How does a urinary tract infection manifest? Urinary tract infections: the first signs of the onset of the disease and the principles of treatment. Used treatment for urinary tract infections

Every year, a huge number of patients, both adults and children, regardless of gender, face such a serious medical problem as urinary tract infection. Women suffer from this infection much more often than men, but men with the development of a urinary tract infection will tend to a protracted and even severe course of the disease.

Urinary tract infections are inflammatory diseases of the human urinary system caused by infectious microorganisms that have a recurrent course with the possible development of complications.

The urinary system (urinary tract) is a single complex of organs for the formation of urine and its excretion from the body, this is a serious excretion system, on the precise functioning of which not only the state of the human body depends, but also the patient's life in some cases (with acute renal failure). The urinary tract consists of bean-shaped kidneys (urine forms in them), ureters (through them urine enters the bladder), bladder (urine reservoir), urethra or urethra (urine is released outward).

The urinary tract plays a significant role in maintaining the body's water-salt balance, the production of a number of hormones (erythropoietin, for example), and the release of a number of toxic substances from the body. On average, up to 1.5-1.7 liters of urine are excreted per day, the amount of which can vary depending on the fluid, salt, and diseases of the urinary tract.

Risk groups for urinary tract infections:

The female sex (women suffer from such infections 5 times more often than men, this is due to the physiological feature of the woman's body - a short and wide urethra, which makes it easier for the infection to penetrate the urinary tract).
- Children under 3 years of age (inadequate immunity, in particular, infections of the coexcretory system are the most common cause of fever of unknown origin among boys under 3 years of age).
- Elderly persons due to the development of age-related immunodeficiency.
- Patients with structural features of the urinary system (for example, an enlarged prostate gland can make it difficult for urine to drain from the bladder).
- Patients with kidney disease (for example, urolithiasis, in which stones are an additional risk factor for the development of infections).
- Patients in the intensive care and intensive care units (such patients require urine excretion for a certain period of time using a urinary catheter - this is the entrance gate of infection).
- Patients with chronic diseases (for example, diabetes mellitus, in which there is a high risk of developing urinary tract infections due to a decrease in the body's resistance).
- Women using some form of contraception (for example, a diaphragmatic ring).

The factors that predispose to the occurrence of urinary tract infections are:

1) hypothermia (the bulk of problems of this nature arise in the cool season),
2) the presence of a respiratory infection in the patient (frequent activation of urological
infections during the cold season),
3) decreased immunity,
4) violations of the outflow of urine of a different nature.

Causes of urinary tract infections

In the kidneys, urine is formed absolutely sterile from microorganisms; it contains only water, salts and various metabolic products. The infectious agent first enters the urethra, where favorable conditions are created for its reproduction - urethritis develops. Then it spreads higher to the bladder, in which inflammation of its mucous membrane occurs - cystitis. In the absence of adequate medical care, the infection enters the kidneys through the ureters with the development of pyelonephritis. This is the most common ascending type of infection.

Pathogens that cause urinary tract infections:

1) E. coli (Escherichia coli). This pathogen is a representative of the normal flora of the large intestine, and its ingress into the urethra is mainly associated with non-compliance with the rules of personal hygiene. Also, E. coli is almost always present on the external genital organs. 90% of all urinary tract infections are associated with E. coli.
2) Chlamydia and mycoplasma are microorganisms that mainly affect the urethra and ducts of the reproductive system. They are transmitted mainly sexually and affect the genitourinary system.
3) Klebsiella, Pseudomonas aeruginosa can cause urinary tract infections in children.
4) Streptococci of serogroups A and B are found periodically.

How can microorganisms enter the urinary tract:

1) In case of non-observance of the rules of personal hygiene after visiting the toilet room.
2) During sexual intercourse and during anal sex.
3) When using certain methods of contraception (diaphragmatic ring, spermicides).
4) In children, these are inflammatory changes due to stagnation of urine in the pathology of the urinary tract of a different nature.

Symptoms of urinary tract infections

What clinical forms of urinary tract infections are found in medical practice? It is an infection of the urethra or urethra - urethritis; bladder infection - cystitis; infection and inflammation in the kidneys - pyelonephritis.

Also, there are two main types of spread of infection - an ascending infection and a descending infection. With an ascending infection, the inflammatory process affects the organs of the urinary system located anatomically below, and then the infectious process spreads to the higher organs. An example is cystitis and the subsequent development of pyelonephritis. One of the causes of ascending infection is the so-called functional problem in the form of vesicoureteral reflux, which is characterized by the return flow of urine from the bladder to the ureters and even the kidneys. Top-down infection in origin is better understood. In this case, the pathogen spreads from the higher located parts of the urinary system to the lower ones, for example, from the kidneys to the bladder.

Many cases of infectious diseases of the urinary system are asymptomatic. But still, for specific clinical forms, there are certain symptoms that patients most often complain about. Most patients are characterized by nonspecific symptoms: weakness, feeling unwell, overwork, irritability. A symptom such as a seemingly unreasonable fever (temperature) is in the overwhelming majority of cases a sign of an inflammatory process in the kidneys.

With urethritis, patients are worried: pain during urination, pain and burning at the beginning of the process of urination, discharge from the urethra of a mucopurulent nature, having a specific smell.

With cystitis frequent urination is noted, which can be painful, accompanied by painful sensations in the lower abdomen, a feeling of insufficient emptying of the bladder, and sometimes the temperature can rise.

Pyelonephritis characterized by the appearance of pain in the lumbar region, an increase in body temperature (with an acute process), chills, symptoms of intoxication (weakness, body aches), the patient may not feel urination disorders. Only with an ascending infection can first be disturbed by pain when urinating, frequent urination.

Summarizing the above, we list the symptoms characteristic of urinary tract infections that require medical attention:

1) pain, burning and cramps during urination;
2) frequent urination;
3) pain in the lower abdomen, in the lumbar region;
4) pain in the suprapubic region in women;
5) temperature and symptoms of intoxication without symptoms of a cold;
6) discharge from the urethra of a mucopurulent nature;
7) change in the color of urine - becomes cloudy, the appearance of mucus, flakes, blood streaks;

Features of urinary tract infections in children

Common causes of urinary tract infections in children are obstruction of the urinary tract, various functional disorders, phimosis, congenital anomalies of the urinary tract, and rare emptying of the bladder.

