Urinary tract infections in children. The main signs of urethritis and possible consequences. Diagnosis of diseases of the genitourinary system

Our genitourinary system is exposed to very high risks of diseases if we lead an incorrect lifestyle. All this leads to the appearance of inflammatory processes and infectious diseases in the genitourinary system. Let's look at the main diseases genitourinary system, their symptoms and possible treatment methods.

Major diseases of the genitourinary system

The human urinary system includes the urethra, bladder, ureters and kidneys. Anatomically and physiologically, the urinary tract is closely related to the organs reproductive system. The most common form of pathology urinary tract- infectious diseases - diseases of the genitourinary system.

Urethritis

Many people know too little about this disease to see a doctor in time and begin treatment. We will talk further about the causes, treatment methods and other features of urethral disease.

Unfortunately, many suffer urological diseases, including urethritis. This disease has now been sufficiently studied, effective treatment methods have been developed, which are developing more and more every day. The symptoms of urethritis are not always pronounced, so the patient may contact a specialist late, which significantly complicates treatment.

Causes of urethritis

The main cause of this disease is an infection of the urethra, which is a tube containing layers of epithelium. It is the tube that can be the center of infection. What complicates the disease is that the virus can long time not give any sign of its existence. Only when exposed negative factors(cold, stress) the infection makes itself felt. The disease can be chronic or acute. The first form is more dangerous, because its signs are not as pronounced as the second.

But even more serious is inflammation of the urethra. The disease can be caused by chlamynadia, trichomonas, dangerous condylomatous growths, and herpes viruses.

Infection with urethritis

You should always remember about the safety of sexual intercourse, because this is the main threat of contracting viral infections of the genital organs, urethritis is no exception. Note that the disease in women is much milder than in men. Urethritis in the stronger sex can occur with significant pain and complications. It is important to remember that the disease does not make itself felt during the incubation period - it proceeds without pronounced symptoms. And only in the next stages of the disease will you begin to notice that not everything is in order with your genitourinary system. But the treatment will be much more difficult. Therefore, for your own safety, periodically check with a specialist.

The main signs of urethritis and possible consequences

The disease has a number of signs that everyone needs to remember in order to start treatment on time:

• Pain accompanied by a burning sensation that intensifies with urination.
• Discomfort in the urethral area.
• Mucopurulent discharge that has an unpleasant odor.
• Cutting and spasms in the lower abdomen.

If a person does not see a doctor in time, complications arise and the inflammatory process spreads to other organs and systems. Remember that treatment of the urethra should be started on time, and only after consulting a doctor.

Methods for treating urethritis

A good specialist, before prescribing treatment, carefully examines the causes of the disease, because not all of them are caused by infections. Urethritis can also be caused by an allergic reaction caused by the influence of chemical substances. Treatment of this form of urethral disease differs from infectious.

Before you start treatment viral urethritis, it is necessary to conduct laboratory tests so that the prescribed medical supplies effectively affected the disease. Gives in well pharmacological treatment acute urethritis. In cases where it has developed into a chronic form, treatment may take a long time.

Every person who understands what urethritis is understands that self-medication will not give any positive result. Only under the supervision of doctors does the patient have every chance of regaining a healthy genitourinary system.

Folk remedies for urethritis

Balanoposthitis

This disease has many different forms, the occurrence of which depends on the causes. Symptoms of the disease:

• Soreness.
• Raid.
• Swelling.
• Discharge.
• Rash.
• The appearance of ulcers on the genitals.
• Unpleasant smell.

Symptoms of prostatitis

The signs of the disease are quite vague, and they are characteristic of other diseases. Symptoms that may indicate prostatitis:

• Weakness.
• Low performance.
• Feeling of discomfort in the area of ​​the external genital system.
• Unpleasant feeling in the lower abdomen.
• Pain in the testicles and perineum.
• Very frequent and painful urination.
• Weak urine pressure.
• Discharge.
• Weak erection and pain.
• Lack of feeling of orgasm.
• Short prolonged sexual intercourse.

If you feel any of the symptoms, you should immediately consult a doctor.

The disease has a variable course: significant pain alternates with a relative feeling of comfort and health. If you do not consult a doctor in time, inflammation can lead to cystitis, pyelonephritis, vesiculitis, orchiepididymitis, and impotence.

A frivolous attitude to treatment can also cause impotence and. It is worth periodically undergoing examination in the hospital to avoid complications and irreversible disastrous consequences of the disease.

Folk remedies for chronic prostatitis

Vesiculitis

With this disease, a man's seminal vesicles become inflamed. As a result, pain occurs in the groin, perineum, and lower abdomen during urination. The pain is aching, pulling and monotonous. Discomfort continues throughout the entire disease process and may periodically increase or decrease. The symptoms are very close to.

Vesiculitis is a fairly long-term disease that is difficult to cure. For a complete recovery you need to put in a lot of effort. Very rarely this disease occurs without concomitant diseases. Sometimes it is considered a complication of prostatitis.

Types of vesiculitis

There are acute and chronic forms of vesiculitis. But the first one is much more common.

Acute vesiculitis is characterized by sudden onset, high fever, weakness, pain in the lower abdomen and bladder.

Chronic vesiculitis is a complication after the acute form, which is characterized by nagging pain. Erectile dysfunction.

The worst complication is suppuration, which is associated with the formation of a fistula with the intestines. This form is characterized by a very high temperature, feeling unwell. It is necessary to urgently take the patient to a doctor.

Source of vesiculitis infection

When a person is already sick with the prostate, the prostate gland - main source infections. Urethritis can also be the cause of vesiculitis. Less often, but sometimes, the urinary system is a source of infection (if a person is sick with cystitis or pyelonephritis). Infection can also enter through the blood from other organs (with sore throat, pneumonia and osteomyelitis). The cause of the disease may be various injuries lower abdomen.

Symptoms of vesiculitis

There are no specific symptoms that indicate this particular disease. Therefore, it is very important that the doctor carefully diagnoses the patient. Signs that may indicate vesiculitis:

• Pain in the perineal area, above the pubis.
• Increased pain when the bladder is full.
• Presence of mucous discharge.
• Presence of erectile dysfunction.
• Painful sensations during ejaculation.
• Deterioration in health.

Diagnosis of vesiculitis

The latent course of the disease and the absence of clear signs significantly complicate diagnosis and treatment. If vesiculitis is suspected, doctors perform a number of procedures:

• I examine for the presence of sexually transmitted infections.
• A series of smears are taken to determine the presence of an inflammatory process.
• The prostate and seminal vesicles are checked by palpation.
• Examine the secretions of the prostate and seminal vesicles.
• An ultrasound of the urinary and reproductive systems is performed.
• Blood and urine tests are taken.
• A spermogram is performed.
• Throughout the entire treatment process, careful monitoring of the dynamics of the disease.

Treatment of vesiculitis

An important condition for the disease is bed rest. If a person is constantly tormented by high fever and acute pain, doctors prescribe antipyretics and painkillers.

