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|Title:||1 Clinical outcome of a prospective case series of patients with ketamine cystitis who underwent standardized treatment protocol|
|Abstract:||P.Y.H. TAM and C.F. NG Division of Urology, Department of Surgery, Prince of Wales Hospital, Hong Kong Objective: We are reporting the management outcome of a prospective cohort of patients from a dedicated centre treating ketamine-associated uropathy. Patients & Methods: All patients who attended our centre for ketamine related urological problems were recruited. Management includes a 4-tier approach, namely anti-infl ammatory drug/anticholinergic, opioid analgesic/pregabalin, intravesical hyaluronic acid, and surgical intervention. Outcome was assessed with functional bladder capacity (FBC), pelvic pain and urgency/frequency (PUF) symptom scale, EuroQol Visual Analogue Scale (EQ VAS) and general response assessment (GRA). Results: Between December 2011 and June 2014, 463 patients attended our clinic for ketamine-associated uropathy. All were managed by the same standardized protocol. Amongst these patients, 319 patients came back for follow-up. For patients who received fi rst-line treatment (290 patients), there was a signifi cant improvement in PUF scores, EQ VAS and FBC. Abstinence from ketamine abuse and the amount of ketamine consumed were factors predicting the improvement of PUF scores. Among patients who required second-line oral therapy (62 patients), 42 (67.7%) patients reported improvement in symptoms. Eight patients have completed intravesical therapy. Th ere was a signifi cant improvement in voided volume for the patients aft er treatment. Conclusion: Th e study demonstrated the effi cacy of managing ketamine-associated uropathy using a four-tier approach. 2 Review of the microbiology and antibiotic sensitivities of Fournier ’ s gangrene in a local centre: 12 years ’ experience B. HO, W.K. MA, A. NG, H.L. TSU and M.K. YIU Division of Urology, Department of Surgery, Queen Mary Hospital, Hong Kong Objective: To review the local microbiology & antibiotic sensitivities of organisms found in cultures from patients with Fournier ’ s gangrene in a local centre over 12 years Patients & Methods: All patients diagnosed with Fournier ’ s Gangrene since 2001 were recruited and their records retrieved and evaluated. Patient demographics, culture results, antibiotic sensitivities from culture results, antibiotics given to patients on presentation, number of operations, and outcomes were analyzed. Results: A total of 32 patients were identifi ed. Only 29 patients have complete set of culture and sensitivities, with a mean age of 65 years. Among them, 81.3% had multiple organisms on culture. Th e 3 most common organisms were bacteroids (62%), E. coli (48%), and Enterococcus (34%). 27.6% of the microbes produced ESBL. Th e antibiotics that most organisms were sensitive to were gentamicin, augmentin, and septrin. Levofl oxacin was resistant in 62.5% of the patients, whereas cefuroxime resistance reached 47.1%. Only 17 patients’ records described the antibiotics used on presentation, of which only 7 patients (41.2%) had been prescribed an antibiotic that did not have antibiotics resistance on culture. Conclusion: When prescribing antibiotics for patients with Fournier ’ s gangrene, one must take into consideration the high resistance to levofl oxaci|
|Appears in Collections:||British Journal of Urology International 2015|
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