The symptoms of urinary tract infections in babies may be worn away. Children under 1.5 years of age with such an infection can become irritable, whiny, refuse to eat, there may be a not very high, but unreasonable temperature, poorly controlled by conventional antipyretic drugs. Only from the age of two, the child will complain of pain in the abdomen or back, pain in the lower abdomen, you will notice frequent urination, urinary disorders, body temperature rises more often than remains normal.

The outcome of a urinary tract infection in a child is often favorable, but there are consequences such as sclerosis of the kidney tissue, arterial hypertension, protein in the urine, and functional disorders of the kidneys.

Features of urinary tract infection in pregnant women

Up to 5% of pregnant women suffer from inflammatory kidney disease. The main reasons for this include hormonal changes in the body during pregnancy, a decrease in the body's immunological defenses, and a change in the location of some organs associated with a growing fetus. For example, due to the increase in the size of the uterus, there is pressure on the bladder, stagnation occurs in the urinary organs, which will eventually lead to the multiplication of microorganisms. Such changes require frequent monitoring of this system in a pregnant woman.

Features of urinary tract infection in men

First of all, the causes of urinary tract infections in men are different from those in women. This is mainly a pathology such as urolithiasis and an increase in the size of the prostate gland. Hence, the disturbed outflow of urine and inflammatory changes in the urinary system. In this regard, the treatment program for men includes such an item as removing an obstacle to the outflow of urine (stone, for example). Also, certain problems are caused by a chronic inflammatory process in the prostate gland, which requires massive antibiotic therapy.

Diagnosis of urinary tract infections

The preliminary diagnosis is made on the basis of the patient's clinical complaints, but not in all cases this is sufficient to establish the correct diagnosis. For example, pyelonephritis can only be accompanied by fever and symptoms of intoxication, lower back pain does not appear on the first day of the disease. Therefore, it is difficult for a doctor to diagnose without additional laboratory research methods.

Laboratory diagnostics includes:

1) general clinical analyzes: general blood test, general urine analysis, biochemical blood tests (urea, creatinine) and urine (diastasis).
The most informative at the initial stage is the general analysis of urine. For research, an average portion of morning urine is taken. In the study, the number of leukocytes, erythrocytes is counted, so that bacteriuria (bacterial inflammatory process) can be suspected. Indicators such as protein, sugar, and specific gravity are also informative.
2) bacteriological method (sowing urine on special nutrient media in order to detect the growth of certain types of microorganisms in them), in which the average portion of morning urine is taken into a sterile dish;
3) PCR method (with negative bacterial culture and ongoing urinary tract infection) - to detect microorganisms such as chlamydia, mycoplasma.
4) Instrumental diagnostic methods: ultrasound of the kidneys and urinary bladder, cystoscopy, X-ray contrast study or intravenous urography, radionucleide studies and others.

Basic principles of treatment of urinary tract infections

1. Regime measures: home semi-bed treatment regimen for urinary tract infections, and, if indicated, hospitalization in the therapeutic or urological department of the hospital. Adherence to a dietary regimen with salt restriction and adequate fluid intake in the absence of renal impairment. In case of kidney diseases, diets No. 7, 7a, 7b according to Pevzdner are shown.

2. Etiotropic treatment (antibacterial) includes various groups of drugs that
appointed ONLY by a DOCTOR after the correct diagnosis. SELF-TREATMENT will lead to the formation of resistance to antibiotics of the causative agent of the infection and the occurrence of frequent relapses of the disease. For treatment are used: primethoprim, bactrim, amoxicillin, nitrofurans, ampicillin, fluoroquinolones (ofloxacin, ciprofloxacin, norfloxacin), if necessary, combinations of drugs. The course of treatment should be 1-2 weeks, less often longer (with concomitant pathology, the development of septic complications, anomalies of the urinary system). After the end of treatment, the effectiveness of the treatment must be monitored by a complete laboratory examination prescribed by the attending physician.

Launched cases of urinary tract infections with the formation of a protracted course sometimes require longer courses of etiotropic treatment with a total duration of several months.

Doctor's recommendations for the prevention of protracted urinary tract infections:

Drinking regimen (sufficient fluid intake throughout the day);
- timely emptying of the bladder;
- hygiene of the perineal area, daily shower instead of taking a bath;
- thorough hygiene after sexual intercourse;
- do not allow self-medication with antibiotics;
- avoid spicy and salty food, coffee intake;
- drink cranberry juice;
- drastically reduce smoking up to the complete elimination;
- avoid sexual intercourse for the period of treatment;
- exclude alcohol.

Features of treatment for pregnant women:

When registering urinary tract infections in a pregnant woman, treatment measures are carried out without delay to prevent more serious problems (premature birth, toxicosis, arterial hypertension). The choice of an antibacterial drug remains with the doctor and depends on the duration of pregnancy, assessment of its effectiveness and possible risks to the fetus. Prescribing drugs is strictly individual.

3. Syndromic therapy (antipyretic at temperature, urological fees, herbal
uroseptics, for example, phytolysin, immunomodulators and others).

4. Herbal medicine for urinary tract infections: use herbal infusions (birch leaves, bearberry, horsetail herb, dandelion root, juniper fruits, fennel fruits, black elderberry, parsley fruits, chamomile flowers and others).

The main problem with urinary tract infections is the frequent development of a recurrent form of infection. This problem is typical mainly for women, every 5th woman after the initial onset of urinary tract infection meets with a recurrence of all symptoms, that is, the development of a relapse, and sometimes frequent relapses. One of the important properties of relapses is the formation of new modified strains of microorganisms with an increase in the frequency of relapses. These modified strains of bacteria are already acquiring resistance to specific drugs, which, of course, will affect the quality of treatment for subsequent exacerbations of the infection.

Relapses of urinary tract infections can be associated with:

1) with an incomplete primary infection (due to incorrect low doses of antibacterial drugs, non-compliance with the treatment regimen, the development of resistance of the pathogen to drugs);
2) with prolonged persistence of the pathogen (the ability of the pathogen to attach to the mucous membrane of the urinary tract and stay in the focus of infection for a long time);
3) with the occurrence of re-infection (reinfection with a new pathogen of the periurethral space, rectum, perineal skin).

