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The stent-on-string is a double‑J catheter that the patient can remove himself, as an alternative to removal using cystoscopy. The aim of this research is to map luxations, residence time and complaint pattern in self-removal. To this end, 60 patients were examined how and when the stent-on-string was removed and how the stent was tolerated. 42 stents (70.0%) were removed on the indicated day. 46 patients (76.7%) did this themselves; five patients (8.3%) did not succeed. In two cases (3.3%), a cystoscopy was necessary. Five patients (8.3%) reported severe symptoms. Inclusion took place in two phases, with an obvious adjustment seen in included patients in phase 2. The use of a stent-on-string leads to a reduction in the number of cystoscopies, a limited number of premature luxations and in most cases the patient does not experience any to mild complaints. Experience with the technique seems to lead to fewer luxations. [ABSTRACT FROM AUTHOR]

Abstract An infectious disease with obstructive hydronephrosis, pyonephrosis causes suppurative destruction of the renal parenchyma. In such cases, retrograde ureteric stenting is considered a good choice for the drainage of pyonephrosis, as an alternative to percutaneous nephrostomy and nephrectomy. The complication rate is minimal in retrograde ureteric stenting compared with about 4% in percutaneous nephrostomy.

Urinary or ureteral catheter insertion remains one of the most common urological procedures, yet is considered a predisposing factor for urinary tract infection. Diverse bacterial consortia adhere to foreign body surfaces and create various difficult to treat biofilm structures. We analyzed 347 urinary catheter- and stent-related samples, treated with sonication, using both routine culture and broad-range 16S rDNA PCR followed by Denaturing Gradient Gel Electrophoresis and Sanger sequencing (PCR-DGGE-S). In 29 selected samples, 16S rRNA amplicon Illumina sequencing was performed. The results of all methods were compared. In 338 positive samples, from which 86.1% were polybacterial, 1,295 representatives of 153 unique OTUs were detected. Gram-positive microbes were found in 46.5 and 59.1% of catheter- and stent-related samples, respectively. PCR-DGGE-S was shown as a feasible method with higher overall specificity (95 vs. 85%, p < 0.01) though lower sensitivity (50 vs. 69%, p < 0.01) in comparison to standard culture. Molecular methods considerably widened a spectrum of microbes detected in biofilms, including the very prevalent emerging opportunistic pathogen Actinotignum schaalii. Using massive parallel sequencing as a reference method in selected specimens, culture combined with PCR-DGGE was shown to be an efficient and reliable tool for determining the composition of urinary catheter-related biofilms. This might be applicable particularly to immunocompromised patients, in whom catheter-colonizing bacteria may lead to severe infectious complications. For the first time, broad-range molecular detection sensitivity and specificity were evaluated in this setting. This study extends the knowledge of biofilm consortia composition by analyzing large urinary catheter and stent sample sets using both molecular and culture techniques, including the widest dataset of catheter-related samples characterized by 16S rRNA amplicon Illumina sequencing.

Urinary or ureteral catheter insertion remains one of the most common urological procedures, yet is considered a predisposing factor for urinary tract infection. Diverse bacterial consortia adhere to foreign body surfaces and create various difficult to treat biofilm structures. We analyzed 347 urinary catheter- and stent-related samples, treated with sonication, using both routine culture and broad-range 16S rDNA PCR followed by Denaturing Gradient Gel Electrophoresis and Sanger sequencing (PCR-DGGE-S). In 29 selected samples, 16S rRNA amplicon Illumina sequencing was performed. The results of all methods were compared. In 338 positive samples, from which 86.1% were polybacterial, 1,295 representatives of 153 unique OTUs were detected. Gram-positive microbes were found in 46.5 and 59.1% of catheter- and stent-related samples, respectively. PCR-DGGE-S was shown as a feasible method with higher overall specificity (95 vs. 85%, p < 0.01) though lower sensitivity (50 vs. 69%, p < 0.01) in comparison to standard culture. Molecular methods considerably widened a spectrum of microbes detected in biofilms, including the very prevalent emerging opportunistic pathogen Actinotignum schaalii. Using massive parallel sequencing as a reference method in selected specimens, culture combined with PCR-DGGE was shown to be an efficient and reliable tool for determining the composition of urinary catheter-related biofilms. This might be applicable particularly to immunocompromised patients, in whom catheter-colonizing bacteria may lead to severe infectious complications. For the first time, broad-range molecular detection sensitivity and specificity were evaluated in this setting. This study extends the knowledge of biofilm consortia composition by analyzing large urinary catheter and stent sample sets using both molecular and culture techniques, including the widest dataset of catheter-related samples characterized by 16S rRNA amplicon Illumina sequencing. [ABSTRACT FROM AUTHOR]

