Urinary Tract Infection

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Discussion :

This patient most likely has cystitis. Patients with cystitis usually complain of dysuria, urinary frequency and urinary urgency. The presence of more than one of these symptoms increases the likelihood of UTI. Burning through out the course of micturition may help differentiate cystitis from urethritis where pain is classically at the beginning of urination (most patients however cannot explain this difference). Patients usually have no fever or constitutional symptoms and are comfortable except during micturition. There is no costovertebral angle tenderness. Mild suprapubic tenderness is elicited. Cystitis is very common in adult females. At least 30% of women experience at least one episode of cystitis in their lifetime. In contrast, cystitis is very rare in men. This is thought due to be secondary to the presence of a longer urethra making the ascension of bacteria more difficult and also due to the bacteriostatic nature of prostatic secretions. Male infants are however at a higher risk of urinary tract infections (UTI). Prostatic hypertrophy and prostatic carcinoma along with urethral obstruction, urinary retention and stasis contribute to the increased incidence of UTI in older men. Pregnant women (especially if they have sickle cell trait) have a higher incidence of UTI. Diabetes mellitus per se does not increase the risk of UTI unless associated with a disorder of bladder emptying. UTIs in diabetics however may be more virulent.

A recent categorization of UTIs is most helpful clinically because it divides patients into groups based on clinical factors and their impact on morbidity and treatment (Table 1).These categories are as follows: acute uncomplicated cystitis in young women; recurrent cystitis in young women; acute uncomplicated pyelonephritis in young women; complicated UTI and its subcategories; UTI related to indwelling catheters; UTI in men; and asymptomatic bacteriuria.

Cystitis is rare in men
30%of women have cystitis in their life time
Consider obstructive pathology in older men

UTI in diabetics is more virulent

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dada 

for urinary problem which doctor shall I contact Medicine or Urologist

kkgrg 

I have UTI generally recurring. Last time I had around a years back and got treated with Ofloxacin for about 15 days. Today I am suffering for very frequent urination with sensation and unable to control. Kindly suggest some medicine.

lovetoread 

First UTI in over 10 yrs. Unfortunately I've had over a month of UTI symptoms. The first two urine specimens were [ ] for blood, WBC, and bacteria but were NEVER cultured. I went through two different rounds of antibiotics. Symptoms still there. My doctors were saying obviously it isn't an UTI, that it must be stress or something else. We'll finally after suffering a month, the next urine sample WAS cultured and it came back I have coagulase negative staph. And get this, the bacteria is resistant to most antibiotics, including penicillin, Levaquin, Sulfa, and Cipro. I'm not so sure not culturing a positive urine sample is such a great idea. I know I have greatly suffered. I'm now on macrobid and hoping this will take care of it.

Anglkitty77 

I have a recalled bladder sling and I have been having recurring UTI synptoms. Nitrites and leukocytes are always present, but cultures grow nothing. I am at a loss and so is my Dr. I am seeing a specialist at Vanderbilt and he is removing the sling in a couple of weeks. Anyone else have this issue?

edouartawil 

i have found that UTIs with no symptoms should not be treated especially if they have ESBL or KPC.
A well known case ESBL to me I stoped treating her with antibiotics works now well for more than 8 months

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