URINARY TRACT INFECTION (UTI)
Definition
- Urinary tract infection is a bacterial infection involving any part of the urinary system.
- It may affect kidneys, ureters, bladder, or urethra.
Types
- Cystitis: Infection of the bladder.
- Pyelonephritis: Infection of the kidneys.
- Urethritis: Infection of the urethra.
- Urethral syndrome: UTI-like symptoms without bacterial growth.
- Lower urinary tract infection (LUTI): Bladder and urethra.
- Upper urinary tract infection (UUTI): Kidneys and ureters.
- UTI in pregnancy
Causes
- Entry of bacteria from gastrointestinal tract or skin through urethra.
- Poor hygiene.
- Urinary retention.
- Catheterization.
- Urinary tract abnormalities.
- Weakened immunity.
Predisposing Factors
- Female gender.
- Children and elderly.
- Diabetes mellitus.
- Pregnancy.
- Incomplete bladder emptying.
- Catheter use.
- Sexual activity.
- Poor hygiene.
- Chronic illness.
- Family history.
Pathology
- Bacterial colonization of urinary tract.
- Ascending infection from urethra to bladder and kidneys.
- Inflammation of mucosa.
- Chronic infection may cause scarring and renal damage.
Clinical Features
Lower Urinary Tract Infection
- Dysuria.
- Increased frequency.
- Urgency.
- Suprapubic pain.
- Hematuria.
- Cloudy or foul-smelling urine.
- Mild fever.
Upper Urinary Tract Infection
- High fever with chills.
- Flank pain.
- Nausea and vomiting.
- Severe illness.
Investigations
- Urine routine examination.
- Urine culture and sensitivity.
- Ultrasound abdomen.
- CT scan or MRI in complicated cases.
- Cystoscopy in recurrent cases.
Complications
- Pyelonephritis.
- Renal scarring.
- Chronic kidney disease.
- Urosepsis.
- Septicemia.
Management
- Adequate hydration.
- Antibiotic therapy.
- Pain relief.
- Bladder training.
- Treat underlying cause.
Treatment
- First line: Trimethoprim-sulfamethoxazole, fluoroquinolones.
- Second line: Amoxicillin-clavulanate, ciprofloxacin.
- Hospitalization for severe cases.
Homoeopathic Therapeutics
- Apis mellifica: Burning and stinging pain.
- Berberis vulgaris: Painful urination with radiating pain.
- Equisetum: Bladder inflammation.
- Cantharis: Intense burning during urination.
- Lycopodium: Recurrent UTI, digestive association.
Blood Supply
- Kidneys: Renal arteries.
- Ureters: Ureteric arteries.
- Bladder: Superior and inferior vesical arteries.
Nerve Supply
- Kidneys: Renal plexus.
- Ureters: Inferior hypogastric plexus.
- Bladder: Pudendal nerve and pelvic nerves.
Clinical Anatomy
- Kidneys: Located in lumbar region.
- Ureters: Carry urine from kidneys to bladder.
- Bladder: Muscular organ in pelvis for urine storage.
- Urethra: Passage for urine excretion.
INTERSTITIAL CYSTITIS (HUNNER’S ULCER)
Definition
- Chronic inflammatory condition of the bladder without infection.
Pathology
- Loss of protective bladder lining.
- Chronic inflammation.
- Formation of Hunner’s ulcers.
Clinical Features
- Painful urination.
- Urinary urgency.
- Increased frequency.
- Suprapubic pain.
- Hematuria.
Investigations
- Urine analysis.
- Cystoscopy.
Complications
- Chronic pelvic pain.
- Urinary incontinence.
- Reduced bladder capacity.
Management
- Symptomatic treatment.
- Bladder training.
- Medications.
- Physical therapy.
Treatment
- Chronic condition.
- Treatment aimed at symptom control only.