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Title: The role of bacterial infection in the aetiology of the overactive bladder
Author: Khasriya, R.
ISNI:       0000 0004 2728 0751
Awarding Body: University College London (University of London)
Current Institution: University College London (University of London)
Date of Award: 2012
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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.
Supervisor: Not available Sponsor: Not available
Qualification Name: Thesis (Ph.D.) Qualification Level: Doctoral
EThOS ID:  DOI: Not available