BackgroundThe present study was aimed at determining the prophylactic efficacy of American cranberry (AC) extract (Cysticlean®) in women with recurrent symptomatic postcoital urinary tract infections (PCUTI), non-consumer of AC extract in the past 3 months before inclusion, and to determine changes in their quality of life (QoL).MethodsThis was a single center, observational, prospective study in a total of 20 women (mean age 35.2 years; 50.0% were married). Patients were followed up for 3 and 6 months during treatment.ResultsThe number of PCUTIs in the previous 3 months prior to start the treatment with Cysticlean® was 2.8±1.3 and it was reduced to 0.2±0.5 at Month 6 (P<0.0001), which represent a 93% improvement. At baseline, the mean score on the VAS scale (range from 0 to 100) for assessing the QoL was 62.4±19.1, increasing to 78.2±12.4 at Month 6 (P=0.0002), which represents a 20% improvement. All patients had an infection with positive urine culture at baseline, after 6 months there were only 3 symptomatic infections (P<0.001). The most common bacterium was Escherichia coli.ConclusionsProphylaxis with American cranberry extract (Cysticlean®) could be an alternative to classical therapies with antibiotics. Further studies are needed to confirm results obtained in this pilot study.
Resumen:
Descripción del caso clínico: Varón de 47 años con sintomatología inespecífica del tracto urinario inferior. Se le practica una uretroscopia en la que se aprecia un pequeño orificio en la porción inferior de la uretra bulbar por el que no se puede progresar. En la uretrografía retrograda se observa una pequeña cavidad de 8 mm bajo la uretra, compatible con siringocele. Se completa estudio mediante uretrosonografía retrograda donde se aprecia una cavidad de 22x4 mm (APxL) sin apreciar el orificio. Finalmente, mediante uretrosonografía retrograda con contraste ecográfico se aprecio el orificio y un tamaño del siringocele de 35x5 mm (APxL).
Relevancia: El caso pone de manifiesto como las nuevas técnicas de imagen pueden contribuir en el estudio de la patología uretral.
Implicaciones clínicas: El hecho de que el siringocele sea muy poco frecuente en adultos y en muchas ocasiones asintomático puede provocar que su estudio mediante los protocolos habituales no sea optimo produciéndose falsos negativos, infraestimaciones de su tamaño, errores en su clasificación o errores diagnósticos.
Conclusiones: La uretrosonografía retrograda simple y la uretrosonografía retrograda con contraste ecográfico son técnicas de utilidad en el estudio del siringocele.
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