Prevention of urinary tract infections

1) Timely rehabilitation of chronic foci is of great importance in preventive measures
bacterial infection (tonsillitis, sinusitis, cholecystitis, dental caries and others), from which the infection can spread through the bloodstream and affect the urinary system.
2) Compliance with hygienic rules for caring for intimate areas, especially girls and
women, pregnant women.
3) Avoid overwork, hypothermia of the body.
4) Timely correction of changes in the human immune system.
5) Timely treatment of diseases of the urinary system (urolithiasis, prostatitis, developmental anomalies).

Infectious disease doctor N.I. Bykova

Diseases of the urinary tract include diseases of organs such as the ureters, bladder, urethra, and renal calyx. A feature of these diseases is that the urinary organs in their function are closely related to the human reproductive system.

Among the causes of diseases of the urinary tract, the most common is an infectious lesion caused by the multiplication of bacterial microflora due to violations of the patient's immune status, a decrease in the body's resistance due to stress or hypothermia. The presence of frequent unprotected casual sex also plays a huge role.

Knowledge of the risk factors makes it possible to adequately prevent these diseases. It is also important to know the peculiarities of the course of diseases of the genitourinary sphere in men, women, and also in children. A large number of pathologies are distinguished in which the above organs are affected. Let us consider separately the diseases of each part of the excretory system, how they manifest themselves and what features they have.

Pyelitis

Pyelitis is an inflammatory process that occurs in the mucous membrane of the renal pelvis. Very often, the inflammation is not limited only to the mucous membrane and passes to the parenchyma of the kidneys, as a result of which a disease such as pyelonephritis develops. However, in the early stages of the disease, it is more correct to talk about isolated pyelitis.

The reasons

Pyelitis usually occurs due to infectious processes that develop as a result of the penetration of pathogenic microflora into the kidney cavity through the blood, lymph or urinary tract. Such routes of distribution are called hematogenous, lymphogenous and urogenic.

Among the pathogens, E. coli is most common, which usually enters the pelvis by the lymphogenous route.

Other common pathogens include staphylococci, streptococci, and other bacteria. Therefore, pyelitis usually occurs as a consequence of infectious diseases such as intestinal pathologies, tonsillitis, scarlet fever, typhoid fever.

Urolithiasis plays an important role in creating conditions for infection. When the stones are in the renal pelvis, they can injure the epithelium of the mucous membrane, which creates conditions for the penetration of pathogenic microorganisms into the organ wall. Gradually, the infectious process spreads to functionally active kidney tissue or to the ureters and bladder - the descending route of infection.

The ascending path of spread is that the infection passes from the urethra to the bladder, then through the ureters bacteria enter the cavity of the calyx-pelvic system and the parenchyma of the kidney. If the inflammation of the pelvis began due to the penetration of the pathogenic microflora from the bottom up, such pyelitis is called ascending. It can be caused by injury, pregnancy or hypothermia.

Symptoms

There are acute and chronic variants of pyelitis. In acute, there is an increase in temperature up to 40 degrees with short periods of temperature normalization. Fever is the result of general intoxication of the body, it is accompanied by a decrease in overall performance, headache.

Another symptom of inflammation of the renal pelvis is pain in the lumbar region radiating to the groin and genitals. When tapping on the lower back, pain intensifies, blood appears in the urine. Urination can be painful, and the patient is concerned about frequent urge to empty the bladder.

Pregnancy can cause inflammatory diseases of the urinary system

The duration of the course of the disease depends on what caused its development. For example, pyelitis associated with infectious diseases can last up to several weeks and then disappear completely (if the correct treatment has been carried out). Pregnancy-related pyelitis disappears only after delivery. If the necessary therapeutic measures have not been taken, there is a risk that the disease will become chronic with damage to the renal parenchyma (pyelonephritis).

If pyelitis has arisen against the background of urolithiasis, then it is considered chronic in the early stages.

Diagnostics

A general urine analysis is performed, in which pyuria is determined - an increased content of leukocytes. The urine may become cloudy due to the presence of pus in it. An important feature is that when standing, urine does not precipitate.

You can also conduct a microscopic examination of urine, the purpose of which is also to determine the leukocytes in this biological fluid. In some cases, when the amount of pus in mine is large, protein may be found.

Treatment

The effectiveness of treatment is determined primarily by eliminating the cause of the disease. If inflammation of the pelvis has arisen as a result of an infectious process, it is necessary to carry out antibiotic therapy in order to combat the pathogen. If pyelitis has become a complication of urolithiasis, then it is required to remove calculi from the urinary tract.

The patient is required to stay in bed, it is recommended to drink plenty of fluids. Drinking plenty of fluids is necessary to increase the load on the kidneys and increase the excretion of waste products of bacteria, as well as the dead microorganisms themselves.

Antibiotic therapy usually consists of the use of sulfonamides (the recommended drugs are Sulfacil, Urosulfan). If there is a tendency for the generalization of the infection, other antibiotics are prescribed, including combination drugs.

Furagin, Furadonin, Urotropin are also used - these agents have shown their effectiveness in the treatment of infectious diseases of the urinary tract. In the operating room, it is possible to wash the pelvis with disinfectants.

Prevention

The most effective means of preventing inflammatory diseases of the calyx-pelvic system is the prevention and early treatment of infectious diseases. This is especially true for intestinal infections, as well as sore throats. It is also important to resolve the issue of stone removal in a timely manner.

The urinary tract is affected by this disease due to metabolic disorders. The factors that predispose to the appearance of stones are:

• violation of calcium metabolism;
• violation of phosphorus metabolism;
• stagnant urine;
• excessive intake of calcium salts, for example, with drinking water;
• inflammatory processes.

Pain is the main symptom of urolithiasis

There are three types of stones, depending on their composition. Allocate urate (uric acid), oxalate (oxalic acid) and phosphate (phosphoric acid). Conditions for the precipitation of these salts arise during the formation of products of inflammation of the mucous membranes, for example, pyelitis.

Elements such as mucus, pus, blood clots, epithelial cells, which are located in the lumen of the urinary tract, contribute to the formation of stones, as a result of which their blockage can occur.

Symptoms

At the onset of the disease, when the stones are still too small (in the form of "sand"), there may be no symptoms. Sometimes sand can come out with urine. The clinical picture develops when signs of irritation of the mucous membrane by foreign bodies appear - the mucous membrane of the urethra is mainly affected. Larger stones may not bother the patient for a long time, since they can stay in the pelvis for a long time without moving or causing irritation.

