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The Journal-lancet Aug 1948
Topics: Humans; Infertility; Pyuria; Suppuration; Urine
PubMed: 18871899
DOI: No ID Found -
Archives of Disease in Childhood Jun 1962
Topics: Humans; Pyuria
PubMed: 13916273
DOI: 10.1136/adc.37.193.257 -
Urologic Oncology Sep 2016To investigate the association of preoperative pyuria with pathologic features and oncologic outcomes in patients with urothelial carcinoma of the upper urinary tract...
Preoperative pyuria predicts advanced pathologic tumor stage and worse survival in patients with urothelial carcinoma of the upper urinary tract treated by radical nephroureterectomy.
OBJECTIVES
To investigate the association of preoperative pyuria with pathologic features and oncologic outcomes in patients with urothelial carcinoma of the upper urinary tract (UTUC) treated by radical nephroureterectomy (RNU).
MATERIAL AND METHODS
A cohort of 176 patients treated with RNU from January 2001 to December 2014 were retrospectively reviewed. Logistic regression and survival analysis methodology was used to investigate the association of preoperative pyuria with clinicopathologic outcomes.
RESULTS
Among this cohort, 36 (20.5%) presented with preoperative pyuria. Logistic regression revealed that pyuria was significantly associated with advanced pT stage (P = 0.001). During a median follow-up of 41 months (interquartile range: 22-60), 65 (37%) patients died, including 54 (31%) from UTUC. Overall survival rates at 3 year and 5 years in patients with pyuria were significantly lower than those in patients without pyuria (62.3% and 36.1% vs. 78.4% and 65.3%, respectively; P = 0.004). Also, cancer-specific survival rates at 3 year and 5 years in patients with pyuria were significantly lower than in patients without pyuria (65.7% and 50% vs. 80% and 67.6%, respectively; P = 0.016). Furthermore, in the multivariate analysis, after incorporating only preoperative factors, pyuria was found to be an independent predictor of overall survival and cancer-specific survival (P = 0.005 and P = 0.028, respectively).
CONCLUSIONS
Preoperative pyuria among UTUC patients underwent RNU was significantly associated with advanced pathologic tumor stage and worse survival. Our data suggested that pyuria as a prognostic predictor could be valuable in preoperative risk stratification and guiding better therapeutic approaches, but further validation in a larger population is needed.
Topics: Aged; Female; Humans; Male; Middle Aged; Neoplasm Staging; Nephrectomy; Nephroureterectomy; Preoperative Period; Prognosis; Pyuria; Retrospective Studies; Survival Rate; Ureter; Urologic Neoplasms; Urothelium
PubMed: 27238381
DOI: 10.1016/j.urolonc.2016.04.011 -
Indian Pediatrics Jun 1965
Topics: Child; Child, Preschool; Humans; Male; Pyuria
PubMed: 5828613
DOI: No ID Found -
International Urogynecology Journal Jul 2018Urinary dipsticks and culture analyses of a mid-stream urine specimen (MSU) at 10 cfu ml of a known urinary pathogen are considered the gold standard investigations for...
INTRODUCTION AND HYPOTHESIS
Urinary dipsticks and culture analyses of a mid-stream urine specimen (MSU) at 10 cfu ml of a known urinary pathogen are considered the gold standard investigations for diagnosing urinary tract infection (UTI). However, the reliability of these tests has been much criticised and they may mislead. It is now widely accepted that pyuria (≥1 WBC μl) detected by microscopy of a fresh unspun, unstained specimen of urine is the best biological indicator of UTI available. We aimed to scrutinise the greater potential of symptoms analysis in detecting pyuria and UTI.
METHODS
Lower urinary tract symptom (LUTS) descriptions were collected from patients with chronic lower urinary tract symptoms referred to a tertiary referral unit. The symptoms informed a 39-question inventory, grouped into storage, voiding, stress incontinence and pain symptoms. All questions sought a binary yes or no response. A bespoke software package was developed to collect the data. The study was powered to a sample of at least 1,990 patients, with sufficient power to analyse 39 symptoms in a linear model with an effect size of Cohen's f = 0.02, type 1 error probability = 0.05; and power (1-β); 95% where β is the probability of type 2 error). The inventory was administered to 2,050 female patients between August 2004 and November 2011. The data were collated and the following properties assessed: internal consistency, test-retest reliability, inter-observer reliability, internal responsiveness, external responsiveness, construct validity analysis and a comparison with the International Consultation on Incontinence Modular Questionnaire for female lower urinary tract symptoms (ICIQ-FLUTS). The dependent variable used as a surrogate marker of UTI was microscopic pyuria. An MSU sample was sent for routine culture.
