category. Most women (93.7%) reported that they wanted to be asked and offered voluntary information about PFD from physicians and nurses; however, only 16.6% reported receiving such information. Barriers to seeking treatment were mainly related to low awareness. The study’s main limitation was selection bias due to the questionnaire’s design. Conclusions: These findings show the importance of raising awareness of the different therapeutic solutions to PFD symptoms and designing more available services for this common problem. Full article

(This article belongs to the Special Issue Urinary Tract Health and Care)

► Show Figures

Figure 1

11 pages, 649 KiB

Open AccessArticle

The Impact of Systemic Sclerosis on Sexual Health: An Italian Survey

by Alessandro Ferdinando Ruffolo, Maurizio Serati, Arianna Casiraghi, Vittoria Benini, Chiara Scancarello, Maria Carmela Di Dedda, Carla Garbagnati, Andrea Braga, Massimo Candiani and Stefano Salvatore

Healthcare 2023, 11(16), 2346; https://doi.org/10.3390/healthcare11162346 - 20 Aug 2023

Cited by 1 | Viewed by 1457

Abstract

Objective: To evaluate the impact of systemic sclerosis (SSc) on vulvovaginal atrophy (VVA) and sexual health in an Italian population. Methods: An Italian survey about the prevalence and severity of VVA (on a 0 to 10 scale) and sexual dysfunction (using the Female Sexual Function Index—FSFI) through an anonymous online questionnaire. We investigated couple relationships and intimacy with partners, the predisposition of patients to talk about their sexual problems, physicians’ receptivity, and treatment scenarios. Risk factors for VVA symptoms and sexual dysfunction were assessed. Results: A total of 107 women affected by SSc were enrolled. Of these, 83.2% of women (89/107) complained about VVA symptoms and 89.7% (among sexually active women; 87/97) about sexual dysfunction. Menopausal status did not affect VVA symptoms, while age was the only independent risk factor for sexual dysfunction. About 70% (74/107) of women reported a negative impact of disturbances on intimacy with their partner. A total of 63 women (58.9%) had never discussed their sexual problems and VVA condition with a physician. Lubricants were the only treatment prescribed, and 75% of women would welcome new therapies, even if experimental (62.9%). Conclusions: In women with SSc, VVA symptoms and sexual dysfunction are highly prevalent, independently from menopause. In more than half of the investigated women with SSc, we found reluctance to talk about their sexual problems, despite being symptomatic. This should encourage physicians to investigate vulvovaginal and sexual health. SSc patients would welcome the advent of new treatment possibilities for their VVA and sexual complaints. Full article

(This article belongs to the Special Issue Urinary Tract Health and Care)

► Show Figures

Figure 1

10 pages, 276 KiB

Open AccessArticle

Flat Magnetic Stimulation for Stress Urinary Incontinence: A 3-Month Follow-Up Study

by Marta Barba, Alice Cola, Giorgia Rezzan, Clarissa Costa, Tomaso Melocchi, Desirèe De Vicari, Stefano Terzoni, Matteo Frigerio and Serena Maruccia

Healthcare 2023, 11(12), 1730; https://doi.org/10.3390/healthcare11121730 - 13 Jun 2023

Cited by 3 | Viewed by 855

Abstract

Background: flat magnetic stimulation is based on a stimulation produced by electromagnetic fields with a homogenous profile. Patients with stress urinary incontinence (SUI) can take advantage of this treatment. We aimed to evaluate medium-term subjective, objective, and quality-of-life outcomes in patients with stress urinary incontinence to evaluate possible maintenance schedules. Methods: a prospective evaluation through the administration of the International Consultation on Incontinence Questionnaire-Short Form (ICIQ-SF), the Incontinence Impact Questionnaire (IIQ7), and the Female Sexual Function Index (FSFI) was performed at three different time points: at the baseline (T0), at the end of treatment (T1), and at 3-month follow-up (T2). The stress test and the Patient Global Impression of Improvement questionnaire (PGI-I) defined objective and subjective outcomes, respectively. Results: 25 consecutive patients were enrolled. A statistically significant reduction in the IIQ7 and ICIQ-SF scores was noticed at T1 returned to levels comparable to the baseline at T2. However, objective improvement remained significant even at a 3-month follow-up. Moreover, the PGI-I scores at T1 and T2 were comparable, demonstrating stable subjective satisfaction. Conclusion: despite a certain persistence of the objective and subjective continence improvement, the urinary-related quality of life decreases and returns to baseline values three months after the end of flat magnetic stimulation. These findings indicate that a further cycle of treatment is probably indicated after 3 months since benefits are only partially maintained after this timespan. Full article