If the stones change their location for one reason or another, symptoms such as pain appear. If there is a blockage of the ureter, pain can be significantly pronounced. This condition is called renal colic.

In its development, an important role is played by the spastic contraction of the urinary tract muscles, stretched by accumulated urine or a passing stone. The pain appears unexpectedly, the intensity rapidly increases, it can radiate to the groin area, urethra. Along with this, vegetative symptoms appear - nausea, vomiting, cold sweat, and the pulse weakens.

If the stone does not pass through the ureter, creating an obstacle to the outflow of urine, hydronephrosis and renal failure develop over time. Development of a life-threatening condition is possible.

Calculi-pelvic calculi are removed with lithotripsy

Diagnostics is based on general examination data and special research methods. Pasternatsky's symptom (pain and the appearance of blood after tapping on the lower back) is positive. Urine analysis reveals hematuria, which can be visible to the naked eye - the color of urine often turns reddish.

Blood appears in the urine due to damage to the mucous membrane of the urinary tract by a passing stone. For diagnosis, it is important that blood appears only in one kidney or ureter. Therefore, it is possible to determine the side of the lesion by drawing urine from separate catheters inserted into the ureters.

However, this method is inappropriate to use - currently, X-ray methods are used to determine the lesion focus.

The clinical picture depends on the size of the stone, so small stones can only cause mild symptoms. Large stones that cannot independently leave the pelvis lead to the development of a chronic variant of the disease. In this case, the patient from time to time notes the appearance of signs of inflammation of the urinary tract, which after treatment temporarily disappear.

Treatment

Small stones or kidney sand require the patient to follow a diet based on dairy and plant products that do not have an irritating effect on the mucous membrane of the urinary tract. It is recommended to consume a sufficient amount of vitamins A, D.

Drinking plenty of fluids is indicated to improve the passage of urine and flush the urinary tract. Mineral waters are highly efficient.

Renal colic requires more drastic measures. The patient should be in complete rest, a heating pad is applied to the lumbar region, and warm baths are prescribed to reduce muscle spasm. Subcutaneous administration of morphine, promedol or omnopon, as well as atropine is indicated. If there is a cold snap of the extremities, then heating pads are applied to them. If there are cardiac abnormalities, then they are corrected.

Blockage of the ureter by calculus

Removal of large calculi should be surgical, especially in cases where they cause attacks of renal colic or are the cause of inflammation in the urinary tract. Pyelitis and pyelonephritis associated with urolithiasis are treated with the above methods.

Prevention of stone formation consists in a complete balanced diet, as well as in the timely treatment of inflammatory pathologies of the kidneys and urinary tract.

Pathology of the ureters

In diseases of these organs, the most common and characteristic symptom is lower back pain in the area of \u200b\u200bthe projection of the ureters. This can be a manifestation of urolithiasis, tuberculous lesions, empyema (suppuration) of the ureteral stump. Only a qualified doctor, after carrying out certain diagnostic procedures, will be able to establish the exact cause of the onset of pain.

Inflammation of the bladder mucosa occurs as a result of exposure to microorganisms that enter this organ either from the kidneys or through the urethra. The ascending route of infection is more common.

The triggering factor for the development of the disease is usually hypothermia and a cold. In addition, cystitis is caused by damage to the mucous membrane from urinary stones or irritating chemicals.

Some cases of the disease are associated with non-compliance with the technique of inserting urinary catheters when non-sterile instrumentation is used. More often women are ill, which is caused by the structure of the urinary tract.

Manifestations

Acute cystitis is manifested by an increase in body temperature and general malaise. The patient complains of pain in the lower abdomen, in the area of \u200b\u200bthe bladder, radiating to the genitals and urethra. Symptoms such as a frequent urge to urinate are common, and the process of urine expulsion itself is usually not painful.

Cystitis usually presents with lower abdominal pain

The total amount of urine excreted once is reduced, there is pus in it, which makes it cloudy. Sometimes it can have a red tint due to the presence of blood. Flakes may be present in the urine, mucus is a sign of damage to the cystic epithelium. After some time, urine acquires a pungent smell of ammonia, its reaction becomes alkaline.

In chronic cystitis, the clinical picture is much less pronounced, there may be no sharp painful sensations in the lower abdomen. Fever is often absent, the urge to urinate may not bother the patient. In the urine, the presence of pus is determined both in appearance and in the results of the analysis, its reaction is alkaline, the smell is sharp. The duration of the course of acute cystitis with timely treatment does not exceed several weeks, chronic cystitis can disturb for several years, alternating phases of relapse and remission.

Treatment

Bed mode. Drink plenty of fluids, mostly milk or alkaline mineral waters. Patients are shown a dairy-plant diet, the use of all products that irritate the mucous membrane is prohibited. You should take warm baths, put a heating pad on the lower abdomen.

Antimicrobial therapy consists of the use of sulfonamides and other drugs indicated for pyelitis. In chronic cystitis, washing of the bladder cavity with disinfectant solutions is indicated. The rest of the principles of treatment and prevention do not differ from those for pyelitis.

The urinary system plays an important role in the proper functioning of the body.

Filtration of blood by the kidneys, excretion of excess fluid with metabolic products, maintenance of water-salt balance in the body, regulation of blood pressure are far from all processes that can be disrupted when inflammation occurs.

Can affect both adults and children, causing functional disorders and significantly reducing the quality of life.

Urinary tract infections

The concept "" (UTI) unites a group of inflammatory diseases of the urinary system, which develop when an infectious agent enters the body.

The organs of the urinary system include:

• kidneys - a paired organ responsible for filtering blood and;
• ureters - hollow tubes through which urine flows into the bladder
• the bladder is a hollow organ, a smooth muscle reservoir in which urine accumulates;
• (or urethra) - a tubular organ that carries urine out of the body.

Despite the fact that the urinary tract is normally sterile, any of the organs can be susceptible to the development of an infectious process. A peculiarity is that in most cases, inflammation is transmitted between organs along the ascending (from the urethra up to the kidneys) or descending path (from the infected kidneys to the bladder).

Disease classification

There are several classifications of infectious diseases of the urinary system.

By localization:

• infections of the upper urinary tract, these include inflammation of the kidneys (pyelonephritis), ureters;
• lower urinary tract - bladder (cystitis) and urethra ().

