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.
The most frequent etiology of symptomatic hydronephrosis during pregnancy is external compression by the gravid uterus, followed by ureteral lithiasis. We consider conservative treatment as the treatment of choice, leaving ureteral double J cotheter insertion or percutaneous nephrostomy for the refractory cases. Ureteroscopy is a new diagnostic and therapeutic option when other less aggressive meosures fail.
It is more and more common to have patients in our clinics with the diagnosis of BPH and indication for surgery who present limitations due to their medications, age, associated morbidity or psychosocial conditions. Transurethral resection of the prostate, though it is the surgical standard of reference, is not free from complications such as reabsorption syndrome, bleeding, or even blood transfusion in a percentage of cases. Laser PVP may be a valid alternative in this subgroup of patients. We review our experience with this procedure, as well as the published articles on this topic, and describe technical recommendations we consider useful to avoid complications when possible during surgery or the immediate postoperative period.
The development of new, revolutionary systems for the treatment of SUI has simplified the surgical treatment of this entity, so that we can say a high percentage of patients may be included in an ambulatory surgery program, significantly improving cost-efficacy without diminishment of health-care quality or patient satisfaction.
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