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Objective: To analyze the role of urodynamic dysfunctions as risk factors for recurrent urinary tract infections (rUTIs) in patients with multiple sclerosis (MS). Material and methods: We conducted a prospective cohort study of 170 patients with MS who underwent a urodynamic study due to lower urinary tract symptoms. Patients were followed for one year, and 114 (84 women [74%] and 30 men [26%]; mean age 49 years) completed the study. Clinical variables and urodynamic findings (free uroflowmetry, cystometry, and pressure-flow study results) were recorded. Results indicated rUTIs was present in 37 patients (32%). Statistical analysis was performed using Fisher's exact test, chi-square test, Student's t-test, and multivariate regression analysis. Results: In univariate analysis, significant differences were observed between patients with and without rUTIs for the following clinical variables: symptom progression time, MS duration, Expanded Disability Status Scale score, and MS type. Regarding urodynamic findings, significant differences were observed in maximum flow rate (Qmax) (lower in patients with rUTIs), voided volume, bladder voiding efficiency, stress urinary incontinence (SUI) (greater rUTI frequency in affected patients), detrusor pressure at maximum flow, and bladder contractility index score. Multivariate analysis identified the urodynamic factors: low Qmax [Odds Ratio (OR) = 0.90 and SUI (OR = 2.95) as the independent predictors of rUTs. Conclusions: Two urodynamic variables: Qmax and SUI, are independent risk factors for rUTIs in MS patients. These two variables might be associated with Pelvic floor dysfunctions. [ABSTRACT FROM AUTHOR]

Purpose: To establish whether the expression of markers of cell differentiation (CK7, CK14, CK20, GATA3), apoptosis (p53), proliferation (Ki67, STAG2) and peri-tumoural lymphocytes (CD3, CD8), provides specific information about urothelial carcinogenesis in neuro-urological patients with bladder cancer (NBC). Methods: Tissue samples from NBC were retrieved from 15 centres in France and compared to control samples from non neuro-urological patients with bladder cancer (NNBC) and from neuro-urological patients without bladder cancer (NB). The expression of CK7, CK14, CK20, GATA3, p53, Ki67, STAG2, CD3 and CD8 markers was analysed using immunohistochemistry of tissue microarray sections. Results: Overall, tissue samples from 124 patients were included in the study (n = 72 NBC, n = 26 NNBC and n = 26 NB). Muscle invasive bladder cancer (MIBC) was found in 52 NBC patients (72.2%) and squamous cell differentiation in 9 (12.5%). In NBC samples, the expression of CK20 and GATA3 was significantly more frequent in NMIBC compared to MIBC (p = 0.015 and p = 0.004, respectively). CK20 and GATA3 were significantly more expressed in NBC compared to NNBC (p < 0.001 and p = 0.010, respectively). The expression of CK14, Ki67, CD3 and CD8 was significantly more frequent in NBC than in NNBC samples (p = 0.005, p < 0.001, p < 0.001 and p < 0.001, respectively). The expression of CD3 and CD8 was similar in NBC and NB samples. Conclusion: In NBC, markers of basal differentiation, proliferation and peri-tumoural lymphocytes were significantly more expressed compared to NNBC controls. These results suggest the aggressiveness of NBC and the role of chronic inflammation in the carcinogenesis of bladder cancer in neuro-urological patients. [ABSTRACT FROM AUTHOR]

Introduction. Spinal Dysraphism is present in nearly 1,500 newborns each year in Mexico. Of these, 95% will show neurogenic urinary bladder, most frequent disease attended at CRIT Estado de Mexico Urology Service. Objective. To evaluate urinary bladder function alteration (urodynamics and cystography), and upper urinary tract deterioration (renal ultrasound and serum creatinine) in children with Spinal Dysraphism Material and methods. Observational, descriptive, retrospective and transversal study. Patients from 5 to 18 years old, with at least one urodynamic study, retrograde cystography, serum creatinine, and renal ultrasound. From January, 2005 to December, 2008. Statistical analysis: Mann-Whitney U Test, Kruskal-Wallis Test and linear association. Results. According to the anatomical level of presentation the patient distribution (n = 97) was lumbar 47% (46), thoracic 39% (38), thoracolumbar 12% (12), and cervical 1% (one). 93% received some form of treatment. Urodynamics showed normal findings in 5%, hyperactive bladder 68% and hypoactive bladder 27%. Hyperactive bladder presented significant lower bladder capacity. 22 patients showed vesicoureteral reflux, 10 of them of high grade (IV/V). 78 (80%) children had a normal renal ultrasound. The median serum creatinine was 0.57 mg/dL (± 0.25 SD). A positive but weak linear association between hydronephrosis and vesicoureteral reflux vs. creatinine level was shown (R2 = 0.051 y R2 = 0.024). Conclusions. A linear positive association between ultrasonographic findings, serum creatinine and vesicoureteral reflux was demonstrated (an increased upper urinary tract deterioration with higher levels of vesicoureteral reflux was observed). There were no associations between renal function deterioration and urodynamic bladder findings. [ABSTRACT FROM AUTHOR]