URINARY DISORDERS
Cystitis
Urinary tract infections (UTIs) are caused by pathogenic microorganisms in the
urinary tract.
Cystitis is the inflammation of the urinary bladder.
●
● There can be acute or chronic nonbacterial causes of inflammation
that can be misdiagnosed as bacterial infections.
● Several mechanisms maintain the sterility of the bladder: the physical
barrier of the urethra, urine flow, ureterovesical junction competence,
various antibacterial enzymes and antibodies, and anti-adherent
effects mediated by the mucosal cells of the bladder.
Pathophysiology
The process of infection occurs as such:
● Entry. For infection to occur, bacteria must gain access to the bladder.
● Attachment. The bacteria then must attach to and colonize the
epithelium of the urinary tract to avoid being washed out with
voiding.
● Evasion. The bacteria evade host defense mechanisms.
● Inflammation. After the bacteria has evaded the defense mechanism
of the body, inflammation now starts to set in.
Statistics and Incidences
A urinary tract infection is the second most common infection in the body.
● Most cases of cystitis occur in women; one out of every five women
in the United States will develop a UTI during her lifetime.
● Approximately 11.3 million women are diagnosed with UTIs in the
United States annually.
● Cystitis is nearly ten times more common in women than in men and
affects about ten percent to twenty percent of all women at least once.
, ● Lower UTI is also a prevalent bacterial disease in children, with girls
again most commonly affected.
Causes
Cystitis usually occurs due to:
● Bladder incompetence. The inability to empty the bladder
completely could lead to infection.
● Bladder tumors. Urine flow is obstructed by the tumor, causing
urinary stasis.
● Decreased natural host defenses. Immunosuppression and a weak
immune system could predispose the patient to infection.
● Ascending infection. More lower UTIs result from ascending
infection by a single, gram-negative, enteric bacterium such
as Escherichia coli, Klebsiella, Proteus, Enterobacter,
Pseudomonas, and Serratia.
● Shortness of the female urethra. The high incidence of lower UTI
among women may result from the shortness of the female urethra,
which predisposes women to infection caused by bacteria from the
vagina, perineum, rectum, or a sexual partner.
Clinical Manifestations
A variety of signs and symptoms are associated with cystitis.
●Burning. A sensation of burning upon urination is felt.
● Frequency. The patient experiences voiding more than every three (3)
hours.
● Nocturia. The patient experiences awakening at night to urinate.
● Dysuria. There is difficulty in urinating.
● Urethral discharge. The presence of discharge is also possible,
especially in males.
Prevention
Cystitis
Urinary tract infections (UTIs) are caused by pathogenic microorganisms in the
urinary tract.
Cystitis is the inflammation of the urinary bladder.
●
● There can be acute or chronic nonbacterial causes of inflammation
that can be misdiagnosed as bacterial infections.
● Several mechanisms maintain the sterility of the bladder: the physical
barrier of the urethra, urine flow, ureterovesical junction competence,
various antibacterial enzymes and antibodies, and anti-adherent
effects mediated by the mucosal cells of the bladder.
Pathophysiology
The process of infection occurs as such:
● Entry. For infection to occur, bacteria must gain access to the bladder.
● Attachment. The bacteria then must attach to and colonize the
epithelium of the urinary tract to avoid being washed out with
voiding.
● Evasion. The bacteria evade host defense mechanisms.
● Inflammation. After the bacteria has evaded the defense mechanism
of the body, inflammation now starts to set in.
Statistics and Incidences
A urinary tract infection is the second most common infection in the body.
● Most cases of cystitis occur in women; one out of every five women
in the United States will develop a UTI during her lifetime.
● Approximately 11.3 million women are diagnosed with UTIs in the
United States annually.
● Cystitis is nearly ten times more common in women than in men and
affects about ten percent to twenty percent of all women at least once.
, ● Lower UTI is also a prevalent bacterial disease in children, with girls
again most commonly affected.
Causes
Cystitis usually occurs due to:
● Bladder incompetence. The inability to empty the bladder
completely could lead to infection.
● Bladder tumors. Urine flow is obstructed by the tumor, causing
urinary stasis.
● Decreased natural host defenses. Immunosuppression and a weak
immune system could predispose the patient to infection.
● Ascending infection. More lower UTIs result from ascending
infection by a single, gram-negative, enteric bacterium such
as Escherichia coli, Klebsiella, Proteus, Enterobacter,
Pseudomonas, and Serratia.
● Shortness of the female urethra. The high incidence of lower UTI
among women may result from the shortness of the female urethra,
which predisposes women to infection caused by bacteria from the
vagina, perineum, rectum, or a sexual partner.
Clinical Manifestations
A variety of signs and symptoms are associated with cystitis.
●Burning. A sensation of burning upon urination is felt.
● Frequency. The patient experiences voiding more than every three (3)
hours.
● Nocturia. The patient experiences awakening at night to urinate.
● Dysuria. There is difficulty in urinating.
● Urethral discharge. The presence of discharge is also possible,
especially in males.
Prevention