Also, in order to reduce pain, the doctor prescribes medications with an analgesic effect. The patient periodically undergoes physiotherapy and massage. On advanced stages vesiculitis, surgical intervention may be prescribed. Sometimes it is recommended to remove the seeds.

To avoid this serious illness, there are a number of recommendations that must be followed:

• Avoid constipation.
• Exercise.
• Check with a urologist periodically.
• Avoid shortage or abundance sexual relations.
• Don't get too cold.
• Eat healthy.
• Visit a venereologist regularly.

Orchiepidimitis

This is an inflammation that occurs in the area of ​​the testicle and its appendages. The disease is caused by infection. The testicle and its appendages enlarge and become denser. All this is accompanied by severe pain and elevated temperature bodies.

There are two forms of orchiepididymitis: acute and chronic. Most often, the first goes into the second form due to untimely contact with a doctor or inaccurate established diagnosis. Chronic form diseases are very difficult to cure.

Methods of infection with orchiepididymitis

You can become infected with the disease through unprotected sexual intercourse. There is also a risk of prostatitis. Fixed rare cases infection using circulatory system. The cause of the disease may be injuries to the scrotum, hypothermia, excessive sexual activity, or cystitis. You need to be treated very carefully, because if not treated correctly, the disease can return.

Epididymitis orchioepididymitis is a very dangerous disease because it entails sad consequences. Acute form can lead to problems with abscesses, tumors or infertility.

Treatment of orchiepididymitis

The main weapon against the disease is antibiotics. But medications must be selected very carefully, taking into account individual characteristics body. Treatment is also influenced by the form of the disease, the patient’s age and his general health. Doctors prescribe taking medications for the inflammatory process, for high temperature. If the disease returns again, then its treatment is carried out with the help of surgical interventions.

Preventing a disease is much easier than treating it. It is necessary to avoid hypothermia, casual sexual relations, and injuries to the scrotum. You should also wear underwear that fits tightly to your body. This will improve blood circulation in the genital area. You should not overload your body either physically or mentally. You need to rest well and take care of your health. It is necessary to undergo periodic examination by a doctor. By following all these recommendations, you protect yourself from infection.

Cystitis

Cystitis is a disease characterized by difficulty urinating and pain in the pubic area. But these signs are also characteristic of other infectious and non-infectious diseases (prostatitis, urethritis, diveculitis, oncology).

Most often, inflammatory processes in the bladder occur in girls. This is due, first of all, to the distinctive anatomical structure of a woman’s body. Cystitis has two forms: chronic and acute (the upper layer of the bladder becomes inflamed). The disease most often begins to develop during infection or hypothermia. As a result improper treatment the disease can develop into chronic cystitis, which is dangerous due to the weak manifestation of symptoms and the ability to mask other diseases. As you can see, it is very important to start proper treatment on time.

What causes cystitis?

Most often, the disease is caused by an infection that enters the body through the urethra. Sometimes, people who have weak immunity, infection occurs hematogenously. Cystitis can be caused by the following bacteria:

• E. coli.
• Proteas.
• Enterobacters.
• Bacteroides.
• Klibsiella.

The above bacteria reside in the intestines.

Cellular bacteria can also cause cystitis:

• Chlamydia.
• Mycoplasma.
• Ureaplasma.

Often the disease can be caused by thrush, ureaplasmosis, vaginosis and diabetes.

Non-infectious cystitis can be caused by medications, burns, or injuries.

Symptoms of cystitis

Signs of the disease depend to some extent on the characteristics of the body. Therefore, it is impossible to name any clear symptoms of cystitis. Let us pay attention to the most common features of the disease:

• Stinging and pain when urinating.
• Painful sensations in the pubic area.
• Frequent need to urinate.
• Changed color, consistency and odor of urine.
• High temperature (in acute form).
• Digestive disorders.

It is worth remembering that the symptoms of cystitis may hide much more serious illnesses, so you should not self-medicate.

Diagnosis of the disease

Examination for cystitis is not quite complicated. The main thing is to determine what caused the disease. And sometimes it is difficult to determine this factor, because there are many sources of infection. In order to confirm the diagnosis of cystitis, it is necessary to undergo a number of tests:

• Analysis for the presence of infection.
• Clinical urine tests.
• Biochemical blood tests.
• Conduct bacterial culture of urine.
• Tests for the presence of sexually transmitted diseases.
• Tests to detect other genitourinary diseases.
• Ultrasound of the genitourinary system.

And, having received the results of all tests, you can determine the causes of the disease and prescribe a treatment method.

Folk remedies for cystitis

Pyelonephritis

Infectious kidney disease, which is accompanied by inflammatory processes. The disease is caused by bacteria that enter the kidneys from other already inflamed organs through the blood, bladder or urethra. There are two types of pyelonephritis:

• Hematogenous (infection enters through the blood).
• Ascending (comes from the genitourinary system).

Types of pyelonephritis

There are two forms of the disease:

• Acute (pronounced symptoms).
• Chronic (sluggish pronounced signs, periodic exacerbations of the disease).

The second form of the disease most often results from improper treatment. Chronic pyelonephritis can also occur as a result of the presence of a hidden source of infection. The second form of the disease can be considered a complication.

Pyelonephritis most often affects children under seven years of age, as well as young girls. Men are much less likely to suffer from this disease. Most often in the stronger sex, pyelonephritis is a complication after other infectious diseases.

Symptoms of pyelonephritis

The acute form of the disease is accompanied by the following symptoms:

• Fever.
• Intoxication.
• Acute pain in the lower back.
• Frequent and painful urination.
• Lack of appetite.
• Feeling nauseous.
• Vomit.

More rare signs pyelonephritis may have the following symptoms:

• Blood in urine.
• Changes in urine color.
• The presence of an unpleasant pungent odor of urine.

In order for the treatment of the disease to be effective, it is necessary to accurately determine the diagnosis. When prescribing medications, it is necessary to take into account the individual characteristics of the body.

Treatment and diagnosis of pyelonephritis

The most effective way to diagnose the disease is with a general blood test. Also, if pyelonephritis is suspected, doctors prescribe an ultrasound of the genitourinary system and a urine test.

Proper treatment of the disease consists of taking antibiotics, anti-inflammatory drugs and physical therapy. Taking vitamins also has a positive effect on treatment results.

You must remember that failure to see a doctor in a timely manner can lead to complications, which will slow down the healing process.

Prevention of pyelonephritis

The most effective method of prevention is treatment of diseases that contribute to the development of pyelonephritis (prostatitis, adenoma, cystitis, urethritis and urolithiasis). You also need to protect the body from hypothermia.

Folk remedies for pyelonephritis

Urolithiasis disease

Urolithiasis takes second place after viral diseases of the genitourinary system. Note that, according to statistics, men are many times more likely to suffer from the disease. The disease most often affects one kidney, but there are cases where urolithiasis affects both kidneys at once.

Urolithiasis is typical for any age, but most often it occurs in young, able-bodied people. When the stones are in the kidneys, they make little difference, but when they come out, they begin to cause discomfort to the person, causing irritation and inflammation.

