Infections of the Lower Urinary Tract

Urinary tract infections are a large group of diseases of the urinary system that result from infection of the urinary tract with various pathogenic agents. Among the treatment for a urologist or nephrologist, infectious-inflammatory diseases of the urinary tract account for more than 40% of all cases.

Although these diseases, as a rule, are amenable to therapy, there is always a risk of chronicization of the pathological process. Therefore, to exclude the chronization of the infection, you need to see a doctor at the first clinical manifestations of the infectious process in the urinary organs.

In accordance with what department of the urinary system is affected by the infection, the following types of disease are distinguished:

  • infection of the upper urinary tract — pyelonephritis, characterized by damage to the kidney tissues and the bowl-pelvic apparatus;
  • infection of the lower urinary tract — this is urethritis, cystitis and prostatitis, in which the infectious inflammatory process affects the ureters, bladder or prostate.

Women are more prone to urinary tract infections. This is due to the physiological characteristics of the female urinary system. According to statistics, more than 70% of women in their lives suffer at least one episode of cystitis or urethritis.

Causes

In the etiology of any type of infection of the lower urinary tract, the leading role belongs to the E. coli. Also, the cause of the development of an infectious-inflammatory process can be:

  • klebsiella,
  • pseudomonas aeruginosa,
  • streptococci,
  • enterococci,
  • fungi of the genus Candida.

Less infectious process is provoked by mycoplasma, chlamydia, staphylococcus, hemophilic rod or other infectious agent. Contribute to the development of the pathological process and negative factors, such as:

  • supercooling;
  • congenital malformations of the urinary system;
  • various functional disorders (urinary incontinence, vesicoureteral reflux, etc.);
  • hormonal failures;
  • concomitant diseases and pathological conditions (diabetes mellitus, urolithiasis, nephroptosis, renal failure, kidney cyst, multiple sclerosis, etc.

Leading ways of infection in the urinary system:

  • urethral or ascending — the infection «rises» to the kidneys from the urethral canal or urinary bladder through the ureters;
  • descending — when the pathogenic agent from the kidneys «descends» into the lower urinary tract;
  • hematogenous and lymphogenic — the causative agent penetrates into the lower urinary tract from neighboring organs with blood and lymph flow.

Urethritis, cystitis and prostatitis relate to those unpleasant diseases that are very easy to get sick, but it takes a long and hard treatment. Patients encountering lower urinary tract infections will confirm that they are not treated quickly or immediately. Since in some cases such diseases in the early stages of development have an asymptomatic course, a person may not immediately realize that he needs the help of a doctor.

Many people, instead of immediately seeking help from a specialist, prefer to sit at home with a hot water bottle and drink independently bought antibiotics. And this approach only aggravates the situation and leads to the fact that the infection takes a latent flow and takes on a chronic form.

Symptoms of Urinary Tract Infections

The clinical picture of infections of the lower urinary tract is characterized by an acute onset and a pronounced symptomatology:

  • sharp, cutting pains and burning sensation when urinating;
  • increased frequency of urination;
  • temperature increase;
  • change in color of urine — turbidity;
  • general weakness, fatigue;
  • feeling of incomplete emptying of the bladder;
  • pain in the lower abdomen, often in the lower back or in the side;
  • vaginal (in women) and urethral (in men) discharge.

Infections of the lower urinary tract need long-term careful treatment with drug therapy, physical procedures, regular testing, strengthening immunity and vitamin therapy. It is necessary to remember: urethritis, cystitis or prostatitis do not tolerate self-treatment, so you can not neglect medical help!

Diagnostics

To establish a correct diagnosis, the nephrologist will find out all the patient’s complaints, ask about the onset of the disease, the presence of accompanying pathologies, will conduct a general examination, and give directions for a comprehensive examination. The main biomaterial for laboratory tests for suspected lower urinary tract infection is urine.

The laboratory conducts a spectrum of clinical and biochemical analyzes of urine and blood, bacteriological analysis is performed to determine the type of causative agent of the infectious process and its sensitivity to antibiotics. For the diagnosis of prostatitis, a blood test for a specific prostatic antigen (PSA) is performed.

If necessary, instrumental studies are conducted:

  • Ultrasound of the urinary system,
  • X-ray studies,
  • uroflowmetrometry.

Based on the results of the examination, the nephrologist will diagnose and determine the further treatment tactics.

Treatment

Begin the treatment of infections of the lower urinary tract, usually with a regimen of activities, including:

  • restriction of physical activity;
  • regular urination;
  • abundant drinking;
  • A diet that limits salt intake and excludes marinades, smoked products and spices.

Drug therapy involves the appointment of antibiotics or sulfonamides, to which the sensitivity of the pathogen infection. Symptomatic treatment is also provided — antipyretic, antispasmodics, analgesic and antihistamines. Physiotherapeutic measures are effective. According to the indications, the local anti-inflammatory therapy is applied — the installation of medicinal solutions into the bladder through the urethra.