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The role of bacterial infection in the aetiology of the overactive bladder

Khasriya, R; (2012) The role of bacterial infection in the aetiology of the overactive bladder. Doctoral thesis , UCL (University College London). Green open access

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Abstract

The aim of this programme of work was to examine the role of bacterial infection in the aetiology of the Overactive Bladder (OAB). Recent studies in OAB have identified urinary inflammatory exudates occurring despite negative routine urine cultures. Detection of pyuria by microscopy of fresh unspun urine is established as the best surrogate marker of infection and pyuria has been described in over 33% of people with OAB. The routine methods of urinalysis; dipstick of mid-stream urine (MSU) specimens and MSU culture were scrutinised. New techniques of urine culture were sought by culturing the urinary sediment. Intracellular colonisation of urothelial cells was tested in patients and verified further by using a bladder epithelial cell line. In addition, a cytokine response in the urine was examined as surrogate evidence of an urothelial inflammatory reaction in patients with OAB. The dipstick test was found to have a low sensitivity and specificity in the context of OAB. In addition, culture of the urine sediment using non-selective culture media enhanced the isolation of bacteria from patients with OAB. The bacterial species isolated were predominantly Streptococcus spp and Enterococcus spp.IL-6 was found in higher concentrations in the urine specimens of patients with OAB symptoms and pyuria. Intracellular invasion assays and microscopic methods of identifying intracellular bacteria in this patient group identified adherent and intracellular bacteria.

Type: Thesis (Doctoral)
Title: The role of bacterial infection in the aetiology of the overactive bladder
Open access status: An open access version is available from UCL Discovery
Language: English
Additional information: Copyright restricted material has been removed from the e-thesis.
UCL classification: UCL
UCL > Provost and Vice Provost Offices
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Medical Sciences
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Medical Sciences > Eastman Dental Institute
URI: https://discovery.ucl.ac.uk/id/eprint/1364560
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