Symptoms

The following signs may indicate that a person has stones in the genitourinary system:

• Frequent urination.
• Pain when urinating.
• Cutting pain, most often in one part of the lower back.
• Urine changes color and chemical composition.

Causes of the disease

Most often, stones in the genitourinary system are a genetic problem. In other words, those who suffer from diseases of the genitourinary system have this problem.

The occurrence of stones may also be the cause incorrect exchange substances. Calcium is problematically excreted through the kidneys. The cause of the disease may be the presence of uric acid in the blood.

This problem may be caused by not drinking enough fluid. The rapid loss of water in the body caused by diuretics can also lead to the formation of stones. The disease sometimes occurs as a result of previous infections of the genitourinary system.

Diagnosis and treatment of the disease

If you suspect the presence of such a problem, stones can only be detected by a specialist who will prescribe a number of diagnostic measures:

• Urine delivery.

Having determined the diagnosis and causes of the disease, the urologist selects an individual treatment regimen. If the disease has just begun to develop, it will be enough drug treatment(taking diuretics that help break down stones).

The doctor also prescribes anti-inflammatory therapy in order not to cause cystitis or urethritis. The passage of stones irritates the genitourinary canals, which leads to inflammation. If you are sick, it is recommended to take plenty of fluids. This will improve the functioning of the whole body. Surgical intervention The disease is prescribed for the formation of large stones. In case of urolithiasis, it is important to adhere to a diet and conduct periodic examinations.

Folk remedies for urolithiasis

So, we looked at the most common diseases of the genitourinary system, their main signs and symptoms. It is important to have information about diseases that may await you, because forewarned is forearmed. Be healthy!

Urinary tract infection(IMS) is characterized by the presence of microorganisms in the urinary tract above the bladder sphincter, which normal conditions are sterile.

Significant bacteriuria is the number of live bacteria (so-called colony-forming units - CFU) of one strain per ml of urine, indicating UTI. Depending on the form of the IC, these are:

1) ≥103 CFU/ml in a woman with symptoms of bladder inflammation in a midstream urine sample;

2) ≥104 CFU/ml in a woman with symptoms of acute pyelonephritis (AP) in a midstream urine sample;

3) ≥105 CFU/ml in case of complicated UTI in a midstream urine sample;

4) ≥102 CFU/ml in a portion of urine, collected by a one-time insertion of a catheter into the bladder;

5) any number of CFU in urine obtained during suprapubic puncture of the bladder.

Asymptomatic bacteriuria- this is significant bacteriuria (≥105 CFU/ml in an average portion of urine or ≥102 CFU/ml in a portion of urine collected by a one-time insertion of a catheter into the bladder) in a person without subjective and objective symptoms of UTI. The presence of leukocyturia in a patient without clinical symptoms is not sufficient to diagnose UTI.

Complicated IMS is:

1) every UTI in a man;

2) UTI in a woman with an anatomical or functional disorder that obstructs the outflow of urine, or with a decrease in the level of systemic or local protective mechanisms;

3) IMS caused by atypical microorganisms.

Uncomplicated UTI occurs in women with a normal genitourinary system and without violations of local and systemic protective mechanisms (that is, without risk factors for UTI →see below) and is caused by microorganisms typical for UTI.

Recurrent UTI is a recurrent UTI that occurs after antimicrobial therapy due to the survival in the urinary tract of the microorganism that was the cause of the primary UTI. In practice, a relapse of UTI is diagnosed if its symptoms occur<2 недель после окончания лечения предыдущего ИМС, и этиологическим фактором является тот же микроорганизм.

Repeated UTI (reinfection) - This is a UTI caused by a microorganism coming from outside the urinary system, which is a new etiological factor. In practice, recurrent UTI is diagnosed if symptoms occur after 2 weeks of previous treatment for UTI, even if the etiological factor is the same microorganism.

Under normal conditions, the urinary tract is sterile, with the exception of the distal part of the urethra, which is inhabited mainly by saprophytic coagulase-negative staphylococci (eg Staphylococcus epidermidis), vaginal rods (Haemophilus vaginalis), non-hemolytic streptococci, corynebacteria and lactic acid bacteria (Lactobacillus). Pathogenic microorganisms colonize the urinary system mainly through the ascending route. The first stage in the development of UTI in an ascending manner is the colonization of the urethral orifice by uropathogenic bacteria. This occurs more often in women whose reservoir of uropathogenic microorganisms is the vestibule of the vagina; The distance from the mouth of the urethra to the anus is also smaller. The next stage is the penetration of microorganisms into the bladder in women, often during sexual intercourse. In people with effective defense mechanisms, colonization ends at the level of the bladder. The likelihood of kidney infection increases the longer the bacteria remain in the bladder. Hematogenous and lymphogenous infections account for ≈2% of all UTIs, but these are most often severe cases occurring in patients in severe clinical condition with weakened immunity.

Risk factors for complicated IC: urinary retention, urolithiasis, vesicoureteral reflux, catheter in the bladder, diabetes mellitus (especially decompensated), old age, pregnancy and childbirth, hospitalization for other reasons.

Etiological factors:

1) bacteria:

A) uncomplicated and recurrent cystitis - Escherichia coli (70–95% of cases), Staphylococcus saprophyticus (5–10%, mainly in sexually active women), Proteus mirabilis, Klebsiella spp., Enterococcus spp. and others (≤5%);

b) acute uncomplicated pyelonephritis (AP)→see higher, but greater participation of E. coli without S. saprophyticus;

c) complicated IMS - E. coli (≤50%), more often than in uncomplicated UTIs, the participation of bacteria from the species Enterococcus (20%), Klebsiella (10–15%), Pseudomonas (≈10%), P. mirabilis and infections with more than one microorganism;

G) asymptomatic bacteriuria- in women most often E. coli; In patients with a long-term catheter, several microorganisms are usually present in the bladder, including often Pseudomonas spp. and urease-positive bacteria (eg Proteus spp.);

2) microorganisms not detected by standard methods - Chlamydia trachomatis, gonococci (Neisseria gonorrhoeae), viruses (mainly Herpes simplex); transmitted almost exclusively sexually, cause up to 30% of lower urinary tract infections in sexually active women ( and );

3) fungi - most often Candida albicans and other species of the genus Candida, Cryptococcus neoformans and Aspergillus; are the cause of ≈5% of complicated UTIs. Fungal UTI most often occurs in diabetic patients receiving antibiotics, with a catheter in the bladder, in patients after manipulation of the urinary tract, especially in patients receiving immunosuppressants. Yeast can be present in urine without being the cause of UTI → .

CLINICAL PICTURE AND NATURAL COURSE

Depending on the natural course, as well as the necessary diagnostic and therapeutic procedures, the following are distinguished:

2) recurrent cystitis in women →;

3) uncomplicated AP in women →;

5) asymptomatic bacteriuria (asymptomatic UTI) → .

DIAGNOSTICS

The diagnosis of IMS is determined based on subjective and objective symptoms and the results of additional research methods.

Additional research methods

1. General urine analysis: leukocyturia, leukocyte casts (indicative of pyelonephritis), hematuria (often with cystitis in women).