RESULTS
The symptoms proved reliable predictors of microscopic pyuria. In particular, voiding symptoms correlated well with microscopic pyuria (χ = 88, df = 1, p < 0.001). The symptom inventory has significant psychometric characteristics as below: test-retest reliability: Cronbach's alpha was 0.981; inter-observer reliability, Cronbach's alpha was 0.995, internal responsiveness F = 221, p < 0.001, external responsiveness F = 359, df = 5, p < 0.001. The correlation coefficients for the domains of the ICIQ-FLUTS were around R = 0.5, p < 0.001.
CONCLUSION
This symptoms score performed well on the standard, psychometric validation. The score changed in response to treatment and in a direction appropriate to the changes in microscopic pyuria. It correlated with measures of quality of life. It would seem to make a good candidate for monitoring treatment progress in ordinary clinical practice.
Topics: Bacterial Infections; Female; Humans; London; Lower Urinary Tract Symptoms; Male; Predictive Value of Tests; Psychometrics; Pyuria; Quality of Life; Reproducibility of Results; Surveys and Questionnaires
PubMed: 28971220
DOI: 10.1007/s00192-017-3472-7 -
The Pediatric Infectious Disease Journal May 2009Despite the widespread recognition of pyuria in acute Kawasaki disease (KD) patients and its inclusion in the American Heart Association list of supporting laboratory...
Despite the widespread recognition of pyuria in acute Kawasaki disease (KD) patients and its inclusion in the American Heart Association list of supporting laboratory data for KD diagnosis, no systematic study of pyuria and the origin of these cells in KD patients have been reported. We used automated urinalysis with flow cytometry to characterize urine samples from 135 acute KD subjects and 87 febrile control (FC) subjects without urinary tract infection. Pyuria [defined as > or =12 (for males) or 20 (for females) cells/microL] was present in 79.8% of KD and 54.0% of FC subjects (P < 0.0001). The median number of white blood cells (WBC) in the urine was 42 WBC/microL in KD and 12 WBC/microL in FC (P < 0.0001). No significant difference between the groups was seen for urine red blood cell (RBC) count, protein, or specific gravity. Comparison of voided versus catheter-collected urine samples indicated an origin of the cells from the bladder or upper urinary tract in both patient groups. Pyuria in KD subjects was not correlated with age or day of illness. Overall, the presence of pyuria was neither specific nor sensitive as a marker for KD, but the magnitude of pyuria was significantly higher in KD patients compared with the FC group.
Topics: Child; Child, Preschool; Female; Fever; Humans; Male; Mucocutaneous Lymph Node Syndrome; Pyuria; Sensitivity and Specificity
PubMed: 19319019
DOI: 10.1097/INF.0b013e318193ec8e -
JPMA. the Journal of the Pakistan... Jan 2011To determine the significance of pyuria as a predictor of culture proven urinary tract infections (UTI) in neonates and to assess the frequency of urinary tract...
OBJECTIVES
To determine the significance of pyuria as a predictor of culture proven urinary tract infections (UTI) in neonates and to assess the frequency of urinary tract anomalies in neonates with pyuria.
METHODS
Prospective study conducted at the neonatal intensive care unit of a tertiary care hospital; (Liaquat National Hospital Karachi) for a period of 4 months from April 2008 to August 2008. One hundred and ten consecutive infants < or = 28 days of age admitted to the NICU of Liaquat National Hospital for medical reasons were included in the study. Information regarding age, gender, antenatal history, birth weight, clinical examination, laboratory findings and outcome were recorded on a questionnaire. Septic work up was performed and urine samples were collected using urethral catheterization. Patients showing any number of white blood cells on microscopy were included and their urine sent for culture. All patients had Ultrasound done during their hospital stay and those patients with any renal abnormality were further investigated with Micturating cyestoretherogram (MCUG) at 6 weeks.
RESULTS
Out of one hundred and ten patients admitted, thirty five patients showed the presence of pus cells in urine and were included in the study. Of the 35 neonates with pyuria, 71.4% had no growth in urine cultures and 38.2 % neonates with insignificant pyuria (< or = 9 cells in urine) showed a positive culture. The renal ultrasound was normal in 51.4% neonates with pyuria although it was abnormal in 100% of the subjects with higher number of pus cells in urine (> 20 pus cells).
CONCLUSION
Pyuria is not a useful marker for the diagnosis of culture proven UTI in neonates it cannot be used as an indicator of underlying renal abnormality, though it may have some utility in neonates with > 20 /numerous pus cells.
Topics: Age Distribution; Bacterial Infections; Bacteriuria; Female; Humans; Infant, Newborn; Intensive Care Units, Neonatal; Kidney; Length of Stay; Leukocyte Count; Male; Pakistan; Predictive Value of Tests; Prevalence; Prospective Studies; Pyuria; Sex Distribution; Ultrasonography; Urinalysis; Urinary Catheterization; Urinary Tract Infections
PubMed: 22368908
DOI: No ID Found -
Acta Paediatrica 1948
Topics: Child; Humans; Pyuria; Suppuration; Urine
PubMed: 18885507
DOI: 10.1111/j.1651-2227.1948.tb06786.x -
Clinical Infectious Diseases : An... Jul 2020Urinalysis is a readily available test often used for screening. Pyuria is a common finding in asymptomatic patients; however, it is unknown how often identification of...
