UTI AND PROSTATITIS Flashcards
What are the most common causes of UTI?
E. Coli causes 75-90% of the acute UTI
S.saprophyticus is the 2nd most common cause of UTI in young sexually active women
What are the manifestations of urethritis?
Dysuria- discomfort during voiding
What are the manifestations of asymptomatic bacteria (ABU)?
No symptoms
Urine testing reveals bacteriuria
What are the manifestations of cystitis?
Dysuria
Urgency
Increased frequency
Suprapubic tenderness- pre or post voiding
Small volume voiding
Increased number of WBCs in the urine (pyuria)
What are the manifestations of hemorrhagic cystitis?
Visible blood in urine
Irritative voiding symptoms
May be confused with glomerulonephritis but does not present with hypertension or abnormal renal function
What are the manifestations of the pyelonephritis?
Irritative voiding symptoms Fever Flank pain and tenderness Costovertebral angle tenderness Nausea and vomiting Urine contains WBC casts Can lead to sepsis, septic shock and death
What is difference between reinfection and relapse?
Reinfection- recurrent UTI occurs more than 2 weeks after preceding UTI
Relapse- recurrent UTI occurs less than 2 weeks after preceding UTI
What are the risks factors for UTI?
Abnormalities in the urinary tract Catheters Diabetics Immunosuppressed patients Congenital abnormalities Sexual intercourse Pregnant woman Postmenopausal women with bladder or uterine prolapse
How is acute cystitis in symptomatic young men diagnosed?
Urine culture greater than 1000 CFU/mL
How is acute uncomplicated pyelonephritis diagnosed?
Urine culture 10000 /ml
How is asymptomatic bacteruria diagnosed?
Women- 2 specimens with same species of at least 100,000 CFU/mL
Men- single specimen with one bacterial species of at least 100,000 CFU/mL
How to confirm pyuria and bacteriuria?
Pyuria- Dipsticktest for leukocyte esterase
Bacteriuria- dipstick for nitrites s. Saprophyticus and E. Faecalis are nitrites negatives
What are the lab tests to confirm pyelonephritis?
Antibodies coated bacteria
WBC casts
Ureteral catheterization on extreme cases due to invasive
Which groups benefit from treatment of asymptomatic bacteriuria?
Mostly affects elderly population No treatment needed except for: Pregnant women Patients with renal transplants Patients undergoing GU tract procedures
What are the correlations of UTI and pregnancy?
About 1/3 of untreated UTI in pregnancy develop into pyelonephritis which is associated with low birth weight and premature infants
Pregnant women are screened by urine culture at 12-16 weeks gestation
2 urine samples at least 100,000 CFU/mL
Ow to prevent UTI?
Maintain high fluid intake
Drink cranberry juice
Empty bladder as soon as feeling urge of peeing
Avoid foods that irritate bladder
What are the manifestations of acute bacterial prostatitis?
Irritative symptoms
Obstructive - hesitancy, poor or interrupted stream
Incomplete emptying
Warm,tender, enlarged and boggy prostate on exam
Do not massage prostate to avoid sepsis
What are the manifestations of chronic bacterial prostatitis?
Persistent bacterialinfection of prostate greater than 3 months Common cause of recurrent UTI Irritative symptoms No prostate symptoms between episodes Prostate may be normal,tender or boggy
What are the manifestations of chronic non bacterial prostatitis/chronic pelvic pain syndrome?
Painful ejavulation
Pain along inner aspects of the thighs
No recurrent UTI
Prostate tender in 50%
What are the 2 mechanisms of postatitis?
Reflux of infected urine to prostate via ejaculatory and prostatic ducts
Ascension of urethral infection during intercourse
How is chronic bacterial prostatitis diagnosed?
VB2- urine pre massage of prostate is negative
VB3- urine post massage positive for bacterial counts, leukocytes
How is chronic non bacterial inflammatory prostatitis diagnosed?
VB2- negative
VB3- negative for bacteria, positive for leukocytes
How is chronic non bacterial non inflammatory prostatitis diagnosed?
VB2- negative
VB3- negative, no leukocytes
