Urinary Tract Infection (UTI) Cystitis, Urethritis
Contents
- Infections of the urinary tract
- Pathophysiology
- Risk factors for urinary tract infection
- Clinical features
- Investigations
- Lab investigations
1. Infections of the urinary tract-
Urinary tract infection (UTI) is the term used to describe acute urethritis and cystitis caused by microorganisms. It is a common disorder accounting for 1–3% of consultations in general medical practice.
The urinary tract can become infected with various bacteria but the most common is E. coli derived from the gastrointestinal tract. The most common presenting problem is cystitis with urethritis (generally referred to as urinary tract infection).
2. Pathophysiology-
Urine is an excellent culture medium for bacteria; in addition, the urothelium of susceptible persons may have more receptors, to which virulent strains of E. coli become adherent. In women, the ascent of organisms into the bladder is easier than in men; the urethra is shorter and the absence of bactericidal prostatic secretions may be relevant. Sexual intercourse may cause minor urethral trauma and transfer bacteria from the perineum into the bladder.
3. Risk factors for urinary tract infection-
- Incomplete bladder emptying
- Bladder outflow obstruction
- Benign prostatic enlargement
- Prostate cancer
- Uterine prolapse
- Urethral stricture
- Vesico-ureteric reflux
- Neurological- Multiple sclerosis, Diabetic neuropathy.
- Foreign bodies
- Urethral catheter or ureteric stent
- Urolithiasis
- Diabetes mellitus
4. Clinical features-
• Abrupt onset of frequency of micturition and urgency
• Scalding pain in the urethra during micturition
• Suprapubic pain during and after voiding
• Intense desire to pass more urine after micturition, due to spasm of the inflamed bladder wall (strangury)
• Urine that may appear cloudy and have an unpleasant odour
• Microscopic or visible haematuria.
5. Investigations-
Investigation is necessary, however, in patients with recurrent infection or after failure of initial treatment, during pregnancy, or in patients susceptible to serious infection, such as the immunocompromised, those with diabetes or an indwelling catheter, and older people. The diagnosis can be made from the combination of typical clinical features and abnormalities on urinalysis.
6. Lab investigations-
- Full blood count; urea, electrolytes, creatinine
- Blood cultures
- Renal tract ultrasound or CT
- Pelvic examination in women, rectal examination in men Continuing haematuria or other suspicion of bladder lesion
- Cystoscopy
General Management of UTI
- Drink plenty of water- Water helps to dilute urine and flush out bacteria.
- Avoid drinks that may irritate bladder- Avoid coffee, alcohol, and soft drinks containing citrus juices or caffeine until infection has cleared. They can irritate bladder and tend to aggravate frequent or urgent need to urinate.
- Use a heating pad- Apply a warm, but not hot, heating pad to abdomen to minimize bladder pressure or discomfort.
- Hygiene- Maintain personal hygiene, complete bowel and bladder
Urinary Tract Infection treated by Homeopathy Cantharis-
Strong urging to urinate—with cutting pains that are felt before the urine passes, as well as during and after—may indicate a need for this remedy. Only several drops pass at a time, with a scalding sensation. The person may feel as if the bladder has not been emptied, still feeling a constant urge to urinate.
Sarsaparilla-
Frequent urging is felt, with burning pain at the end of urination. Urine passes when the person is standing up, but only dribbling occurs while sitting. Flakes or sediment are sometimes seen in the urine. (Sarsaparilla is sometimes helpful when stones are forming or the kidneys are involved)
Apis mellifica-
This remedy is indicated when the person frequently needs to urinate, but only small quantities are passed. Stinging and burning sensations are felt (especially with the last few drops) and the person may also experience soreness in the abdomen. Heat and touch make the symptoms worse, and cold applications, cool bathing, and open air bring relief. A lack of thirst is another indication that Apis may be needed.
Berberis vulgaris-
Cystitis with twinges of cutting pain, or a burning feeling that extends to the urethra and its opening, may indicate a need for this remedy. The passage may also burn at times when no attempt at urination is being made. After emptying the bladder, the person feels as if some urine still remains inside. Urging and discomfort are often worse from walking.
Staphysagria-
This remedy is often indicated for cystitis that develops in a woman after sexual intercourse, especially if sexual activity is new to her, or if cystitis occurs after every occasion of having sex. Pressure may be felt in the bladder after urinating, as if it is still not empty. A sensation that a drop of urine is rolling through the urethra, or a constant burning feeling. Staphysagria is also useful for cystitis that develops after illnesses with extended bed rest, or after the use of catheters.
Lycopodium-
This remedy may be helpful if a person has to urinate frequently during the night and passes large amounts of urine. Pain may be felt in the back before the urine passes. (If fever is present, the urine has a reddish color, or discomfort is felt in the kidney region).
Sepia-
This remedy may be helpful if a person has to urinate frequently, with sudden urging, a sense that urine will leak if urination is delayed, and small amounts of involuntary urine loss. The person may experience a bearing-down feeling in the bladder region, or pressure above the pubic bone. A person who needs this remedy often feels worn-out and irritable, with cold extremities, and a lax or sagging feeling in the pelvic area.
Borax-
This remedy can be helpful for cystitis with smarting pain in the urinary opening and aching in the bladder, with a feeling that the urine is retained. Children may cry or shriek, afraid to urinate because they know the pain is coming. Borax is often indicated for people who are sensitive to noise and inclined toward motion sickness.
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