2. Urine culture:

1) you can assume that uncomplicated cystitis in a woman who is not in the hospital is caused by E. coli or S. saprophyticus and begin treatment without urine culture;

2) urine bacteriological examination should be performed in all other cases of UTI and in women with symptoms of bladder inflammation if standard empirical treatment has been ineffective, a complicated UTI is suspected, or if a current UTI has occurred within 1 month. from the previous episode;

3) test strips are intended only for preliminary research in the diagnosis of UTI based on the detection of nitrites in urine, which are produced from nitrates by Escherichia coli (Enterobacteriaceae). Their sensitivity allows detection of bacteria in quantities >105 CFU/ml. For this reason, and because they do not detect bacteria that do not produce nitrites, test strips cannot replace urine culture if it is indicated.

4) in ≈30% of cases of dysuria caused by infection, the result of a standard bacteriological examination (culture) of urine is negative (so-called non-bacterial inflammation of the bladder or urethra →see below).

3. Blood tests: leukocytosis, increased ESR, increased concentration of CRP.

4. Blood culture: Possible positive results severe forms IC.

5. Imaging studies: indicated for complicated UTIs, as well as uncomplicated AP in women, if the symptoms of infection persist or worsen despite standard treatment. Ultrasound of the urinary system- allows you to detect abnormalities of the urinary system (eg nephrolithiasis, urinary retention, cysts, malformations) and complications of UTI (renal and perinephric abscess). Urography is indicated mainly in cases of suspected anomalies of the pyelocaliceal system or ureters. CT scan with contrast agent injection- has the highest sensitivity in detecting perinephric abscesses, allows visualization of focal bacterial inflammation of the kidneys. Renal scintigraphy using DMSA is a test that has very high sensitivity for detecting AP.

Diagnostic criteria

UTI is diagnosed based on clinical symptoms; You should always try to confirm them by doing a urine culture (with the exception of uncomplicated cystitis in women, which is diagnosed based on clinical symptoms only). Significant bacteriuria confirms the presence of UTI in a symptomatic individual.

Differential diagnosis

Other diseases that may cause urination disorders and pain complaints localized in the pelvic area (genital diseases, prostate diseases), renal colic, inflammation of the abdominal organs.

Treatment of clinically significant UTI consists of eliminating pathogens from the urinary system through the use of appropriate antimicrobial drugs, selected empirically in the initial period of treatment, and then based on the results of urine culture (if there were indications for its implementation). In any case, attempts should be made to eliminate known risk factors for UTI.

General instructions

1. Bed rest for infections of the upper urinary system with moderate to severe course.

2. Appropriate fluid intake p/o or IV to ensure proper hydration of the patient.

3. In case of fever or pain→ eg. paracetamol.

Antibacterial therapy

Depends on the shape of the IC →see. below.

1. Uncomplicated UTI: good prognosis.

2. Chronic or recurrent UTI in individuals with persistent anatomical or functional disorders urinary tract (eg nephrolithiasis, vesicoureteral reflux): may lead to chronic renal failure.

3. Complications of UTI (→): some (eg urosepsis, especially in older people) are associated with high mortality.

PREVENTION

Recurrent UTIs- this is most often uncomplicated cystitis, much less often uncomplicated AP. Below are methods for preventing recurrent uncomplicated UTI. Recurrence of uncomplicated UTI are separate clinical problem associated with urinary tract abnormalities, immune disorders, or antimicrobial resistance of uropathogenic microorganisms.

Non-pharmacological methods

1. Increase the volume of fluid consumed (including an additional glass of fluid before sexual intercourse).

2. Urinate immediately after the urge occurs or regularly every 2–3 hours, as well as immediately before bed and after sexual intercourse.

3. Avoid using intimate deodorants, cervical caps and vaginal spermicides.

4. Avoid bubble baths and adding chemicals to the bath.

Pharmacological methods

1. Vaginal use of drugs withLactobacillus.

2. Vaginal use of estrogen cream(in women after menopause).

3. Preventive antibacterial treatment(options):

1) treatment if clinical symptoms occur, undertaken by a woman independently according to the rules, as with uncomplicated inflammation of the bladder →see. below. This strategy is recommended when the number of UTI episodes per year is ≤3. Advise the patient to contact the physician if symptoms do not resolve within 48 hours or are unusual.

2) prevention after sexual intercourse- single dose after sexual intercourse. Medicines and doses, since in the case of continuous prophylaxis, either ciprofloxacin 250 mg or cephalexin 250 mg. This strategy is recommended when the number of UTI episodes per year is >3 and there is a clear temporal association with sexual intercourse.

3) continuous prevention- every day before bedtime or 3 times a week, po cotrimoxazole 240 mg, trimethoprim 100 mg or norfloxacin 200 mg; initially for 6 months. If after this period, UTI recurrences still occur → continue prophylaxis for ≥2 years.

4. Rules for the prevention of UTI associated with bladder catheterization → .

Urinary tract infection in women is the most common infection in medical practice. Cystitis is diagnosed in 10% of women every year. Direct treatment costs amount to $1.6 billion.

During their lifetime, 20-30% of women experience at least one episode of urinary tract infection. In 20% of patients it recurs. About 95% similar diseases are accompanied by symptoms, and in 3/4 of these cases a positive urine test result is obtained. Almost all patients with asymptomatic urinary infection the result of this study is negative.

Terminology

The terminology of urinary tract infections is complex and requires clarification.

Bacteriuria is the presence of bacteria in the urine.

Significant bacteriuria- more than 10 * 5 colonies of bacteria in 1 ml of urine when collected correctly from a patient without clinical symptoms. For clinical symptoms of urinary tract infection in women, fewer colonies are taken into account.

Asymptomatic bacteriuria- significant bacteriuria with or without pyuria in a patient who does not have symptoms of a urinary tract infection.

Pyelonephritis - bacterial infection renal parenchyma, pyelocaliceal system. Acute pyelonephritis is characterized by chills, fever in the flanks, in the area of ​​the ribs and spine, frequent urination, urgency and dysuria. At chronic pyelonephritis changes are represented by focal interstitial nephritis, destruction of tubules, cellular infiltration and inflammatory changes in the renal parenchyma.

Cystitis is inflammation of the bladder. The picture of cystitis is represented by symptoms of irritation of the lower urinary tract: dysuria (burning when urinating), imperative urge to urinate, frequent urination small portions, nocturia, discomfort above the pubis and sometimes urinary incontinence, hematuria.

Persistent bacteriuria- continuous release of the same bacteria before and during treatment. The reasons may be resistance of microorganisms, incorrectly selected antibacterial therapy and poor patient compliance.

Superinfection is infection by another microorganism (another strain or serological type) of a patient receiving treatment.

Relapse is the repeated occurrence of significant bacteriuria caused by the same strain and serological type of pathogen. Relapse usually occurs within 2 weeks after the end of treatment, and is most likely caused by colonization of the perineum by the corresponding pathogen.