By the nature of the course of the disease:

1. Uncomplicated... They proceed without structural changes in the tissues of the organs of the urinary tract, in the absence of obstructive uropathy or other concomitant diseases.
2. Complicated... They arise against the background of difficulty urinating, when using instrumental research methods or treatment (catheterization).

Depending on the site of infection with the pathogen:

1. Hospital... Also known as nosocomial or nosocomial. They develop when an infectious pathogen enters the body while in a hospital.
2. Community-acquired... They develop on an outpatient basis under conditions favorable for infection.

By the nature of the manifestation of symptoms:

1. Clinically significant infections... They are characterized by obvious, often intensely expressed symptoms.
2. Asymptomatic infections. The clinical picture is weak, the symptoms slightly worsen the patient's quality of life.

Factors contributing to the development of the disease

Urinary tract infections are among the most common diseases and are among the five most common infectious diseases. Here are some signs:

The course of UTI is characterized by a number of features, depending on the sex and age of the patient:

In the age group from 20 to 50 years, women are more likely to face UTI problems. But in the category after 50 years, the situation is changing: at this age, the frequency of "male" diseases (prostatitis, adenoma) increases, which can complicate and spread the infection to the organs of the urinary system.

Pathogens and ways of their penetration into the body

Different types of microorganisms can provoke the appearance and development of inflammation in the organs of the urinary apparatus:

• bacteria (E. coli, ureaplasma, gonococcus, streptococcus, Trichomonas, listeria, staphylococcus);
• mushrooms (yeast of the genus Candida);
• viruses (herpes, papillomaviruses, cytomegalovirus).

The most common causative agent of UTI is the gram-negative bacterium Escherichia coli (E. coli). This bacterium belongs to conditionally pathogenic, it is a normal component of the intestinal microflora.

With neglect of hygienic procedures, improper washing of the perineum (from the anus forward), in case of a drop in the body's defenses (with hypothermia, the presence of viral diseases), severe forms of dysbiosis, E. coli begin to actively multiply on the skin and can migrate to the urethral mucosa, developing on which it causes inflammation.

There are several possible ways of penetration and spread of pathogens in the urinary tract:

1. Contact... Unprotected sexual intercourse (vaginal or anal), migration through the skin from the anus, catheterization,.
2. Hemorrhagic and lymphogenous... The penetration of the pathogen through the system of body fluids (from blood or lymph) if there are infectious foci in the body. For example, carious teeth, tonsillitis, sinusitis, pneumonia (against the background of a running viral infection, a pathogenic pathogen can penetrate the mucous membrane of the bladder - it develops).
3. Descending... Moving the pathogen from the kidneys through the ureters, bladder to the urethra.
4. Ascending... Infectious inflammation spreads from the bottom up: from the urethra to the kidneys.

Newborns are prone to developing UTIs due to possible birth defects, underdevelopment or late formation of some parts of the urinary system (urethral valves, ureteral orifice). The occurrence of infectious and inflammatory diseases is possible with improper use of diapers.

Manifestation of symptoms

Clinical manifestations of UTI can be manifested already at the initial stage of the disease. But also the process of infectious inflammation can be asymptomatic for a long time.

With a urinary tract infection, various symptoms can occur:

• painful sensations in the pelvic area, lower back, side;
• itching in the urethra;
• burning sensation, pain, difficulty urinating;
• uncharacteristic liquid discharge from the bladder (transparent, serous, greenish-purulent);
• hyperthermia, chills, fever;
• change in smell, color of urine.

In children, especially young children, symptoms of UTI may be even more subtle than in adults.

Children under 1.5-2 years old cannot indicate the localization of pain, they become more weepy and restless.

Parents may notice increased urination, unusual colored urine on the diaper, and increased body temperature.

Diagnostic methods

The preliminary diagnosis is made after the analysis of the patient's complaints by the therapist or. To confirm the diagnosis and draw up a complex of therapeutic measures, the following are prescribed:

• general clinical analysis of blood and urine;
• biochemical analysis of blood and urine (metabolic indicators such as some enzymes characterize the activity of the kidneys);
• or PCR analysis (to establish the nature of the causative agent of the disease);
• instrumental research methods (cystoscopy, X-ray contrast studies, ultrasound of the kidneys and bladder).

Timely and comprehensive diagnostics allows detecting the disease at an early stage and preventing the spread of the inflammatory process.

Therapies

The main task of therapeutic measures for urinary tract infections is to suppress the infectious and inflammatory process and eliminate the pathogen. In the treatment of UTIs, drugs of different groups of antibacterial agents are used:

In order to prevent the development of a fungal infection, antimycotic agents (Fluconazole) are added.

As part of the therapeutic complex, nonsteroidal anti-inflammatory drugs, combined herbal preparations (Kanephron) are prescribed (to restore urinary function).

Renal herbal preparations, teas, are widely used. Additionally, physiotherapy sessions can be prescribed.

During treatment, it is imperative to adhere to a diet limiting the use of sour, spicy, salty foods, alcoholic and carbonated drinks, coffee and chocolate. These foods, by changing the pH of the urine, can irritate the mucous membranes of the urinary system.

Consequences of the disease

Urinary tract infections, affecting the mucous membranes, can cause serious consequences for the whole body. Painful sensations, frequent urge to urinate greatly impair the patient's quality of life.

In case of improperly selected treatment or non-compliance with the doctor's prescriptions, the UTI comes back again, causing severe relapses.

Against the background of progressive pyelonephritis, renal failure, deformation of the ureters (prolapse of the kidney), and impaired urinary excretion (reflux) may develop. Carrying a UTI while carrying a baby can cause spontaneous abortion at any time.

Preventive measures

Preventive measures to prevent UTIs consist in lifestyle correction and following some rules:

• timely treatment of infectious foci in the body;
• compliance with hygiene standards;
• prevent hypothermia of the body;
• empty the bladder on time;
• using condoms during intercourse.

Urinary tract infections are not a strict indication for hospitalization of the patient, outpatient treatment shows high efficiency with timely access to a doctor.

But without fulfilling medical appointments, ignoring the symptoms of the disease, you can cause the spread of the disease to neighboring organs, provoke the transition of UTI into a chronic form.

Currently, a large number of people, regardless of age and gender, are faced with such a difficult ailment as urinary tract infection. This problem is an infectious and inflammatory process in the organs of the human urinary system, caused by pathogenic bacteria.

