Inflammation of the lower tract, including the bladder and urethra
Most common UTI
Most are mild with no complications in individuals with uncomplicated UTIs
Can occur on its own or with pyelonephritis, prostatitis or kidney stones
Most common UTI micro-organism is uropathic strains of E. coli (80-85%)
Fungal infections are not common but the most common fungal pathogen is Candida
Parasitic infections occur in more than 200 million people, with the most common pathogen being Schistosomiasis haematobium
Pathophysiology:
Bacteria enters the urinary system usually due to the movement of gram-negative bacilli from the urethra and bladder to the kidneys and ureter through the urine
An inflammatory response occurs with infection, and edema of the bladder wall causes the symptoms of UTI by stretch receptors discharge (McCance et al., 2014)
Interstitial Cystitis (painful bladder syndrome):
Can be non-bacterial infectious cystitis or non-infectious cystitis
Commonly seen in immuno-compromised individuals and women aged 20-40 years
Unknown cause but the inflammation may be due to an autoimmune response
Inflammation of the glycosaminoglycan layer may cause bacteria and harmful urinary solutes to penetrate the bladder mucosa, which can lead to fibrosis and decreased urine output
An antiproliferative factor may block the normal growth of cells in the bladder wall lining, which increases bladder sensation (McCance et al., 2014)
[Untitled illustration of Cystitis]. Retrieved May 17, 2016 from http://www.theayurveda.org/ayurveda/common-things-about-cystitis-and-its-ayurvedic-cure/
Pyelonephritis. Normal kidney and Chronic Pyelonephritis [Online Image]. n.d. Retrieved May 17, 2016, from: http://www.dreamstime.com/stock-illustration-pyelonephritis-normal-kidney-chronic-image51792876
PYELONEPHRITIS
An infection of one or both of the upper urinary tracts, which includes the ureter, renal pelvis and kidney interstitium
Acute pyelonephritis:
Most common pathogens are: E. Coli, Proteus or Pseudomonas
Infection is likely due to ascending pathogens along the ureters, but can occur through the bloodstream too
Usually occurs from a lower UTI
Inflammation occurs at a focal point and is irregular, usually affecting the pelvis, calyces and medulla
As a result, renal inflammation occurs with edema, pus in the urine, and abscesses can occur in the medulla
Renal tubules are most affected and necrosis may occur, but renal failure is not often seen
Atrophy of affected tubules occurs after healing due to fibrosis and deposition of scar tissue (McCance et al., 2014)
Chronic pyelonephritis:
Recurrent infection of the kidney, causing kidney scarring
Unknown cause (may be idiopathic or associated with renal stones)
Bacteria cannot be excreted due to a chronic obstruction of the urinary tract
Progressive inflammation occurs, changing the renal pelvis and causing kidney scarring
Chronic kidney failure is the eventual end result due to the inability to concentrate urine (McCance et al., 2014)