Reinfection is re-infection with another microorganism or another serological type of the primary pathogen. Reinfection usually occurs 2-12 weeks after the previous episode.

Recurrent urinary tract infection - two episodes of urinary tract infection in six months or three or more episodes in a year. Women with blood type B or AB are at particularly high risk of recurrent infection.

Prevalence, incidence and causes

At the end of the first year of life and in older age, women are sick more often than men (10:1). For girls preschool age The prevalence of asymptomatic bacteriuria increases from 1 to 5% and reaches a peak in postmenopausal women (10%). Up to 70% of children with urinary tract infections suffer from urological disorders.

Risk factors for urinary tract infection in women

Causes of urinary tract infections in women before

• History of urinary tract infection.
• Frequent or recent sexual activity.
• Using a diaphragm for contraception.
• Use of spermicides.
• A large number of births.
• Diabetes.
• Obesity.
• Sickle cell deformation of red blood cells.
• Congenital malformations.
• Formation of stones in the urinary tract.
• Diseases requiring constant or periodic. bladder catheterization.

Causes of urinary tract infections in women after menopause

• Vaginal atrophy.
• Incomplete emptying Bladder.
• Poor perineal hygiene.
• Recto-, cysto-, urethrocele or prolapse of the vagina and uterus.
• Diabetes mellitus type 1

Pathogenesis

Bacteria penetrate the urinary tract in three ways: ascending, descending (hematogenous) and lymphogenous.

Ascending infection

Due to the short length of the urethra, colonization of it, the entrance and vestibule of the vagina by pathogenic bacteria of the rectum, as well as as a result of a decrease in the resistance of the urethra after menopause, women are more susceptible to ascending infection. Sexual intercourse is the main source of bacteriuria that develops during the day, and the relative risk of its occurrence is proportional to the frequency of sexual intercourse during the last 7 days (for example, “honeymoon” cystitis).

Hematogenous infection

The hematogenous route of infection into the urinary tract is recorded very rarely. It is possible in elderly, debilitated patients or with immunosuppression and extensive infectious lesions, when infectious kidney disease is only part of a multisystem process. Renal tuberculosis almost always occurs as a result of hematogenous spread of infection.

Lymphogenous infection

According to experimental data, bacterial infection spreads across lymphatic vessels connecting the intestines and urinary tract.

Body defense mechanisms

The penetration of microorganisms into the urinary tract does not always lead to infection. Natural barriers - the “flushing” effect of periodic normal urination, antiseptic properties bladder tissue and the high concentration of organic acids in normal urine prevent bacterial invasion. The presence of ammonia and organic acids in urine, as well as a pH less than 5.0, helps to inhibit the growth of microorganisms. Once infected, the bacteria may remain in the urinary tract or spread to the kidneys. Short-term vesicoureteral reflux, which occurs with severe damage to the urinary tract, promotes the penetration of infected urine into the kidneys

Supporting and exacerbating factors

Mechanical obstruction of the urinary tract. With recurrent urinary tract infections in women, obstruction of the junction of the pelvis and the ureter, stenosis of the urethra and calculi are often found.

Functional obstruction of the urinary tract. Incomplete emptying of the bladder and vesicoureteral reflux increase urinary stasis and bacterial growth. Pregnancy causes short-term functional obstruction of the ureters under the influence of mechanical and hormonal factors. Hypospadias lead to repeated infections after sexual intercourse (honeymoon cystitis).

System factors. Diabetes mellitus, gout, sickle cell deformation, polycystic kidney disease, and metabolic disorders (nephrocalcinosis, chronic potassium deficiency, and tubular disorders) predispose to pyelonephritis.

Clinical classification

From the standpoint of pathogenesis and treatment, urinary tract infections in women can be complicated or uncomplicated. Uncomplicated infections, which rarely involve kidney damage, account for 95% of cases. This may be either the first episode of infection, or its recurrence after a long break. About 90% of primary infections are caused by Escherichia coli. In 75% of cases, these diseases do not recur for several years. In patients with neurological, obstructive diseases or damage to the renal parenchyma, complications of urinary tract infection in women occur.

Diagnostics

Analysis of urine

Accuracy microscopic examination of a non-centrifuged, unstained specimen (a drop of urine is placed on a glass slide and covered with a coverslip) with significant bacteriuria exceeds 90%, while at high magnification more than one bacteria is detected in one field of view. A positive Gram stain is almost always accompanied by positive result tank research. Negative result Gram staining virtually excludes significant bacteriuria.

Pyuria is the detection in a specimen of centrifuged urine at high magnification of five or more leukocytes in the field of view. The combination of pyuria, erythrocyturia and bacteriuria is characteristic of an infectious lesion. Pyuria without significant bacteriuria indicates aseptic inflammation, a foreign body, or a tumor of the urinary tract. It is also a classic symptom of urinary tract tuberculosis. Detection of casts indicates damage to the renal parenchyma.

Urine culture and microbiological examination urine

Bacteriological examination of urine is the most important laboratory method diagnosis of complicated and uncomplicated urinary tract infections in women. In 80-85% of patients, E. coli predominates. In the remaining patients, Klebsiella, Enterobacter, Proteus, Enterococcus, Staphylococcus and group D streptococci are detected. Fecal anaerobic bacteria are poorly preserved in urine and rarely cause urinary tract damage. In the urine of patients with diabetes mellitus and persons receiving immunosuppressive therapy (especially in the presence of foreign bodies or indwelling catheters), the yeast Candida albicans (funguria) is sometimes found.

There are three methods for collecting urine:

1. — receiving a medium portion after treating the periurethral area with antiseptics;
2. - urethral catheterization;
3. - suprapubic aspiration.

The reliability of the study of an average portion of urine is 80%, and if in two consecutive analyzes the number of colonies exceeds 100 thousand, it increases to 95%. For common uncomplicated infections, the detection of two or more types of microorganisms during one test indicates contamination of the sample. Catheterization is the optimal method for obtaining urine. The accuracy of a positive bacteriological urine test is 95%. False positive results are rarely obtained.

Suprapubic aspiration gives the most reliable result and is intended for those individuals in whom it is difficult to avoid urine contamination (for example, young children, elderly women).

X-ray studies

Radiological studies play a major role in relapses associated with persistent bacteriuria (eg, stones or congenital anomalies), but are of little value in 99% of patients with reinfections. The most commonly used are intravenous pyelography and urography with CT. Cystography and urethrocystography during urination can detect ureteral reflux, diverticula and fistulas in patients with persistent bacteriuria.

Endoscopic studies

Endoscopic examinations are used to diagnose chronic trigonitis, urethritis, urethral or bladder diverticulum, fistulas, foreign bodies or trabeculae of the bladder walls.

Kidney function tests

For the first episode of uncomplicated urinary tract infection in women, renal function tests are not performed. In case of relapses, the concentration of urea and creatinine in the blood is determined. Renal failure is characterized by changes in creatinine clearance.

Treatment

If during a physical examination and urine analysis (bacteriuria) accurate data indicating a urinary tract infection in women are not obtained, it is advisable to refrain from antibacterial therapy. As a rule, treatment is prescribed for bacteriuria, but not for pyuria. General principles Treatments for urinary tract infections are listed below.