The female body is more susceptible to these diseases, however, urinary tract infections in men are often characterized by a severe and prolonged course. Unfortunately, in many cases, this pathological condition acquires a recurrent course with the development of a possible severe complication - chronic renal failure, which can often result in the patient's disability.

In our article, we want to talk about the risk factors for the development of urinary tract infections, describe their main signs, modern methods of diagnosing these diseases and rational treatment.

What is the human urinary system?

The urinary tract is a unified system of organs involved in the processes of urine formation and excretion of urine from the body. This complex consists of:

• kidneys - paired bean-shaped organs in which the processes of filtration of biological fluids and the formation of urine take place;
• ureters - hollow tubular organs through which urine from the renal pelvis enters the bladder;
• bladder - a hollow muscular organ that acts as a reservoir for urine;
• the urethra (or urethra) - an unpaired tubular organ through which urine is released from the human body.

The state of human health, and in some cases, his life depends on the precise functioning of this complex. The urinary organs are of great importance in maintaining the water-salt balance in the body, the secretion of a number of biologically active substances, and the elimination of a number of toxins.

About 1.6 liters of biological fluid are released through the urinary tract per day, the amount of which varies depending on the human consumption of salt and water, as well as on diseases of the urinary system

Factors predisposing to the development of diseases of the urinary organs

In the development of pathological processes in the excretory system of the human body, a bacterial infection plays the main role. The circumstances that predispose to a UTI are:

1. Hypothermia.
2. Frequent respiratory illness.
3. Decreased body resistance.
4. Disruption of the normal outflow of urine.

Factors contributing to the development of urinary tract infections in women are:

• anatomical features of the urinary tract - a shorter and wider urethra, facilitating the penetration of pathogens;
• using some methods of contraception (for example - spermicides or vaginal ring).

The risk group for the development of infectious and inflammatory pathology is represented by:

• children under 3 years old;
• elderly people;
• men with structural features of the prostate gland (for example, its enlargement can make it difficult to remove urine from the bladder);
• persons suffering from renal pathologies (for example, urolithiasis);
• patients who have undergone surgery - for some time they need to carry out the outflow of urine using a urinary catheter;
• patients with diabetes mellitus - this ailment leads to a decrease in immunity.

Very often there is a urinary tract infection during pregnancy - during the period of carrying a baby, the body of the expectant mother becomes susceptible to various harmful pathogens.

Read more about urinary tract infection in children.

The reasons for the development of infectious processes in the urinary system

The kidneys excrete absolutely sterile urine containing salts, metabolic products and water. The causative agents of infection most often penetrate first into the urethra - the most favorable conditions for the reproduction of microorganisms and the development of the inflammatory process (urethritis) are created in it.

In the absence of timely therapeutic therapy along the ureters, pathogenic bacteria enter the kidneys and cause damage to their tubular system - pyelonephritis. This process is called ascending infection.

The reasons for the development of an infectious and inflammatory process in the urinary tract are pathogenic bacteria that penetrate when one of the mechanisms for protecting the sterility of the organs of the excretory system is weakened

Infectious lesions of the urinary organs are caused by the following types of microorganisms:

• streptococci;
• staphylococci;
• gonococci;
• trichomonas;
• chlamydia;
• mycoplasma;
• klebsiella;
• yeast-like fungi;
• intestinal and Pseudomonas aeruginosa.

Escherichiacoli (Escherichia coli) is the main culprit of inflammation of the urinary system - about 90% of infections are associated with this microorganism

This bacterium is a representative of the intestinal and external genital microflora, its entry into the urethra occurs if basic hygiene requirements are not followed.

The main route of transmission of pathogenic microorganisms is contact, with:

• non-observance of hygiene rules after using the toilet;
• unprotected sexual intercourse with an unfamiliar partner;
• anal intercourse.

Classification of infectious diseases of the urinary organs

The urinary tract from the kidneys to the external opening of the urethra is resistant to bacterial colonization. Mechanisms that maintain their sterility include:

• the constancy of the acidic environment of urine;
• emptying the bladder with urination;
• vesicoureteral and vesicourethral segments;
• sphincter of the urethra;
• immunological protection of mucous membranes.

Practicing urologists distinguish between the following types of urinary tract infections. Complicated - observed if the patient has predisposing circumstances that contribute to the ascent of a bacterial infectious process, this occurs when:

• anatomical anomalies - congenital defects, spinal cord injuries;
• surgical interventions;
• obstruction of the normal outflow of urine - neoplasms, stones, enlarged prostate;
• insufficient emptying of the bladder caused by neurogenic disorders, pregnancy, prolapse of the bladder into the vagina.

Uncomplicated - characterized by the absence of previous violations of the outflow of urine and various anomalies. Most often develop in:

• young people who have unprotected sex;
• the elderly - with contamination of the perineum as a result of fecal incontinence;
• patients with AIDS and diabetes mellitus;
• patients who use antibiotics uncontrolled.

Symptoms of the infectious and inflammatory process

The manifestation of urinary tract infection often depends on the causes of the pathological condition. Common features are:

• pain in the muscles;
• malaise;
• temperature increase;
• excessive sweating.

Local symptoms of urinary tract infection:

• sharp, dull or bursting pain in the inflamed organ;
• increased frequency of mictions (urge to empty the bladder);
• pain and cramps when urinating.

With the development of the inflammatory process, a change in the excreted urine occurs - it becomes cloudy, with strands of mucus, streaks of pus and blood

Chronic infection is characterized by blurred clinical signs or their complete absence during remission, with an exacerbation of the process, there are signs of acute inflammation.

Diagnostic methods

The leading role in diagnosing infections of the urinary system is played by laboratory diagnostics, which includes:

1. General clinical urine analysis - allows you to assess the change in various properties of urine (color, transparency, odor, density, urinary sediment) and to identify inflammation in the urinary organs. With bacterial damage, there is an increase in the number of leukocytes, mucus, epithelial cells, the presence of pathogenic microbes.
2. Urine study according to the Nechiporenko method - carried out in the presence of changes in the results of general clinical analysis. With this test, the exact number of leukocytes, erythrocytes, cylinders in 1 ml of urine is determined.
3. Clinical blood test - allows you to study the erythrocyte sedimentation rate (an increase in which is the main sign of the presence of an inflammatory process in the body), the level of hemoglobin, the number of erythrocytes and leukocytes (increasing with the development of inflammation), the composition of the leukocyte formula.
4. Bacteriological urine culture on the microflora with the determination of the susceptibility of the identified pathogens to antibacterial drugs.