Actinotignum schaalii is an emerging, opportunistic pathogen and its connection to non-infectious diseases and conditions, such as prostate or bladder cancer, or chronic inflammation has been proposed. Here, we analyzed 297 urine, ureteral and urinary catheter samples from 128 patients by Polymerase Chain Reaction followed by Denaturing Gradient Gel Electrophoresis and Sequencing (PCR-DGGE-S), and culture, and 29 of these samples also by 16S rRNA Illumina sequencing, to establish A. schaalii’s prevalence in urinary tract-related samples, its relation to other bacteria, and its potential association with patients’ conditions and samples’ characteristics. A. schaalii-positive samples were significantly more diverse than A. schaalii negative and between-group diversity was higher than intra-group. Propionimicrobium lymphophilum, Fusobacterium nucleatum, Veillonella sp., Morganella sp., and Aerococcus sp. were significantly more often present in A. schaalii-positive samples; thus, we suggest these species are A. schaalii’s concomitants, while Enterobacter and Staphylococcaceae were more often identified in A. schaalii-negative samples; therefore, we propose A. schaalii and these species are mutually exclusive. Additionally, a significantly higher A. schaalii prevalence in patients with ureter stricture associated hydronephrosis (p = 0.020) was noted. We suggest that A. schaalii could be an early polybacterial biofilm colonizer, together with concomitant species, known for pro-inflammatory features.

Introduction: Double-J ureteral catheters in patients with ureteral lithiasis undergoing extracorporeal shockwave lithotripsy (ESWL) procedures reduce the efficacy of the procedure or have no effect on the stone-free rate. However, the effect of double-J catheters on the patients in whom they were inserted for infected hydronephrosis is not known. The aim of our study was to evaluate the efficacy and safety of the ESWL procedure in patients with ureteral lithiasis and double-J catheters previously inserted for infected hydronephrosis., Method: We conducted a comparative case-control, match-paired study in a group of patients with ureteral lithiasis treated by ESWL from January 1, 2018, to March 1, 2023, who were divided into two groups according to the presence of the double-J catheter. For each patient with the double-J catheter from the study group, we selected one patient for the control group without the double-J catheter and matched them in terms of size, location of stones, and body mass index (BMI). We analyzed the stone-free rate and complications that occurred in the two groups., Results: Forty patients with ureteral lithiasis and a double-J catheter inserted for infected hydronephrosis were enrolled in the study group. The control group included 40 patients with ureteral stones without double-J catheters. The patients in the two groups were predominantly men with stones located in the lumbar region and on the right side and with a BMI between 25 and 30 kg/m 2 . The stones had an average size of 0.9+/-0.12mm and 0.89+/-0.15mm, respectively (p=0.624). There was no statistically significant difference in stone-free rate between the two groups after the first session of ESWL (47.5% vs. 52.5%, p=0.502), the second (70% vs. 75%, p = 0.616), and the third session (85% vs. 87.5%, p=0.761). The rate of complications was similar in both groups (7.5% vs. 5%, p=0.761)., Conclusions: The presence of double-J catheters inserted in patients with ureteral stones who underwent ESWL for infected hydronephrosis does not affect the stone-free rate of the procedure or the complication rate. The procedure of ESWL in patients with ureteral lithiasis and double-J catheters inserted for infected hydronephrosis is a safe and efficient method that can be recommended as an initial treatment alongside retrograde ureteroscopy., Competing Interests: The authors have declared that no competing interests exist., (Copyright © 2024, Bandac et al.)

Background: Ureteral stricture is a complication of several etiologies including idiopathic retroperitoneal fibrosis, infection, radiotherapy, instrumentation, and surgical procedures. A variety of techniques have been reported for management. The transureteroureterostomy and bladder flap have been the standard procedures for repairing distal ureteral defects of unilateral ureter. Bilateral ureteral stricture is an uncommon condition that challenges usual reconstructive procedures. It is a difficult task to reconstruct the complex situation of bilateral ureteral strictures. Case presentation: A 54-year-old female underwent concurrent chemoradiotherapy for stage IVB squamous cell carcinoma of cervix. Subsequently, she had stricture of bilateral distal ureters with bilateral hydroureteronephrosis which was found by computed tomography. The renal function deteriorated during the follow-up period. She had periodic change of double-J stents and percutaneous nephrostomy. However, the renal function still deteriorated. We performed a combined Y-shaped common channel transureteroureterostomy with Boari flap to reconstruct bilateral long-segment ureteral strictures. The patient recovered uneventfully. Conclusion: Reconstruction of bilateral ureteral strictures is a difficult treatment. We developed a modified technique for the complex situation of bilateral ureteral strictures. To our knowledge, this has not been previously reported in the scientific literature and it is a feasible procedure to treat bilateral long-segment ureteral strictures. [ABSTRACT FROM AUTHOR]