Hydration. Helps reduce the number of bacteria, frequent urinary emptying and reduce the osmolality of the renal medulla, which facilitates phagocytosis.

Acidification of urine. For increase antibacterial activity urine and suppression of bacterial growth are prescribed ascorbic acid(500 mg 2 times/day), ammonium chloride (12 g per day in several doses), apricot, plum or cranberry juice. Grapefruit juice and carbonated drinks, especially those containing citrates, alkalinize urine and should be avoided.

Analgesics. Taking penazopyridine hydrochloride 100 mg twice a day for 3 days often eliminates dysuria.

Basic principles of antibacterial therapy

The drug for treatment should be accessible, inexpensive, quickly absorbed from the gastrointestinal tract, practically non-irritating and selectively excreted in the urine. For treatment acute cystitis Creation high concentration antibacterial drugs in the blood is undesirable because they affect normal microflora. Nitrofurantoin creates a low concentration in the blood, and its half-life is 19 minutes, which virtually eliminates the possibility of intestinal and vaginal dysbiosis. Nitrofurantoin is effective against all uropathogenic microorganisms except Proteus.

Single dose medicines- a good alternative to a 3-7-day course of treatment, especially in patients with uncomplicated cystitis, but with lesions upper section urinary tract it is effective in less than 50% of cases.

For the treatment of pyelonephritis, a drug is chosen that, when taken, can achieve its high concentration in the blood, since the blood supply to the infected kidney tissue is weakened. In this case, the most effective cephalosporins are those with less side effects. They (for example, cephalexin, duricef) are slowly excreted in the urine, which reduces the number of daily doses of the drug (500-1000 mg 2 times a day).

Ampicillin, tetracycline and co-trimoxazole change the intestinal microflora, cause the development of dysbiosis of the vagina and periurethral tissues, which can lead to relapse of infection. I and II generation quinolones (eg, ciprofloxacin, norfloxacin) are very effective against uropathogenic microorganisms.

An increase in the pH of urine when infected with Proteus bacteria is due to its breakdown with the release of ammonia, and the urine acquires a characteristic fishy odor. In case of a sharply alkaline urine reaction (pH >8.0), co-trimoxazole is prescribed.

The administration of ampicillin, co-trimoxazole and doxycycline to patients with renal failure helps to create sufficient concentrations of drugs in the urine without toxic concentrations in the blood. Nitrofurantoin is not used because an increase in its content in the blood leads to peripheral neuropathy. Similarly, tetracycline causes heavy defeat liver. The dose of aminoglycosides is adjusted in accordance with creatinine clearance and their concentration in the blood is monitored.

Recurrent urinary tract infections in women

In patients with recurrent infections, the presence of pathological biological factors in the vagina. Bacteriuria is usually preceded by colonization of the vaginal and urethral epithelium. The latter occurs as a result of the adhesion of bacteria to cells in the absence of antibodies to E. coli. Women resistant to E. coli are found to have specific antibodies to its own representatives of this group of microorganisms.

There is evidence of the beneficial effects of long-term administration of antibacterial drugs to women with recurrent infections. Co-trimoxazole is an effective remedy. In addition, it is the only antibacterial drug secreted into the vaginal fluid. Sulfonamides, tetracycline and ampicillin are not used for prophylactic purposes, since resistance of fecal microflora to these drugs quickly develops. Recurrent infections tend to occur in groups. In the period between them, long-term remissions often develop, but the time of onset of the next disease is impossible to predict. Preventative treatment begin when two infections occur in six months, since the probability of developing another disease over the next 6 months is 65%.

If frequent relapses are associated with sexual activity, a single dose of an antibacterial drug immediately after sexual intercourse prevents the development of bacteriuria and symptomatic infection.

It is necessary to prevent the development of nosocomial urinary tract infections in women.

About 60% of nosocomial infections in gynecological patients are associated with the urinary tract and catheterization. After the bladder, the principles presented below should be followed.

Principles of bladder catheterization

• Avoid unnecessary catheterizations.
• Remove catheters quickly.
• Maintain sterility to prevent the penetration of bacteria.
• Keep closed.
• Disconnect drainage system, only if it is clogged.
• Avoid prophylactic use of antibacterial drugs.
• For long-term catheterization of the bladder, use suprapubic catheterization.

The article was prepared and edited by: surgeon

Urinary tract infections are caused by bacteria and are 10 times more common among women than men. More than 50% of women have encountered these diseases at least once during their lives. About 30 - 40% of infections recur within 6 months after the first case is diagnosed. Relapses can occur both due to incomplete sanitation of the lesion, and in the event of re-infection with other strains of pathogenic microflora.

Signs and symptoms of the disease

Symptoms of urinary tract infections in women begin to appear 12 to 72 hours after infection. Time incubation period depends on the microflora and the degree of tolerance of the immune system. Symptoms may include:

• Pain or burning when urinating.
• The need to urinate more often than usual.
• Feeling of urgency while urinating.
• Blood or pus in the urine.
• Cramps and pain in the lower abdomen.
• Chills or fever (fever may be the only symptom in infants and children).
• Strong smell of urine.
• Pain during intercourse.
• Nausea, vomiting, malaise.

The clinical picture of the disease may include the entire complex of the listed symptoms or individual sets of them. Therefore, if you have at least 2 of these signs, you should immediately consult a doctor.

Causes of infections

The main causes of urinary tract infections in women lie in violation of personal hygiene rules, a decrease in the level of the body's defenses, and poor lifestyle choices. Risk factors include:

• A new sexual partner or several partners.
• More frequent and intense sexual intercourse.
• Diabetes.
• Pregnancy.
• Penetration of Escherichia coli (E.coli) into the urethra.
• Infection with Staphylococcus saprophyticus.
• Using irritating products such as strong skin cleansers.
• Use of irritating contraceptives such as diaphragms and spermicides.
• Use of birth control pills.
• Intensive uncontrolled use of antibiotics.
• Blockage of urine in the urinary tract (benign or malignant tumors, small stones).

Diagnostics

When making a diagnosis, it is important not only to determine the focus of the inflammatory process, but also the degree of its prevalence. Important has urine culture to identify pathogenic microflora and its sensitivity to antibiotics. Therefore, diagnosis begins with the appointment:

• general urinalysis;
• general blood test;
• ultrasound examination of the pelvic organs;
• urine culture for sensitivity to antibacterial agents.

After a course of antibacterial therapy, all tests must be repeated to monitor the success of treatment. If the infection recurs, urine culture is repeated.

Treatment

The basis of treatment of urinary tract infections in women is antibacterial therapy. Depending on the type of pathogen and the degree of damage to the mucous membranes, the course of treatment can range from 3 days to 2 weeks. Antibacterial therapy is not recommended without supervision by the attending physician. In most cases, cystitis occurs due to infection with a pathogenic form of fungi of the genus Candida. Modern antibiotics only aggravate the situation, causing rapid growth of these pathogenic microorganisms. There are also forms of medications that allow treatment of urinary tract infections in women in record time, in 2 to 3 days.