Bacteriological research is of great importance for the selection of a rational treatment for infectious pathological processes in the urinary organs - with its help, the type of microorganism that caused the inflammation and the medicine acting on this type of bacillus are determined

Additional diagnostic methods are:

• intravenous excretory urography - X-ray examination of the organs of the urinary system;
• cT scan;
• ultrasonography is one of the safest and fastest methods for diagnosing urinary tract infections in pregnant women.

A contraindication to instrumental research is a recurrent bacterial infection.

Treatment methods

Treatment of a urinary tract infection requires antibiotic therapy. Antimicrobial agents are prescribed by the attending physician after bacteriological culture of urine - this study helps to cure the disease completely.

If, for some reason, this analysis was not carried out, it is necessary to use drugs that have a wide range of antibacterial effects. However, some of them have a nephrotoxic effect, which is why, if the patient is at risk of developing renal failure, the use of Gentamicin, Streptomycin, Polymyxin is prohibited.

Most often, to treat an ailment, means of the cephalosporin group are used:

• Cephalexin;
• Ceftriaxone;
• Cefipim;
• Cefuroxime;
• Cefatoxime.

Good results are obtained by using:

• semi-synthetic penicillins - Ampicillin, Amoxacillin, Oxacillin;
• the modern group of macrolides - Roxithromycin, Clarithromycin, Azithromycin;
• fluoroquinolones - Ciprofloxacin, Levofloxacin, Ofloxacin.

If the infectious and inflammatory process in the urinary tract is caused by the simplest microorganisms, it is necessary to use antiprotozoal drugs - Ornidazole, Metronidazole, Metrogyl.

In the complex treatment of infections, the following are widely used:

• sulfonamides - Etazole, Norsulfazole, Urosulfan;
• uroantiseptics - Furazolidone, Canephron, Uroflux

An excellent effect in the treatment of acute, chronic and often recurrent urinary tract infections is provided by the use of the drug 5-NOK, which belongs to the group of hydroxyquinolines (derivatives of 8-hydroxyquinolinic acid)

The course of complex therapy also includes the use of:

• physiotherapy sessions;
• taking vitamins and immunomodulators.

An important role in the treatment of the infectious and inflammatory process in the urinary system is assigned to a balanced diet. Patients are strictly prohibited from eating foods that can irritate the mucous membranes of the genitourinary organs - spicy, pickled, sour and spicy foods, alcoholic and sugary carbonated drinks, coffee, tea, chocolate.

Traditional medicine methods

Nowadays, the treatment of many diseases with folk remedies is gaining in popularity. Healing plants have become indispensable helpers in getting rid of urinary tract infections.

People's advice in the treatment of these diseases include the use of various herbal teas and tinctures, berry juices

The most famous herb that helps in the treatment of urethritis, cystitis, pyelonephritis is earthy incense (scientific name is yellow zelenchuk). To prepare the broth, you need to brew 1 teaspoon of dry herb with 250 ml of boiled water, insist for half an hour. Consume before meals 3 times a day.

A very good result is brought by the herb Kupena (hernia is smooth), to prepare a medicinal infusion take 1 tsp. raw materials and pour 1 glass of boiling water. Take 100 ml of the product in the morning and evening.

No less effective is the use of:

• cranberry juice - capable of preventing the spread of pathogenic bacteria along the urinary tract, suppressing their reproduction and promoting excretion in the urine, it is recommended to drink 1 glass of juice a day;
• echinacea root - strengthening the immune system, it is advisable for patients to drink at least three cups of herbal tea a day;
• milk thistle, which is a storehouse of vitamins C, B, E, A - its use increases immunity, promotes speedy recovery and prevention of recurrence of the pathological process;
• bearberry leaves, which has an antiseptic effect - it is used only in the acute period of the inflammatory process;
• tea from nettle, which is considered a powerful diuretic - it enhances the formation of urine and helps to remove bacteria from the urinary tract, you need to brew 1 tsp 1 time a day. herbs 200 ml of boiling water and drink.

Warm sitz baths with sage and chamomile before bed relieve discomfort and soreness in the lower abdomen

Preventive actions

Following some simple rules will help prevent infection of the urinary system organs with pathogens:

• regular emptying of the bladder;
• compliance with personal hygiene requirements;
• wearing cotton underwear;
• the use of special products to cleanse the genital area;
• the use of fermented milk products;
• condom use;
• exclusion of hypothermia of the body.

Summing up all of the above, I would like to add that, although bacterial lesions of the urinary system are quite common, problematic and painful ailments, they are very successfully amenable to adequate treatment. And when all the necessary preventive measures are taken, the occurrence of relapses of these pathological processes is reduced to zero.

The urinary tract is part of a single and vital body system. In women, the urinary system is closely related to the reproductive system.

That is why the overwhelming majority of sick patients are female.

Symptoms of urinary tract infection vary and depend on:

• the type of infection itself;
• individual characteristics;
• the presence of concomitant or chronic diseases;
• the course of the infection and its form.

In order for an infection of the urinary stream to begin, it is enough not to observe one of the main factors:

1. Personal hygiene.
2. Private change of different partners.
3. Neglect your overall health.

The infection provokes inflammation at the time of a drop in immune activity or in the presence of active provocations. The main causes of inflammation are:

• frequent intercourse, even if with a regular partner;
• anal sex;
• the use of methods of protection that irritate the mucous membrane of the ureters;
• taking some birth control pills
• escherichia coli (candidiasis);
• uncontrolled and unreasonable intake of any group of antibiotics;
• pregnancy;
• diabetes of any kind;
• genital infections (gonococci, trichomoniasis).

In fact, in most cases, human carelessness becomes the reason for the occurrence of diseases such as cystitis, urethritis and even pyelonephritis.

How does infection occur

Once in the body, the infection progressively affects the urinary system.

It first penetrates the nearest point: the urethra. Depending on the type of infection, certain symptoms may appear already at this stage.

But more often men notice inflammation at this stage. Having fixed, the pathogen penetrates further and affects the mucous membrane of the bladder. Already at this stage, a person has two diseases caused by infection: urethritis and cystitis.

If the infection is not stopped at this point, the ureter and the kidneys themselves are involved in the inflammatory process. By nature, the kidneys are designed to produce sterile urine.