An infectious disease with obstructive hydronephrosis, pyonephrosis causes suppurative destruction of the renal parenchyma. In such cases, retrograde ureteric stenting is considered a good choice for the drainage of pyonephrosis, as an alternative to percutaneous nephrostomy and nephrectomy. The complication rate is minimal in retrograde ureteric stenting compared with about 4% in percutaneous nephrostomy. [ABSTRACT FROM AUTHOR]

Actinotignum schaalii is an emerging, opportunistic pathogen and its connection to non-infectious diseases and conditions, such as prostate or bladder cancer, or chronic inflammation has been proposed. Here, we analyzed 297 urine, ureteral and urinary catheter samples from 128 patients by Polymerase Chain Reaction followed by Denaturing Gradient Gel Electrophoresis and Sequencing (PCR-DGGE-S), and culture, and 29 of these samples also by 16S rRNA Illumina sequencing, to establish A. schaalii's prevalence in urinary tract-related samples, its relation to other bacteria, and its potential association with patients' conditions and samples' characteristics. A. schaalii-positive samples were significantly more diverse than A. schaalii negative and between-group diversity was higher than intra-group. Propionimicrobium lymphophilum, Fusobacterium nucleatum, Veillonella sp., Morganella sp., and Aerococcus sp. were significantly more often present in A. schaalii-positive samples; thus, we suggest these species are A. schaalii's concomitants, while Enterobacter and Staphylococcaceae were more often identified in A. schaalii-negative samples; therefore, we propose A. schaalii and these species are mutually exclusive. Additionally, a significantly higher A. schaalii prevalence in patients with ureter stricture associated hydronephrosis (p = 0.020) was noted. We suggest that A. schaalii could be an early polybacterial biofilm colonizer, together with concomitant species, known for pro-inflammatory features. [ABSTRACT FROM AUTHOR]

This study was undertaken to assess the effect of antegrade placement of internal double-J catheters for patients who underwent open pyeloplasty for ureteropelvic junction (UPJ) obstruction. Medical records of unilateral dismembered pyeloplasties of 71 patients with UPJ obstruction treated between 1998 and 2008 were reviewed retrospectively. In all patients, a double-J catheter was placed in an antegrade fashion during the operation. The patients were reviewed in terms of age, sex, postoperative complications and length of hospital stay. All children but one using double-J catheter were discharged within 24 hours after the operation. Neither urinary leak nor re-obstruction occurred in the operated kidneys during a follow-up. Transanastomotic stenting with double-J catheter is recommended as the reasonable mode of drainage in open pyeloplasty in pediatric patients. [ABSTRACT FROM AUTHOR]

Although ureteral length (UL) is highly variable in children, reliable data on this topic are scarce. During urinary tract surgery, the use of an inappropriately dimensioned ureteral stent is associated with adverse effects. This study aimed to evaluate UL as a function of the child's age, using contrast-enhanced computed tomography (CT) of the abdomen and pelvis, and to calculate a new equation for predicting UL (and thus the optimal length of ureteral stents) in children. A retrospective, single-centre study of children (younger than 16 years) who are free of abdominal mass syndrome and severe scoliosis was conducted. After three-dimensional reconstruction of the CT data, the ureter was measured between the ureteropelvic junction and ureterovesical junction by two observers. The lengths of the right and left ureters were analyzed by age, with at least 10 CT measurements per age class. The mean ULs on the right and left were, respectively, 9.7 and 9.91 cm before the age of 1 year, 20.10 and 21.08 cm at the age of 7 and 26.55 and 27.46 cm at the age of 16. The interobserver reproducibility of UL determination was high (intraclass correlation coefficient [95% confidence interval]: 0.97 [0.94–0.99]). On the basis of these results, the length of the double-J catheter should be equal to the child's age +12 cm (Table 1). Computed tomography measurement of the UL in healthy children is reproducible and reliable and enabled the estimation of the UL by age group. This knowledge should facilitate the choice of the stent used in ureteral surgery. To confirm the study results, the stent size suggested here should be evaluated in routine practice. [ABSTRACT FROM AUTHOR]