• Childhood Kidney Diseases
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• v.7 no.1
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• pp.106-111
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• 2003

We experienced a 4-month-old boy presenting with fever and painful scrotal swelling. Diagnostic work-up showed the presence of urinary tract infection and concurrent acute epididymitis. On the voiding cystourethrography, vesicoureteral reflux and urinary reflux through the ejaculatory duct and the seminal vesicle were detected without obvious urethral obstruction. In general, urinary reflux into the seminal vesicle can take place with obstructive lesions of the urethra and may cause epididymitis in infants. We report a case of urinary reflux without urethral obstruction with a brief review of related literatures.

• Journal of Veterinary Clinics
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• v.38 no.2
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• pp.63-68
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• 2021

Urethral obstruction is a life-threatening feline lower urinary tract disease (FLUTD). The rate of recurring urethral obstruction was 14.8-58.1% after the first occurrence. Ultrasonographic findings associated with reobstruction had been rarely reported although ultrasonography was a valuable technique for diagnosing urinary bladder calculi and distinguishing different FLUTD causes. This retrospective study aims to describe the ultrasonographic findings, urinalysis, and serum chemistry profile in cats with FLUTD and determine the associations of reobstruction with ultrasonographic findings, urinalysis, and serum chemistry profile. The present study included 141 cats that were followed up for more than 1 year. The ultrasonographic criteria included the presence of cystolithiasis, urine echogenicity, sediment, suspended linear strand, pericystic effusion, hyperechoic pericystic fat, ureteral dilation, pyelectasia, and perirenal effusion. The urinalysis criteria included hematuria, urine-specific gravity, pH, sediment, and proteinuria. The most common ultrasonographic findings in cats with FLUTD were echogenic urine and sediment. However, this study did not find an association between reobstruction and ultrasonographic findings, urinalysis, and serum chemistry profiles. Thus, an ultrasonographic examination may be insufficient to predict the risk of reobstruction although it is a useful modality for diagnosing FLUTD and making treatment direction.

• Childhood Kidney Diseases
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• v.28 no.1
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• pp.1-7
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• 2024

Antenatally diagnosed urinary tract dilatation (UTD), previously referred to as antenatal hydronephrosis, is the most commonly detected abnormality by prenatal ultrasonography. Several grading systems have been developed for the classification of antenatal UTD using prenatal and postnatal ultrasonography. UTD comprises a wide variety of congenital abnormalities of the kidney and urinary tract ranging from transient UTD to more significant abnormalities such as vesicoureteral reflux, ureteropelvic junction obstruction, ureterocele, ureterovesical junction obstruction, posterior urethral valves, and non-refluxing megaureter. Optimizing the evaluation of antenatally detected UTD is essential to recognize children with important disorders while avoiding excessive investigations. Conservative approach with close follow-up is increasingly accepted as an appropriate treatment option for patients with asymptomatic vesicoureteral reflux and ureteropelvic junction obstruction in recent years. However, predicting permanent kidney damage in an unselected group of children with antenatal UTD is still challenging. The management and follow-up of children with UTD should be individualized based on recommendations from a pediatric nephrologist, a pediatric urologist, or both. Future research directed at predicting long-term outcomes of children diagnosed with UTD from mild findings to severe disease is needed to refine management for those at higher risk of kidney disease progression.

• Journal of Veterinary Science
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• v.25 no.2
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• pp.27.1-27.12
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• 2024