(This article belongs to the Special Issue Urinary Tract Health and Care)

9 pages, 254 KiB

Open AccessArticle

Prevalence and Severity of Pelvic Floor Disorders during Pregnancy: Does the Trimester Make a Difference?

by Yoav Baruch, Stefano Manodoro, Marta Barba, Alice Cola, Ilaria Re and Matteo Frigerio

Healthcare 2023, 11(8), 1096; https://doi.org/10.3390/healthcare11081096 - 11 Apr 2023

Cited by 1 | Viewed by 1368

Abstract

(1) Background: Women experience pelvic floor dysfunction symptoms during pregnancy. This study is the first to investigate and compare variances in the prevalence and severity of pelvic floor symptoms between trimesters using a valid pregnancy-targeted questionnaire. (2) Methods: A retrospective cohort study was conducted between August 2020 to January 2021 at two university-affiliated tertiary medical centers. Pregnant women (n = 306) anonymously completed the Pelvic Floor Questionnaire for Pregnancy and Postpartum with its four domains (bladder, bowel, prolapse, and sexual). (3) Results: Thirty-six women (11.7%) were in the 1st trimester, eighty-three (27.1%) were in the 2nd trimester, and one hundred and eighty-seven (61.1%) were in the 3rd trimester. The groups were similar in age, pregestational weight, and smoking habits. A total of 104 (34%) had bladder dysfunction, 112 (36.3%) had bowel dysfunction, and 132 (40.4%) reported sexual inactivity and/or sexual dysfunction. Least prevalent (33/306; 10.8%) were prolapse symptoms. Increased awareness of prolapse and significantly higher rates of nocturia and the need to use pads due to incontinence were recorded in the 3rd trimester. Sexual dysfunction or abstinence were equally distributed in all three trimesters. (4) Conclusions: Bladder and prolapse symptoms, equally frequent throughout pregnancy, significantly intensified in the 3rd trimester. Bowel and sexual symptoms, equally frequent throughout pregnancy, did not intensify in the third trimester. Full article

(This article belongs to the Special Issue Urinary Tract Health and Care)

10 pages, 803 KiB

Open AccessArticle

Functional Exercise Versus Specific Pelvic Floor Exercise: Observational Pilot Study in Female University Students

by Esther Díaz-Mohedo, Itxaso Odriozola Aguirre, Elena Molina García, Miguel Angel Infantes-Rosales and Fidel Hita-Contreras

Healthcare 2023, 11(4), 561; https://doi.org/10.3390/healthcare11040561 - 14 Feb 2023

Viewed by 1710

Abstract

Objectives: To evaluate the electromyographic (EMG) activity of the pelvic floor musculature (PFM) that takes place when performing the functional movement screen (FMS) exercise, comparing it with the activation in the maximum voluntary contraction of PFM in the supine position (MVC-SP) and standing (MVC-ST). Material and Methods: A descriptive, observational study conducted in two phases. In the first study phase, the baseline EMG activity of PFM was measured in the supine position and standing during MVC-SP and MVC-ST and during the execution of the seven exercises that make up the FMS. In the second phase of the study, the baseline EMG activity of PFM was measured in the supine position and standing during MVC-SP and MVC-ST and during the FMS exercise that produced the most EMG in the pilot phase: trunk stability push-up (PU). ANOVA, Friedman’s and Pearson’s tests were used. Results: All FMS exercises performed in the pilot phase showed a value below 100% maximum voluntary contraction (MVC) except PU, which presented an average value of 101.3 μv (SD = 54.5): 112% MVC (SD = 37.6). In the second phase of the study, it was observed that there were no significant differences (p = 0.087) between the three exercises performed: MVC-SP, MVC-ST and PU (39.2 μv (SD = 10.4), 37.5 μv (SD = 10.4) and 40.7 μv (SD = 10.2), respectively). Conclusions: There is no evidence of the existence of significant differences in EMG activation in PFM among the three exercises analysed: MVC-SP, MVC-ST and PU. The results show better EMG values in the functional exercise of PU. Full article

(This article belongs to the Special Issue Urinary Tract Health and Care)

