Pathophysiology of UTI

A UTI or a urinary tract infection refers to an infection of any organ of the urinary system, i.e. the kidneys, bladder, ureters and urethra. A majority of the infections occur in the lower section of the urinary tract, i.e. the urethra and the bladder.

Women are more vulnerable to developing a UTI as compared to men. Infection that is restricted to the bladder can be discomforting and painful. However, when UTI spreads to the kidneys, then it can result in severe medical complications.

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UTIs are normally treated with antibiotics. However, there are many preventive steps that one can indulge in to avoid contracting the condition.

Pathophysiology of UTI

The pathophysiology of UTI refers to the infection of different parts of the urinary system such as the urethra, ureters, bladder and kidneys. A UTI can be caused by various microorganisms, but the pathophysiology of a UTI for each organism remains the same. The bacteria and other microorganisms gain entry into the urinary system via the blood stream or via contact with skin during urination and enter the body via the urethra. Later, they can spread to other organs of the urinary system.

Symptoms of UTI

UTI normally does not elicit any signs and symptoms. The symptoms which may indicate the presence of UTI include the following:

  • A strong and frequent desire to pass urine
  • Persistent urination involving small quantities of urine
  • Burning sensation during urination
  • Urine that appears cloudy
  • Cloudy appearance of urine
  • Smelly urine with putrid odor
  • Change in the color of urine to cola color, reddish or bright pinkish, signifying presence of blood in urine
  • Rectal pain in males
  • Pelvic pain in females

It is often possible to misdiagnose or overlook other disorders in adults as UTI

Types of UTI

Depending of the urinary system organ that is affected, it can result in different types of UTI with specific symptoms. They are as follows:

  • If the bladder is affected by UTI, then the condition is called cystitis and it can result in different symptoms including pressure in the pelvis, painful and frequent urination, discomfort in the lower abdomen and bloody urine.
  • When a UTI affects the kidneys, the condition is called acute pyelonephritis which causes symptoms such as pain in the sides or the flank as well as in the upper back, chills and trembling, high fever, vomiting and nausea.
  • UTI of the urethra is known as urethritis which causes burning sensations while urinating

Causes of UTI

  • UTIs generally occur due to the entry of bacteria into the urinary tract via the urethra and then travelling to the bladder where they multiply. Even though design of the urinary system prevents the entry of microorganisms, occasionally these defenses fail. In such cases bacteria may take control and develop into severe instances of UTI.
  • UTIs commonly occur in women and affect the urethra and the bladder.
  • Urethritis can develop when gastrointestinal bacteria present in the anus spread to the urethra. Additionally, due to the proximity of the vagina to the urethra in females, sexually transmitted infections like gonorrhea, herpes and Chlamydia can lead to its occurrence.
  • Cystitis is caused by E.coli bacteria which can be seen in the gastrointestinal tract. Sexual intercourse can result in the condition, but individuals who are sexually inactive can also develop it. Women are at greater susceptibility to developing cystitis due to their genital anatomy, wherein the distance between the urethra and the anus as well as that from the urethral orifice to the bladder is very short.

UTI Risk Factors

The different risk factors which increase the vulnerability to developing a UTI are listed below:

  • As discussed above, females are at increased risk due to their peculiar anatomy
  • Individuals who use a catheter to aid the process of urination are at greater risk to developing UTI
  • Women using spermicidal agents as well as diaphragms as a method of birth control are at increased vulnerability
  • Sexually active individuals, particularly women are at greater vulnerability
  • Women post menopause are lacking in estrogen which causes urinary tract changes, thereby increasing the risk to developing UTI
  • An enlarged prostate, kidney stones and other obstruction of the urinary tract can lead to trapping of urine in the bladder and thus elevating the risk of UTI
  • The presence of abnormalities of the urinary tract that prevent the normal elimination or trapping of urine increases the risk
  • Diabetes and other disorders that suppress the body’s immune system can result in decreased ability to fight infections and thus increase the vulnerability of UTI

Treatment of UTI

The treatment of UTI is dependent on the severity of the condition.

  • Simple infections are treated with antibiotics that have to be consumed for a few days as per the doctor prescription, till the symptoms disappear. Pain killers may be given for alleviation of burning sensations and painful urination associated with UTI.
  • Recurrent infections may require a longer antibiotics course, vaginal estrogen therapy for post menopausal women and home urine tests to check for persistent UTI cases.
  • Severe UTI cases may require hospitalization and intravenous administration of drugs.
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