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Open Access 19-07-2023 | Schistosomiasis | Review

Diagnosis and management of complicated urogenital schistosomiasis: a systematic review of the literature

Authors: Tommaso Manciulli, Davide Marangoni, Joaquin Salas-Coronas, Cristina Bocanegra, Joachim Richter, Federico Gobbi, Leonardo Motta, Andrea Minervini, Alessandro Bartoloni, Lorenzo Zammarchi, on behalf of TropNet Schisto Task Force

Published in: Infection | Issue 5/2023

Abstract

Background

Currently, there are no standardized guidelines for the diagnosis or management of the complications of urogenital schistosomiasis (UGS). This systematic review of the literature aims to investigate the state of the art in reference to diagnostic approaches and the clinical management of this condition.

Methods

A systematic review of literature published between January 1990 and January 2021 was conducted in the MEDLINE database, scoping for articles regarding diagnostic means or therapeutic options for the complications of UGS, namely obstructive uropathy, bladder cancer, abortion, ectopic pregnancy, infertility, kidney failure, urolithiasis and the need for invasive procedures. Relevant data were then extracted from the articles deemed eligible according to the inclusion criteria.

Main results

In total, 3052 articles were identified by the research query, of which 167 articles fulfilling inclusion criteria after title/abstract screening and full-text evaluation were included, 35% on both diagnostic and therapeutic aspects, and 51% on diagnosis and 14% on therapy. Ultrasound was the most frequently tool employed for the diagnosis of UGS complications showing a good performance. Concerning the management of hydronephrosis, the majority of available evidences came from community-based studies where universal treatment with praziquantel was used leading to decrease of prevalence of obstructive uropathy. Concerning studies on surgical procedures, laser endoureterotomy followed by stenting was mostly employed in adult patients leading to a crude cure rate of 60% (43 of 71 patients). In the case of severe hydronephrosis, surgery consisting of ureteral re-implantation showed excellent results with a crude cure rate of 98% (157 cured patients of 160 treated). Concerning bladder cancer, data on 93 patients with a clear diagnosis of UGS-related bladder were available reporting a variable and sometime combined approach based on disease stage. Available data on diagnosis and management of abortion, ectopic pregnancy, infertility, kidney failure, urolithiasis and the need for invasive procedures due to UGS are also presented.

Conclusions

The review produced a complete picture of the diagnostic and therapeutic options currently available for complicated UGS. These results can be useful both for guiding clinicians towards correct management and for tracing the direction of future research.

Available only for authorised users

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Title: Diagnosis and management of complicated urogenital schistosomiasis: a systematic review of the literature
Authors: Tommaso Manciulli
Davide Marangoni
Joaquin Salas-Coronas
Cristina Bocanegra
Joachim Richter
Federico Gobbi
Leonardo Motta
Andrea Minervini
Alessandro Bartoloni
Lorenzo Zammarchi
on behalf of TropNet Schisto Task Force
Publication date: 19-07-2023
Publisher: Springer Berlin Heidelberg
Keywords: Schistosomiasis
Praziquantel
Ultrasound
Ultrasound
Infertility
Infertility
Published in: Infection / Issue 5/2023
Print ISSN: 0300-8126
Electronic ISSN: 1439-0973
DOI: https://doi.org/10.1007/s15010-023-02060-5

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