► Show Figures

Figure 1

10 pages, 576 KiB

Open AccessArticle

Pelvic Floor Muscle Exercises as a Treatment for Urinary Incontinence in Postmenopausal Women: A Systematic Review of Randomized Controlled Trials

by María Paz López-Pérez, Diego Fernando Afanador-Restrepo, Yulieth Rivas-Campo, Fidel Hita-Contreras, María del Carmen Carcelén-Fraile, Yolanda Castellote-Caballero, Carlos Rodríguez-López and Agustín Aibar-Almazán

Healthcare 2023, 11(2), 216; https://doi.org/10.3390/healthcare11020216 - 11 Jan 2023

Cited by 1 | Viewed by 2498

Abstract

Women frequently suffer from urinary incontinence due to atrophic changes in the urogenital tract. Recommended conservative treatment includes evaluation of pelvic-floor strength and the functional use of pelvic-floor-muscle (PFM) training. Following the PRISMA 2020 guidelines, a search was conducted in the electronic databases PubMed, Web of Science, and Scopus for articles with at least one group performing PFM exercises in post-menopausal women with urinary incontinence. Eight articles were included, and each study had at least one group of PFM exercise-based intervention alone or combined. The volume or duration, frequency, and number of sessions were heterogeneous. All the studies reported significant differences in favor of PFM exercise in strength, quality of life, and/or severity of urinary incontinence. PFM exercise is a highly recommended intervention to treat urinary incontinence in postmenopausal women. However, more research is needed to establish specific factors such as dose–response relationships and to standardize methods for measuring effects. Full article

(This article belongs to the Special Issue Urinary Tract Health and Care)

► Show Figures

Figure 1

8 pages, 255 KiB

Open AccessArticle

Coexistent Detrusor Overactivity-Underactivity in Patients with Pelvic Floor Disorders

by Matteo Frigerio, Marta Barba, Giuseppe Marino, Silvia Volontè, Tomaso Melocchi, Desirèe De Vicari, Marco Torella, Stefano Salvatore, Andrea Braga, Maurizio Serati, Stefano Manodoro and Alice Cola

Healthcare 2022, 10(9), 1720; https://doi.org/10.3390/healthcare10091720 - 08 Sep 2022

Cited by 3 | Viewed by 1313

Abstract

Introduction and Hypothesis: Pelvic floor disorders represent a series of conditions that share, in part, the same etiological mechanisms, so they tend to be concomitant. Recently, awareness of a new lower urinary tract clinical syndrome has risen, namely the coexisting overactive–underactive bladder (COUB). The etiopathogenetic process, prevalence, and related instrumental findings of COUB are not well-established. We aimed to evaluate the prevalence, clinical features, and urodynamic findings of patients with COUB in a large cohort of patients with pelvic floor disorders. Methods: A cohort of 2092 women was retrospectively analyzed. A clinical interview, urogenital examination, and urodynamic assessment were performed by a trained urogynecologist. Based on baseline symptoms, patients were divided into COUB and non-COUB groups, and the degree of concordance between COUB and urodynamic findings, and other parameters related to the clinical aspects of these patients were measured and analyzed. Results: 18.8% of patients were classified as COUB. The association between COUB and patients with coexisting detrusor overactivity–underactivity (DOU) was statistically significant and there were substantial similarities in terms of population characteristics, symptoms, and urodynamic findings. Conclusions: Our study showed a high prevalence of COUB, and a link between this clinical syndrome and DOU was demonstrated. They showed substantial similarities in terms of clinical and urodynamics correlates. Based on these findings, we do think that urodynamic tests can be useful to improve knowledge on COUB and may be of help in the management of this condition. Full article

(This article belongs to the Special Issue Urinary Tract Health and Care)

12 pages, 8083 KiB

Open AccessArticle

Effect of Immersive Virtual Reality on Post-Baccalaureate Nursing Students’ In-Dwelling Urinary Catheter Skill and Learning Satisfaction

by Chu-Ling Chang

Healthcare 2022, 10(8), 1473; https://doi.org/10.3390/healthcare10081473 - 05 Aug 2022