To sanitize the urinary tract, you can use drugs based on nalidixic acid and other urosulfates. Nutrition, diet and water balance are also important.

1. Drink plenty of fluids, e.g. herbal teas and water. Avoid sweetened foods fruit juices and other sweet drinks.
2. Cranberries and blueberries contain substances that inhibit the binding of bacteria in bladder tissue.
3. Try to eliminate potential allergens food products, which may include milk, wheat (gluten), corn, preservatives and food additives.
4. Eat antioxidant foods, including fruits and vegetables in your daily diet.
5. Eat more products High in fiber, including beans, oats, and root vegetables.
6. Avoid refined foods such as White bread, pasta, and especially sugar.
7. Drink 6 - 8 glasses of filtered water per day.

How to treat infections in pregnant women?

The pregnancy period is a time of increased risk of pathogenic microflora joining a woman’s urinary tract and the natural balance is disrupted acid-base reaction. Favorable soil appears for the rooting of various forms of microorganisms. Due to the change hormonal levels there is a risk of developing thrush. Therefore, it is important to observe the rules of personal hygiene, regularly visit a doctor, and take modern urine tests.

If symptoms occur, seek medical attention. During pregnancy, treatment of urinary tract infections in women is carried out without the use of antibacterial agents.

Urinary tract infection is a disease that is infectious in nature and affects both men and women, causing inflammatory process in the organs of the urinary system. Typically, the most common UTIs involve the urethra, prostate, bladder, renal parenchyma, and interstitial tissue.

Today, UTI is the second most common disease, which is associated with infectious nature. According to the latest statistics, due to its anatomical structure The female population is more susceptible to UTIs. So, for example, if we compare, at least 60% of women have experienced symptoms of urinary tract inflammation at least once. But, despite the low likelihood of developing this disease in men, in them it not only has a high probability of a long-term nature, but also frequent relapses are possible.

Causes

As is known, sterility and resistance to bacterial colonization are the norm of the urinary tract from the kidneys to the external opening in the urethra. Mechanisms that maintain this condition include: acidity of urine, regular release of the bladder during urination, the urethral sphincter and the immunological barrier on the mucous membranes.

A urinary tract infection typically occurs when bacteria migrate upward from the urethra to the bladder and from the ureter to the kidney. This happens due to the fact that bacteria that cause the inflammatory process most often live in the large intestine and are released during bowel movements. If, for some reason, they enter the urethra, then, moving along the urethral canal, they enter the bladder, where they become the cause of the onset of the inflammatory process.

It is possible that this disease will develop after insertion of a catheter into the urethra, which is usually used in medical institutions to control urine output. In this case, a urinary tract infection occurs through long stay catheter, which provokes the accumulation and proliferation of microorganisms with subsequent inflammation of the corresponding organs. That is why experienced doctors perform timely replacement of catheters with their subsequent sanitation.

We should not forget that such a disease as diabetes mellitus is due to disorders in immune system can also cause the development infectious inflammation in the kidneys.

It is worth noting the fact that today there is a urinary tract infection, the causes and manifestations of which are still not known and not 100% studied.

It has been proven that this pathology occurs in women who use the diaphragm ring as a method of contraception. Also high probability the appearance of this disease in women whose sexual partners use condoms with spermicidal foam.

People who do not drink large amounts of fluids and have problems urinating are also at high risk of developing UTIs.

Urinary tract infection: symptoms

Usually, this pathology refers to diseases of a hidden or latent nature. A detailed questioning may reveal complaints of frequent and painful urination, a slight burning sensation in the area of ​​the bladder or urethra during urination. This disease is often accompanied by poor health, fatigue and weakness throughout the body. You may experience moderate discomfort in the groin area. Features of the manifestation of this pathology include a false urge to urinate, in which urine is released in very small portions. It is worth noting that a urinary tract infection, the symptoms of which are cloudy urine and severe lower back pain, is a characteristic manifestation of a severe inflammatory process in the kidney area.

Diagnostics

First of all, after a general examination, the attending physician prescribes a list of studies, the main of which is general analysis urine, allowing you to determine the level of leukocytes and the number of bacteria. It should be borne in mind that in some situations the first portion is not always informative, as it can give a false positive result due to “flushing” from the genital area; as a rule, this most often occurs in women. Considering the fact that this flush may also contain bacteria, the reliability of the analysis is questionable. Based on this, the optimal portion is the middle portion - urine, which comes from the urinary tract located at the top. After receiving it, it is sent for laboratory tests.

The norm is considered to be results in which the number of leukocytes does not exceed 4 and there is a complete absence of bacterial flora.

But it is worth remembering that, for example, mycoplasma or chlamydia is a urinary tract infection that is not detected by the above method. In this case, it is recommended to use bacterial culture of urine or scraping of discharge from the genital organs, after which not only the number of bacteria and leukocytes becomes known, but also complete information is provided about those drugs that will be most effective in this situation.

Attention! As an additional diagnostic option, you can use the PCR method, which is used in the case when, after bacterial culture, the pathogen is not identified, and signs of a urinary tract infection persist.

To identify a more complete picture, specialists may also prescribe an X-ray contrast examination, which consists of assessing the structure and condition of the urinary system. This type of examination is called intravenous urography. Its use not only allows one to obtain auxiliary information about the state of internal organs, but also to detect possible deviations from normal or the presence of kidney stones.

One should also not exclude the significance of the results of ultrasound examination of the kidneys and cystoscopy of the bladder, which not only go in combination with other laboratory tests, but are also often used as a first-priority diagnosis for making a preliminary diagnosis.

Manifestation of UTI in men

Urinary tract infection in men most often occurs as a result of urolithiasis or an enlarged prostate, that is, situations where obstacles appear that prevent the normal outflow of urine. As practice shows, there are frequent cases of inflammatory processes occurring after instrumental methods examinations. Based on this, the best option in the treatment of this pathology is to get rid of this obstacle.

As practice shows, chronic infection in the prostate gland can create additional difficulties in treating the disease. This is due to the fact that an antibiotic is required for a urinary tract infection with the subsequent prescription of restorative therapy. It should be borne in mind that the choice of antibiotic should be based on previously conducted studies, which should confirm its high sensitivity to a given microorganism.

UTI classification

One of the most commonly diagnosed urinary tract diseases is urethritis. There are specific and nonspecific. A specific type includes the inflammatory process in the urethra, the causative agents of which are various sexually transmitted infections. Unlike specific urethritis, the causative agents of nonspecific urethritis are bacteria, fungi and other infections, for example, herpes urinary tract infection, treatment of which begins with taking antiviral drugs.