Background: A urethral obstruction (UO) is an emergency commonly observed in male cats, which can result in significant clinical and laboratory alterations, leading to complications and death. Objectives: This study aimed to correlate symmetric dimethylarginine (SDMA) with the urea, creatinine, potassium, and bicarbonate levels in cats with UO. In addition, the correlation between clinical score and time of obstruction was evaluated. Methods: Thirty male cats were selected and allocated into a control group (CG, n = 13) and an obstruction group (OG, n = 17). The laboratory analyses were conducted before treatment (M0) and at different times after treatment (12 h [M12], 24 h [M24], and 48 h [M48]). Correlations were established between SDMA and creatinine, urea, bicarbonate, potassium, time of obstruction, and the clinical score. Results: A strong correlation (r > 0.6) was observed between SDMA and creatinine, urea, and potassium in the OG. Furthermore, there was substantial agreement (kappa value) between SDMA and creatinine at M24. A higher clinical score was associated with a longer time of obstruction. In the OG, at M48, the SDMA and creatinine levels were 50% and 41.2% higher, respectively. Conclusions: A correlation was observed between SDMA and creatinine in obstructed cats, and significant agreement between these values was observed 24 h after the unblocking treatment. A correlation among SDMA, urea, and potassium was observed. Approximately 9% more cats continued to have elevated SDMA levels after 48 h of treatment compared to creatinine. This suggests a slightly lower sensitivity of the latter biomarker but does not exclude the possibility of congruent and normalized values after a longer evaluation period.

• Journal of Veterinary Clinics
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• v.32 no.6
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• pp.519-522
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• 2015

A 6-year-old castrated male Shih-Tzu was admitted to the Gyeongsang Animal Medical Center with hematuria and vomiting. Serum chemistry indicated increases in blood urea nitrogen and creatinine values. Radiography showed radiopaque materials attached to the ventralis of the inner bladder wall. Penile urethra also was filled with radiopaque materials. Ultrasonography revealed bilateral perineal effusion in the kidney, thinned bladder wall, and materials with acoustic shadowing at the caudal extremity of the os penis. Because urination was not identified by urinary obstruction, cystocentesis was performed. Hematuria was diagnosed by urinalysis, but clear crystals were not identified. Owing to failure of securing patency to the bladder using retrohydropropulsion, cystotomy and urethrotomy with retrohydropropulsion were performed. In this report, we describe the clinical and radiographic findings of urethral plugs in a male Shih-Tzu dog, wherein the urethral plugs were treated successfully with hydropropulsion, cystotomy, and urethrotomy. It provides an option for the treatment of urethral plugs in a dog.

• Journal of Sensor Science and Technology
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• v.16 no.3
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• pp.202-210
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• 2007

The aim of this study is to acquire useful information of lower urinary tract symptom (LUTS) diagnosis through urophonography signal as a noninvasive method. The hardware and software which could evaluate the function of compensatory hypertrophy with noninvasive and comfortable method was implemented to measure uroflow and urophonography signal during urination. The PSD (power spectrum density) and the log-log plot gradient analysis were accomplished in frequency domain. For evaluation of the system and analysis method, a model system for the lower urinary system of men was used. From the evaluation of the model system, the PDS and the log-log plot gradient were dependent on the occlusion degree significantly. In a pilot study on normal and abnormal male subjects, the PSD and the log-log plot gradient were highly correlated with the artificial urethral obstruction.

• Clinical and Experimental Pediatrics
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• v.58 no.4
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• pp.154-157
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• 2015

Plastibell is one of the three most common devices used for neonatal circumcision in the United States, with a complication rate as low as 1.8%. The Plastibell circumcision device is commonly used under local anesthesia for religious circumcision in male neonates, because of cosmetic reasons and ease of use. Occasionally, instead of falling off, the device may get buried under the skin along the shaft of the penis, thereby obstructing the normal flow of urine. Furthermore, the foreskin of neonates is highly vascularized, and hence, hemorrhage and infection are possible when the skin is cut. Necrosis of penile skin, followed by urethral obstruction and renal failure, is a serious surgical mishap requiring immediate corrective surgery and medical attention. We report a case of fulminant urosepsis, acute renal failure, and pyelonephritis in a 4-day-old male neonate secondary to impaction of a Plastibell circumcision device. Immediate medical management was initiated with fluid resuscitation and mechanical ventilation; thereby correcting life threatening complications. Pediatricians and Emergency Department physicians should be cognizant of the complications from Plastibell circumcision device in order to institute appropriate and timely management in neonates.