Cited by 5 | Viewed by 2143

Abstract

A fundamental skill required from nursing students is how to manage the insertion of in-dwelling urinary catheters, and this skill is a core competency for nurses. However, practice with conventional test models is insufficient for learning this skill and leads to inadequate proficiency among students. To address this problem, this study created an immersive virtual reality (IVR) scheme, based on the theory of situated learning, to simulate clinical situations. Innovative approaches were adopted to design clinical cases, construct three-dimensional environments, design character dialogs, and integrate artificial intelligence voice recognition. The effect of these design elements on students’ in-dwelling urinary catheter skills and learning satisfaction was explored. First, nursing experts assessed the quality of the IVR scheme. Over a 4-week period, 43 students in a post-baccalaureate nursing program used conventional test models to practice the management of in-dwelling urinary catheters in female patients, and their learning was supplemented by at least two practice sessions with IVR. Data were collected from in-class observation records, a questionnaire survey on student satisfaction, and focused group interviews. The results showed that the participating students were highly satisfied with the IVR scheme and stated that it provided a pleasurable learning experience and exerted a positive impact on them. The IVR scheme provided situations closely resembling real clinical environments, helping the students to memorize the steps for catheter management. The students also noted that the IVR scheme should incorporate other nursing skills, such as empathetical and solicitous care and patient companionship. This enables nursing students to fulfill their role and care for patients in clinical settings. Full article

(This article belongs to the Special Issue Urinary Tract Health and Care)

► Show Figures

Figure 1

Review

Jump to: Research, Other

10 pages, 507 KiB

Open AccessReview

Pelvic Organ Prolapse Syndrome and Lower Urinary Tract Symptom Update: What’s New?

by Gaetano Maria Munno, Marco La Verde, Davide Lettieri, Roberta Nicoletti, Maria Nunziata, Diego Domenico Fasulo, Maria Giovanna Vastarella, Marika Pennacchio, Gaetano Scalzone, Gorizio Pieretti, Nicola Fortunato, Fulvio De Simone, Gaetano Riemma and Marco Torella

Healthcare 2023, 11(10), 1513; https://doi.org/10.3390/healthcare11101513 - 22 May 2023

Cited by 2 | Viewed by 1285

Abstract

(1) Background: This narrative review aimed to analyze the epidemiological, clinical, surgical, prognostic, and instrumental aspects of the link between pelvic organ prolapse (POP) and lower urinary tract symptoms (LUTS), collecting the most recent evidence from the scientific literature. (2) Methods: We matched the terms “pelvic organ prolapse” (POP) and “lower urinary tract symptoms” (LUTS) on the following databases: Pubmed, Embase, Scopus, Google scholar, and Cochrane. We excluded case reports, systematic reviews, articles published in a language other than English, and studies focusing only on a surgical technique. (3) Results: There is a link between POP and LUTS. Bladder outlet obstruction (BOO) would increase variation in bladder structure and function, which could lead to an overactive bladder (OAB). There is no connection between the POP stage and LUTS. Prolapse surgery could modify the symptoms of OAB with improvement or healing. Post-surgical predictive factors of non-improvement of OAB or de novo onset include high BMI, neurological pathologies, age > 65 years, and the severity of symptoms; predictors of emptying disorders are neurological pathologies, BOO, perineal dysfunctions, severity of pre-surgery symptoms, and severe anterior prolapse. Urodynamics should be performed on a specific subset of patients (i.e., stress urinary incontinence, correct surgery planning), (4) Conclusions: Correction of prolapse is the primary treatment for detrusor underactivity and for patients with both POP and OAB. Full article

(This article belongs to the Special Issue Urinary Tract Health and Care)

► Show Figures

Figure 1

10 pages, 647 KiB

Open AccessReview

From Clinical Scenarios to the Management of Lower Urinary Tract Symptoms in Children: A Focus for the General Pediatrician

by Pier Luigi Palma, Pierluigi Marzuillo, Anna Di Sessa, Stefano Guarino, Daniela Capalbo, Maria Maddalena Marrapodi, Giulia Buccella, Sabrina Cameli, Emanuele Miraglia del Giudice, Marco Torella, Nicola Colacurci and Carlo Capristo

Healthcare 2023, 11(9), 1285; https://doi.org/10.3390/healthcare11091285 - 30 Apr 2023

