ACVIM Small Animal Consensus Recommendations on the Treatment and Prevention of Uroliths in Dogs and Cats.

In an age of advancing endoscopic and lithotripsy technologies, the management of urolithiasis poses a unique opportunity to advance compassionate veterinary care, not only for patients with urolithiasis but for those with other urinary diseases as well. The following are consensus-derived, research and experience-supported, patient-centered recommendations for the treatment and prevention of uroliths in dogs and cats utilizing contemporary strategies. Ultimately, we hope that these recommendations will serve as a foundation for ongoing and future clinical research and inspiration for innovative problem solving

Noninvasive Assessment of Antenatal Hydronephrosis in Mice Reveals a Critical Role for Robo2 in Maintaining Anti-Reflux Mechanism

Antenatal hydronephrosis and vesicoureteral reflux (VUR) are common renal tract birth defects. We recently showed that disruption of the Robo2 gene is associated with VUR in humans and antenatal hydronephrosis in knockout mice. However, the natural history, causal relationship and developmental origins of these clinical conditions remain largely unclear. Although the hydronephrosis phenotype in Robo2 knockout mice has been attributed to the coexistence of ureteral reflux and obstruction in the same mice, this hypothesis has not been tested experimentally. Here we used noninvasive high-resolution micro-ultrasonography and pathological analysis to follow the progression of antenatal hydronephrosis in individual Robo2-deficient mice from embryo to adulthood. We found that hydronephrosis progressed continuously after birth with no spontaneous resolution. With the use of a microbubble ultrasound contrast agent and ultrasound-guided percutaneous aspiration, we demonstrated that antenatal hydronephrosis in Robo2-deficient mice is caused by high-grade VUR resulting from a dilated and incompetent ureterovesical junction rather than ureteral obstruction. We further documented Robo2 expression around the developing ureterovesical junction and identified early dilatation of ureteral orifice structures as a potential fetal origin of antenatal hydronephrosis and VUR. Our results thus demonstrate that Robo2 is crucial for the formation of a normal ureteral orifice and for the maintenance of an effective anti-reflux mechanism. This study also establishes a reproducible genetic mouse model of progressive antenatal hydronephrosis and primary high-grade VUR

Congenital Anomalies of Urinary Tract and Anomalies of Fetal Genitalia

Congenital anomalies of the kidney, urinary tract and genitalia anomalies are among the most frequent types of congenital malformations. Many can be diagnosed by means of ultrasound examination during pregnancy. Some will be discovered after birth. Kidney and urinary malformations represent 20% of all birth defects, appearing in 3–7 cases at 1000 live births. Environmental factors (maternal diabetes or intrauterine exposure to angiotensin-converting enzyme inhibitors) and genetic factors (inherited types of diseases) seem to be among causes that lead to the disturbance of normal nephrogenesis and generate anomalies of the reno-urinary tract. It is very important to diagnose and differentiate between the abnormalities incompatible with life and those that are asymptomatic in the newborn. The former requires interruption of pregnancy, whereas the latter could lead to saving the renal function if diagnosed antenatally. In many cases, the congenital anomalies of the urinary and genital tract may remain asymptomatic for a long time, even up until adulthood, and can be at times the only manifestation of a complex systemic disease. Some can manifest in more than one member in the family. This is the reason why the accurate genetic characterization is needed; it can help give not only the patient but also her family the appropriate genetic counseling, and also, in some cases, the management may prevent severe complications

Symptoms of urethritis in the male and its treatment in general practice

There Is probably no disease the treatment of which more frequently calls for the utmost patience on the part of the practitioner than Gonorrhoea.There is little difficulty indeed in dealing with an acute uncomplicated attack, but when from any cause the disease becomes chronic - the so called "gleet" - it is far otherwise. The patience of sufferer and physician alike may be tried to the utmost, as the case drags on from month to month, or even from year to year. Cases of this kind, however unpromising they may seem to be, are nevertheless sometimes curable, but others appear to resist every kind of treatment. Even in such apparently hopeless cases, however, there is always a possibility of getting rid of the infecting organism, as I shall endeavour to show later on.Nothing strikes one more than the nonchalance with which many sufferers regard this trouble - deeming it of no more consequence than a common cold. Others again may be apprehensive enough, but are ashamed to consult a physician. Probably they seek assistance from some quack remedy, and only when this fails and the case has become so aggravated that their fears are thoroughly aroused, do they summon up courage to "see the doctor". When the dread results of the disease are considered it would seem in the highest degree desirable that parents shciild take an early opportunity of warning their sons of the dangers that beset their path. No false delicacy should be allowed to come in the way; if they cannot undertake the needful but unpleasant duty, they should certainly get their medical adviser to act for them. It is pitiful to see the many ruined lives which might have been saved by a timely warning

Lower Urinary Tract Dysfunction

Lower urinary tract dysfunction (LUTD) is an umbrella diagnosis that covers the abnormalities of anatomy and function in the bladder, urethra, and, in men, the prostate. People with LUTD face a number of social, mental, and physical health effects due to the symptoms. Despite the increasing evidence in the assessment and management of lower urinary tract symptoms, it remains a challenge to bridge the gap between research evidence and clinical practice. In this book, each and every one of the authors presents a remarkable work for how to apply the evidence to clinical practice from different aspects. I hope this book is a key for every reader to open the door to LUTD

The Female Urethral Syndrome and Urethritis and Prostatitis in the Male

Two common urological problems frequently encountered by the primary care physician are the female urethral syndrome and urethritis in the male. Although I will touch on chronic prostatitis in this discussion, I question whether it is anything but a relatively uncommon entity