• Journal of Veterinary Clinics
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• v.29 no.3
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• pp.250-254
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• 2012

An eight-year-old, castrated male, a Schnauzer dog was presented with dysuria, hematuria and intermittent vomiting. Retrograde positive contrast urethrography was performed under fluoroscope. On the contrast examination, the leakage was observed in the prostatic urethra region and irregular filling defect was also shown from the prostatic urethra and the level of the trigon of the bladder. Surgical treatment was selected because of partial urethral obstruction and dysuria. The metastasis at the time of surgery was suspected, and the owner decided euthanasia. We detected lymph metastasis with immunohistochemical staining for pan-cytokeratins (CK) AE1/AE3, confirming their epithelial origin. This report described typical clinical findings, diagnostic imaging and histopathological examination of a prostatic adenocarcinoma.

• Journal of Yeungnam Medical Science
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• v.5 no.2
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• pp.151-160
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• 1988

To evaluate the features of pyuria related to the bacteriuria, 140 subjects were studied from Jan. 1987 to Dec. 1987. The pyuria was frequently developed from the age 30 to 60 years old, and male to female ratio was 1:1.41. The most common disease was urethrocystitis that was shown 42.8%. Common precipitating factors were urethral catheterization(25%) and urinary tract obstruction(11.4 %). Through the observation, symptomatic pyuric patients were 66 subjects(47.1%), and the subjects with significant urine culture were 121 subjects(86.4%). In the urine culture, the most common bacteria was E. coli(41.4%), and the next was Pseudomonas(19.3%). A large percentage of E. coli and Pseudomonas was susceptible of amikin. The pyuria due to S. epidermidis and Accinatobacter was well treated. High therapeutic rate was observed in the acute pyelonephritis(71%) and urethrocystitis(67%). In the persistent urinary tract infection, there were relapsing(22 cases) and recurrent urinary tract infection(16 cases).

• Journal of Veterinary Clinics
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• v.22 no.4
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• pp.357-364
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• 2005

We surveyed the incidence of urinary calculi for feeding period, urinary lesion, composition of calculi and changes of serum chemistry with Korean native castrated steers, which are growing until 26 through 31 months. Without showing any clinical signs such as urethral obstruction, hydronephrosis and strangury for all group, $37.8\%$ (34 out of 90) of Korean native steers carried urinary calculi in carcass. The incidence of urine calculi far different feeding stages from 26 to 31 months were observed as $13.3-60.0\%$er, no significant differences were detected. The distribution of calculi were kidney $(24.4\%)$, kidney and bladder $(10\%)$ and kidney, bladder and urine $(3.3\%)$. Congestion of urinary bladder was shown in $26.6\%$ of Korean native steers. Korean native steers with urinary calculi $(41.2\%)$ had more possibilities (P<0.05) to bring outbreaks of congestion of urinary bladder than those of without calculi $(17.8\%)$. The main composition of calculi were struvite (magnesium ammonium phosphate crystals), calcium phosphate, calcium carbonate, calcium oxalate, non-oxalate calcium, ammonia and phosphate. The distribution of urine pH was $71.7\%$(above pH 8.0), $12.2\%$ (between pH 7.0 and pH 8.0) and $16.6\%$ (under pH 7.0). Like shown in herbivores, most of the urine pH was distributed as alkaline urine. Serum creatinine was shown significant difference (P<0.05) according to incidence of calculi but other serum chemistry didn't show any difference in serum chemistry. These results suggest that feeding until 26 to 31 months in Korean native steers castrated at 6 months of the age elicits urinary calculi and congestion of urinary bladder, but not clinical abnormality. And adjustment of the dietary Can ratio to a level of 2:1 or greater during feeding period may reduce the possibility of incidence of urinary calculi in Korean native steers.