Urinary Tract Infections

Urinary Tract Infections

Infections involving the urinary tract (kidney,Ureter, bladder, prostate, or
urethra)are among the most common infectious diseases
Acute urinary tract infection (UTI)
 Acute pyelonephritis is an infection of the kidneys and is described as a
syndrome of fever and flank pain with or without dysuria
 Acute cystitis-urethritis is a syndrome consisting of dysuria, urgency, and
increased frequency of urination with or without upper tract infection.
 Acute prostatitis describes a syndrome of fever, perineal and low-back pain,
dysuria, urgency, and increased frequency of urination.
Chronic urinary tract infection (UTI) refers to persistence or frequent reinfection
of the kidney, bladder, or prostate.
Occur commonly in;
 School girls
 Females,and young sexually active females .At least 10-25% of females
develop symptomatic UTI during their lifetimes.
 Pregnancy. Pregnant women are at increased risk.
 Elderly. Among individuals older than 65 years, Risk factors include
prostatic hypertrophy in males, bladder prolapse in females, soiling of the
peritoneum, neurogenic bladder, Diabetes and the use of a chronic
indwelling urinary catheter.
 Men have less common incidence than female
E coli is the most common cause of acute uncomplicated communityacquired
UTI, accounting for ~ 95% of cases.Proteus species, are associated with
calculus formation. S saprophyticus accounts for 5-15% of acute cystitis in young
sexually active females.
Routes of infection
Bacteria may cause UTIs by three possible routes:
 Ascending,
 Hematogenous,
 Lymphatic.
Of these, the ascending route, especially in women, is probably the most
common.. Hematogenous infection of the kidney occurs uncommonly. Lymphatic
spread of infection to the urinary tract is thought to be uncommon.
Risk factors:
 Obstruction of normal urinary flow, resulting in stasis. This may occur as
the result of extrarenal obstruction from congenital abnormalities,
malignancies, calculi, vesicoureteral reflux, prostatic hypertrophy,
neurogenic bladder, pregnancy, or other conditions.
 Vesicoureteral reflux caused by congenital abnormalities or neurogenic
bladder is highly associated with UTI. Reflux results in a residual pool of
urine in the bladder after voiding which, when infected, predisposes to
upper tract infection and renal scarring.
 Incomplete bladder emptying from any cause, such as prostatic
hypertrophy, similarly results in residual urine in the bladder, which
increases susceptibility to UTI.
 Urinary tract instrumentation is another common cause of UTI. Virtually all
patients with a chronic indwelling urinary catheter develop UTI.
 In sexually active women, the use of a diaphragm with spermicidal jelly
increases the susceptibility to UTI.
 Spermicide may cause pH changes that increase colonization of the vagina
with uropathogens.
 Diabetics are more susceptible to infection in general, including UTI. The
presence of glucose in the urine enhances bacterial growth.
Laboratory findings.
1. Urinalysis and Gram stain
A urinalysis should be performed in all patients suspected of having a UTI. The
large majority of patients with symptomatic UTI have pyuria, described as 5-10
leukocytes/high-power field of centrifuged urinary sediments. Microscopic or
gross hematuria may occur in patients with cystitis-urethritis.
2. Quantitative urine culture
3. Imaging.
Imaging studies should be performed in adult patients with complicated
UTIs, such as those with urolithiasis or pyelonephritis, and in patients of any
age in whom structural abnormalities are suspected. Ultrasound imaging
and computed tomographic (CT) scans are more sensitive for detection of
renal pathology.Ultrasonography is useful to detect urinary tract
obstruction, and small calculi may be detected by spiral CT scans.
Complications
Uncommon or rare complications of UTI include
 Acute papillary necrosis
 Renal stone formation
 obstruction
 Perinephric or intrarenal abscess,
 Renal failure
Prevention :
 Good hygiene and clean urinal habits,washing of organs after urination in
children and adult
 Taking good amount of water regularly
 Taking necessary precautions during pregnancy and after sex
 Avoiding restraining of urination for long time, passing urine immediately
when you feel urge
 Keep in control sugar levels in blood and urine
Homoeopathic Management :
Drugs which are similimum to UTI are Cantharis,Berberis
Vulgaris,Staphysagria,Sarsaparilla,Apis mellifica,Senecio Aures,Uva
ursi,Terebinthae,Causticum,Lycopodium,Clematis Erecta,Pariera
Brava,Sabal Serulata,Acid Nit,Cannabis Indica / Sativa,Solidago,Merc
sol,Medorrhinum,Thuja,Benzoic Acid and Kreosotum