Viewed by 1428

Abstract

Lower urinary tract symptoms (LUTS) are a relevant problem in the pediatric population, having a very high prevalence. Diurnal incontinence and nocturnal enuresis are surely the most frequent symptoms, presenting, respectively, in up to 30% of school-age children and up to 10% of children between 6 and 7 years. Stypsis is the most common comorbidity, and it must be considered in the management of LUTS; indeed, the treatment of constipation is curative in most cases for both incontinence and enuresis. The presence or absence of diurnal symptoms in nocturnal enuresis and urgency in diurnal incontinence helps in the differential diagnosis. Urotherapy is always the first-line treatment, while oxybutynin and desmopressin (where appropriate) may help if the first-line treatment is unsuccessful. It is essential to identify conditions that are potentially dangerous for kidney and urinary tract well-being, for which LUTS can be the first manifestation. Starting from a series of clinical scenarios, we will underline the diagnostic clues behind LUTS in children and we will summarize clinical and surgical approaches for the proper management of these conditions. Full article

(This article belongs to the Special Issue Urinary Tract Health and Care)

► Show Figures

Figure 1

16 pages, 811 KiB

Open AccessReview

Microbiota Ecosystem in Recurrent Cystitis and the Immunological Microenvironment of Urothelium

by Mattia Dominoni, Annachiara Licia Scatigno, Marco La Verde, Stefano Bogliolo, Chiara Melito, Andrea Gritti, Marianna Francesca Pasquali, Marco Torella and Barbara Gardella

Healthcare 2023, 11(4), 525; https://doi.org/10.3390/healthcare11040525 - 10 Feb 2023

Cited by 4 | Viewed by 2400

Abstract

Urinary tract infections (UTIs) represent one of the most frequent low genital tract diseases in the female population. When UTIs occur with a frequency of at least three times per year or two times in the last six month, we speak of recurrent UTI (rUTI) and up to 70% of women will have rUTI within 1 year. It was previously thought that antibiotic resistance was principally responsible for the recurrence of UTIs, but nowadays new diagnostic technologies have shown the role of microbiota in the pathophysiology of these diseases. Much research has been conducted on the role of gut microbiome in the development of rUTI, while little is known yet about vaginal and urinary microbiome and the possible immunological and microscopical mechanisms through which they trigger symptoms. New discoveries and clinical perspectives are arising, and they all agree that a personalized, multi-modal approach, treating vaginal and urinary dysbiosis, may reduce rUTIs more successfully. Full article

(This article belongs to the Special Issue Urinary Tract Health and Care)

► Show Figures

Figure 1

Other

Jump to: Research, Review

9 pages, 1771 KiB

Open AccessCase Report

Purple Urine Bag Syndrome in a Home-Dwelling Elderly Female with Lumbar Compression Fracture: A Case Report

by Milka B. Popović, Deana D. Medić, Radmila S. Velicki and Aleksandra I. Jovanović Galović

Healthcare 2023, 11(16), 2251; https://doi.org/10.3390/healthcare11162251 - 10 Aug 2023

Viewed by 1953

Abstract

Purple urine bag syndrome (PUBS) is an uncommon, but usually benign, underrecognized clinical condition with the distressing presentation of purple, blue or reddish discoloration of a patient’s catheter bag and tubing in the setting of catheter-associated urinary tract infections (UTIs). PUBS is the result of the complex metabolic pathway of the dietary essential amino acid tryptophan. Its urinary metabolite, indoxyl sulfate, is converted into red and blue byproducts (indirubin and indigo) in the presence of the bacterial enzymes indoxyl sulfatase and phosphatase. The typical predisposing factors are numerous and include the following: female gender, advanced age, long-term catheterization and immobilization, constipation, institutionalization, dementia, increased dietary intake of tryptophan, chronic kidney disease, alkaline urine, and spinal cord injury (SCI). Here, we present a case of PUBS in a home-dwelling elderly female patient with a history of long-term immobility after a pathological spinal fracture, long-term catheterization, constipation, and malignant disease in remission. Urine culture was positive for Proteus mirabilis. This state can be alarming to both patients and physicians, even if the patient is asymptomatic. Healthcare professionals and caregivers need to be aware of this unusual syndrome as an indicator of bacteriuria in order to initiate proper diagnostics and treatment. Full article

(This article belongs to the Special Issue Urinary Tract Health and Care)

► Show Figures

Figure 1

Journal Menu

Journal Browser

Urinary Tract Health and Care

Share This Special Issue

Special Issue Editors

Special Issue Information

Keywords

Published Papers (13 papers)

Research

Review

Other

Further Information

Guidelines

MDPI Initiatives

Follow MDPI