BACKGROUND
Urinalysis is a readily available test often used for screening. Pyuria is a common finding in asymptomatic patients; however, it is unknown how often identification of pyuria in the absence of confirmatory cultures leads to antimicrobial prescribing. The objective of this study was to measure the association between pyuria and antimicrobial initiation during the perioperative period and assess harms versus benefits of treatment.
METHODS
A retrospective cohort of preoperative patients within the national healthcare system during the period 1 October 2008-30 September 2013 who had a urinalysis performed during the 30-day preoperative period was created; patients with positive urine cultures were excluded. The primary exposure was pyuria on preoperative urinalysis. The primary outcome was antimicrobial initiation. Secondary outcomes included postoperative surgical site (SSI), urinary tract (UTI), and Clostridioides difficile infections. Trend and logistic regression analyses were performed.
RESULTS
Among 41 373 patients, 3617 had pyuria. 887 (24.5%) patients with pyuria received antimicrobials versus 1918 (5.1%) patients without pyuria. As the degree of pyuria increased, the odds of receiving antimicrobials also increased linearly (low, 14.7%; moderate, 24.0%; high pyuria, 37.4%). Preoperative pyuria was associated with postoperative C. difficile infections (aOR, 1.7; 95% CI, 1.2-2.4); risk was higher in patients who received antimicrobials (aOR, 2.4; 1.7-3.4). Pyuria was not associated with SSI but was associated with increases in UTI after orthopedic and vascular procedures; this risk was not mitigated by antimicrobial therapy.
CONCLUSIONS
Urine screening during the preoperative period is a low-value intervention that increases antimicrobial exposure but does not improve postoperative outcomes.
Topics: Anti-Infective Agents; Clostridioides difficile; Humans; Probability; Pyuria; Retrospective Studies; Urinalysis; Urinary Tract Infections
PubMed: 31504317
DOI: 10.1093/cid/ciz861 -
Journal of Endourology Jun 2024To prospectively assess early post-transurethral prostate surgery (TUPS) urinalysis changes and bacteriuria with its clinical relevance. Patients with benign prostate... (Clinical Trial)
Clinical Trial
To prospectively assess early post-transurethral prostate surgery (TUPS) urinalysis changes and bacteriuria with its clinical relevance. Patients with benign prostate obstruction enrolled for TUPS were prospectively assessed. Patients were assessed at 2, 4, 8, 12, and 24 weeks postoperatively by the dysuria-visual-analogue-scale (DVAS), international prostate symptom scores (IPSS)-quality of life, uroflow, and postvoid residual. Routine urinalysis was performed before discharge and at all visits. Midstream urine culture (MSUC) was performed before discharge, and 4 and 12 weeks postoperatively. At final analysis, 152 patients were evaluable. Significant pyuria was reported in 52%, 96.1%, 94.1%, 71.7%, 78.9%, and 52.5% in, before discharge, 2-, 4-, 8-, 12-, and 24-week urinalysis postoperative, respectively. The mean time to nonsignificant pyuria (95% confidence interval [CI]) was 19.1 (17.5-20.7), 20.1 (17.3-22.9), 15.8 (12.8-18.8), and 14 (10.3-17.8) weeks after prostate resection, vaporization, enucleation, and incision, respectively ( = 0.03). Regardless the TUPS technique, half of patients had significant pyuria at 24 weeks postoperative. MSUC was positive in 37/152 (24.3%), 3/152 (2%), 23/152 (15.1%), and 5/152 (3.3%) preoperatively, before discharge, and 4 and 12 weeks postoperative, respectively. Only positive preoperative urine leukocyte esterase independently predicted positive 4-week MSUC (odds ratio 3.8, 95% CI 1.3-11.1, = 0.013). No significant correlation was found between IPSS or DVAS and positive MSUC, nor between IPSS and postoperative pyuria at different follow-up points ( > 0.05). However, the degree of postoperative dysuria was significantly correlated with postoperative pyuria count by urinalysis at 2 weeks ( = 0.69, = 0.03), 8 weeks ( = 0.26, = 0.001), and 12 weeks ( = 0.23, = 0.004). There is a persistent but gradually declining pyuria and microhematuria following TUPS up to 6 months postoperative. An earlier resolution was noted following prostate incision and enucleation. While routine urine analysis screening in these months would be of no clear clinical value, a routine urine culture would be of a reasonable significance at 1 month postoperatively.
Topics: Humans; Male; Pyuria; Aged; Transurethral Resection of Prostate; Middle Aged; Postoperative Complications; Urinalysis
PubMed: 38613814
DOI: 10.1089/end.2023.0667