The main symptoms include:

1. Burning sensation during urination.
2. Discharge from the urethra.

Cystitis is an inflammation of the bladder, characterized by frequent and painful urination. The fair half of humanity is most susceptible to this disease. The main cause of cystitis is called urinary tract infections in women, but one should not exclude:

1. Hypothermia.
2. Unprotected sexual contact.
3. Gastrointestinal tract infections.
4. Instrumental interventions.

Bacterial damage to the kidney parenchyma is called pyelonephritis. But this designation should not be confused with tubulointerstitial nephropathy, at least until documents indicating an infectious lesion are received. According to the latest statistical data, it is indicated that less than 20% of community-acquired bacteremias in women developed as a result of pyelonephritis. It is worth noting that pyelonephritis in men develops only in the presence of urinary tract pathology. Symptoms of acute pyelonephritis are similar to those of cystitis. The hallmark signs of this disease are:

1. High fever and chills.
2. Pain in the side.
3. Nausea and vomiting.
4. An easily palpable enlarged kidney.

Most often, pyelonephritis is diagnosed in pregnant women or girls aged 20-25 years. It is worth noting that this urinary tract infection practically does not occur in children.

Manifestations of UTIs in children

Manifestations of this pathology are typical not only for adults, but also for children. Thus, today the main ways of spreading the disease in children include:

1. Rising. Most often observed in girls.
2. Lymphogenic. Typical for children aged 1-3 years. Favorable factors for a urinary tract infection to begin to progress in children are frequent constipation or diarrhea.
3. Hematogenous. It is one of the most rare paths of disease development. As a rule, it occurs in newborns as a complication of sepsis.

It is worth noting that in 90% of cases the causative agent is E. coli, which, when it enters the urethra, causes an inflammatory process there.

Manifestations of this disease include:

1. Red spots on the external genitalia and anal area.
2. Moodiness and decreased activity.
3. Decrease or complete absence appetite.

Sadly, a urinary tract infection in an infant causes difficulties in diagnosis. This is due to the fact that for staging correct diagnosis A rapid urine test is used, and to ensure that its readings are not distorted, an average portion of urine is required, which is quite difficult to take from small children.

The occurrence of UTIs in pregnant women

As sad as it may be, the development of this pathology in pregnant women is much higher than in other people. Such high level incidence, according to medical experts, is associated with several reasons. The main ones are:

1. Hormonal imbalance, which manifests itself in pregnant women as a result of decreased immunity.
2. A change in the position of organs that are located adjacent to the urinary system and specifically to organ secretions. An example is the increase in pressure created by the pregnant uterus on the bladder and ureters, which, in turn, leads to the development of stagnation in the urinary system, which leads to the growth and reproduction of bacteria in the body, resulting in a urinary tract infection during pregnancy. That is why regular monitoring of the condition of urine discharge by a medical specialist is one of the priorities of the expectant mother.

Urinary tract infection: treatment, medications

Typically, treatment of this disease begins with taking antibacterial drugs. Exceptions are obstructive uropathy, various anatomical and neurogenic anomalies that require surgical intervention. Drainage of the urinary tract using a catheter has worked well. But instrumental intervention should be limited or even temporarily postponed lower sections urinary tract susceptible to this pathology.

As practice shows, a urinary tract infection, which subsequently causes urethritis, is diagnosed in overly sexually active patients. Today, experts recommend prescribing preventive therapy until test results for STIs are received. The main treatment regimens include ceftriaxone 125 intramuscularly, 1 g of azithromycin once or 100 mg of doxycycline 2 times a day for a week. For men whose urethritis is caused by bacteria, viruses or fungi, fluorinchonols are prescribed for a period of up to 2 weeks. Women are prescribed treatment according to a regimen identical to treatment for cystitis.

Treatment of cystitis usually consists of a 3-day course of fluoroquinolones, which are not only an effective remedy for the symptoms of acute cystitis, but also eliminate aggressive microorganisms both in the vagina and in the vagina. gastrointestinal tract. It is worth considering that this drug is only prompt assistance at the first manifestations of cystitis and only further contact with a specialist can help answer the question: “How to treat a urinary tract infection?”

Pyuria, the causative agent of which is considered to be C. Trachomats, causes urethritis in women. Treatment in this case is necessary for both the woman herself and her sexual partner. As a rule, for complete recovery, one course of therapy using a drug that is sensitive to the identified microorganism is sufficient. But there are cases when it is not enough, and repeated tests again reveal a high level of leukocytes together with the previously detected pathogen. Then it is recommended to undergo additional tests for the presence of pyelonephritis and undergo a 2-week course of treatment with co-trimoxazoles.

When diagnosing asymptomatic bacteriuria in elderly people or with a diagnosis diabetes mellitus Treatment is usually not prescribed. But it is worth noting that even if there is asymptomatic bacteriuria in pregnant women, it, like any other UTI, requires antibacterial treatment. The only difference depends on the fact that not every drug may be suitable for pregnant women.

Currently it is believed that acute pyelonephritis- urinary tract infection, treatment of which is possible only in inpatient medical institutions. As medical practice shows, the course of treatment largely depends on the initial condition of the patient, the presence of nausea, vomiting and fever. Standard scheme treatment includes parenteral therapy, which should be based on the drugs that are most sensitive to infection. It is recommended to continue the prescribed therapy until clinical improvement occurs, which usually occurs within 4-5 days. Next, medications are prescribed for oral administration for up to 2 weeks.

Particular attention should be paid to the treatment of pyelonephritis in pregnant women. In this case, in addition to mandatory hospitalization, parenteral therapy with p-lactams is used.

ethnoscience

It is recommended to use it in parallel with medications various fees herbs with antimicrobial and anti-inflammatory properties. One of the undeniable advantages of such herbs is that they are completely devoid of side effects, which cannot be said about antibiotics, right? Some of the most popular herbs that have an antibacterial effect include: bearberry, chamomile, wintergreen.

Prevention

Prevention of urinary tract infections with frequent relapses in women is as follows:

1. Drinking cranberry juice can significantly reduce the incidence of pyuria and bacteriuria.
2. Replacing a bubble bath with a shower, as this will minimize the entry of bacteria into the urethra.
3. Limit douching and the use of various sprays that can cause irritation with further infection.
4. Moderate consumption of drinks and foods containing caffeine.
5. At the slightest manifestation of symptoms of inflammation, immediately take vitamins C, which increase the level of urine acidity, which, in turn, leads to a decrease in the number of bacteria in the urinary tract.
6. In limited consumption of products that can serve irritating factor for the bladder.
7. Avoiding wearing tight-fitting underwear.
8. Direct urination immediately after completion of sexual intercourse.
9. Refusal to use spirals and rings.
10. Non-hypothermia.
11. Drinking large amounts of liquid. It is recommended to drink at least 14 glasses of water per day.

If, however, the exacerbations do not decrease, then for preventive purposes Oral antibacterial drugs may be prescribed. For example, a single dose of 50 mg of nitrofurantoin or co-trimoxazole 40/200 mg.

But it is worth considering that when taking some antibiotics, the enterohepatic circulation of estrogen is disrupted, which can negatively affect the effectiveness of oral contraceptives that a woman takes.

Preventive measures for pregnant women, as a rule, are no different than for non-pregnant women.

Remember that with more detailed information information about this pathology can be found in the section of the International Classification of Diseases (ICD) “Urinary tract infection”.