Purple Urine Bag Syndrome: An Alarming Hue? A Brief Review of the Literature

Table 1

Risk factors and associated mechanisms in PUBS.

Risk factors for PUBS	Associated mechanisms
Female gender	Predisposing anatomy to UTI occurrence
Increased tryptophan dietary content	Increased available substrate for conversion
Increased urine alkalinity [4]	Facilitates indoxyl oxidation
Severe constipation [5]	Increased time for bacterial deamination
Chronic indwelling urinary catheterization	Increased risk of UTIs
High urinary bacterial load [5]	Bacterial sulfatase/phosphatase availability
Renal failure	Impaired clearance of indoxyl sulfate