When a pathogen enters them, the entire excretory system is affected. This creates ideal conditions for the birth of such a dangerous disease as pyelonephritis.

If you suspect infectious diseases of the kidneys and bladder, the first component of the diagnosis is urinalysis. so that the result is as accurate as possible? Read carefully.

Read about the symptoms of cystitis in infants and school children.

Treatment of acute cystitis is aimed at eliminating the cause of the inflammatory process. You can read about medication and home treatments here. How to relieve pain?

Risk group

The above reasons apply to the general group of all patients. They were derived on the basis of clinical observations of that group of patients whose state of health is basically normal, and there are no chronic diseases. But there is an additional group of people who automatically fall into the risk zone for inflammation in the urinary tract:

• the presence of renal disease or chronic disease (ICD, diabetes);
• abnormal structure of the pelvic organs;
• female sex due to the structural features of the urethra;
• elderly people due to a decrease in the activity of the immune system;
• people forced to use a catheter to drain urine;
• small children under 3 years of age due to defective immune function.

Such patients quite often suffer from various inflammations, especially if the infection becomes chronic. In this case, people become more vulnerable to disease.
In general, the urinary system is extremely sensitive to any infection. So, those who often suffer from respiratory diseases can enter the same risk group.

Infection symptoms

Symptoms depend on how the infection started. There are two options: descending and ascending. In the first case, inflammation begins in the lower organs, which is the most common variant. When descending, the kidneys are affected first and then the infection goes down: to the bladder.

When inflammation begins, it is important not to miss the first signs. Some patients will first have pain in the side, others will simply have a fever and a worsening of the general condition, and still others will have only a temperature: significant, but without any pain. Therefore, summarizing cystitis, urethritis and pyelonephritis, the following symptom algorithm can be derived:

• soreness during or after sexual intercourse;
• discomfort when urinating;
• burning sensation and itching;
• the appearance of spotting in the urine (in the absence of menstruation in women);
• frequent urge, feeling of incomplete urinary emptying;
• strong smell of urine and discoloration;
• severe pain or cramps in the groin;
• pain during the very process of urination;
• fever or mild chills.

Usually, the appearance of cystitis or urethritis is not accompanied by high temperatures. Vomiting and other signs of intoxication of the body are even less common. However, with kidney involvement, a temperature of up to 39 degrees will appear, the patient may vomit and vomit. This suggests that the level of poisoning is significantly high. But such a temperature can indicate renal colic or the passage of a stone. In the latter case, we are talking about the patient's life, since some stones can cause blockage of the urinary tract and lead to death.

If there are symptoms of renal colic, do not try to relieve it yourself. In such cases it is necessary to call an ambulance.

Diagnostics

The examination of the patient begins in the same way in any case: donating blood and urine.

This is necessary in order to accurately see the level of leukocytes, the level of protein and whether it is in the urine.

If the patient is not seriously ill, urine culture may be ordered. This is the most accurate way to determine the resistance of an infection to different groups of antibiotics.

This method is used more often if there are signs of inflammation, but the blood and urine did not show the desired result.

This happens when infected with genital infections, for example, chlamydia. Here, you can additionally take a scraping from the genitals, which will allow you to accurately identify the sources and prescribe the correct treatment. With the help of ultrasound, additional diagnostics of the internal organs of the small pelvis is carried out.

TANK-urine culture

The described diagnostics are standard for any clinic. However, everything is decided by the patient's condition. For example, in some cases, urine gives a blurry result or the patient cannot pass it at all. Then the use of a catheter is shown or the doctor, based on his knowledge, makes a preliminary diagnosis. And confirmation of the correctness of this diagnosis is determined in other ways, for example, using intravenous urography.

The listed research methods are not the limit of the capabilities of urologists. In urology, there are a lot of tools in order to accurately identify even the most latent infection. However, today the level of preparedness of some specialists is criminally low. Therefore, do not hesitate to change your doctor if you have doubts about his professional suitability.

Treatment

When treating infections, one thing is important: full doctor's control and no self-medication.

Most often, antibiotic therapy is indicated, certain antibiotics are prescribed.

Usually these are: Ampicillin, Bactrim, Amoxiclav, nitrofurans. For more complex forms or bacteria resistance to treatment, a combination is allowed.

Detailed treatment is prescribed according to indicators. For example, if salts are present, a bladder and kidney lavage may be prescribed.

It is imperative to adhere to a dietary diet to minimize the intake of salts. Maximizing fluid intake is one of the main steps in treatment. Any drink is allowed here, but it is especially useful to take cranberry juice or rosehip broth. These berries contain the maximum collection of useful vitamins, they give a mild diuretic effect. Moreover, this allows you to avoid taking special diuretics, which wash out not only toxins, but also useful substances.
In the presence of kidney stones that can provoke infection, the possibility of crushing or removing them non-operatively is considered. But it all depends on the type and size of the stones themselves.

You can not self-medicate, it is contraindicated as life-threatening.

Prevention

A person consists mainly of liquid. You need to remember this and provide the body with at least 2 liters of fluid per day. This minimum should come regardless of your desire, otherwise there will be an ideal flora for infection and, moreover, the electrolyte balance of the whole organism will be destabilized.

For full prevention, it is important to observe the following points:

1. Personal hygiene. Take a shower more often instead of a bath.
2. Minimize salty / spicy food intake.
3. Empty the bladder in time.
4. Try to quit smoking and drinking.
5. Do not have sexual intercourse during treatment.
6. Observe hygiene during sexual intercourse.

Do not forget that there are already infections in the microflora of our body. In a healthy body, they are in a state of suspended animation, but one has only to give a chance and they will begin to actively colonize the body. Be careful even when you have to wash your private parts with raw water or drink it. Some infections are most active in raw water. It is better to use only purified water and use the same for intimate hygiene.

Do not forget that our body is not a Lego constructor. Everything in it is connected so tightly in order to provide us with the full value of life. If the urinary system is destroyed, at least, it will be followed by violations in the genital. The kidney changes and involvement suggests that part of our cleansing system is out of order. Without this, all incoming toxins will remain in the body, destroying and provoking other diseases. Nature has given us powerful filters and protective barriers: liver and kidney. We are only required to save and help them on time.

Due to the peculiarities of the anatomical structure of the genitourinary system, inflammatory diseases of the bladder in the vast majority of cases worries women. If, then it is necessary to undergo multifaceted diagnostics, including for STDs.

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