The document discusses urinary tract infections (UTIs). It defines UTIs as infections that affect any part of the urinary system, with most involving the lower tract. The types discussed are pyelonephritis (kidney infection), cystitis (bladder infection), urethritis (urethra infection), and prostatitis (prostate infection). Signs and symptoms, causes, diagnostic tests, and treatment options are described for each type of UTI. The document emphasizes the importance of antibiotic therapy and fluid management in treatment.

1. MRS. MERLIN DAYANA. E
BSC (N) NURSING TUTOR,
GANGA COLLEGE OF NURSING
COIMBATORE

2. OUT LINE
Introduction
Definition
Incidence
Factors affecting UT
Types
Medical management
Surgical management
Health education

3. INTRODUCTION
A urinary tract infection (UTI) is an infection
that affects the parts of urinary tract.
the urinary tract is composed of the bladder ,
kidneys , ureters , and urethra.
A urinary tract infection (UTI) is an infection
of any part of the urinary system. most infection
involved in lower urinary system.

4. Anatomy of urinary tract

5. Anatomy of urinary tract

6. Definition
UTI =urinary tract infection .
spectrum of diseases caused by microbial
invasion of the genitourinary tract.
Upper UT includes renal parenchyma and
ureters.
Lower UT includes bladder, urethra and in
males the prostate.
Bacteria= presence of bacteria in urine; may
be symptomatic or asymptomatic.

7. URINARY TRACT INFECTION

8. Incidence
Per year 25,000 cases are reported.
More in women
After 65 greater risk for pyelonephritis in
men due to prostatitis.

9. Factors affecting UTI
Obstruction Microorganisms
Calculi Vesico urethral reflex
Diabetes mellitus Characteristics of
urine gender

10. Factors affecting UTI
Age Sexual activity
Recent use of
antibiotics
Toilet training

11. TYPES
 UPPER UTI Pyelonephritis
 LOWER UTI Urethiritis
Cystitis
Prostatitis

12. PYELONEPHRITIS

13. LOWER UTI

15. PYELONEPHRITIS
• It is the bacterial infection and
inflammation of the kidney and
renal pelvis.

16. types
Acute pyelonephritis
Chronic pyelonephritis

19. acute pyelonephritis
 it is the active bacterial infection.
 it involves acute tissue inflammation ,
tubular cell necrosis and abscess formation,
which are pockets of infection with pus can
occur anywhere with in the kidney.

20. CASUES
Bacterial invasion
Pregnancy
Obstruction
Reflux

22. Chronic pyelonephritis
It results repeated or continous
urinary tract defect, obstruction or
commonly when urine refluxes from
the back into the ureters.
CASUES:
Any structural deformity.

23. pathophysiology
Microbial invasion of renal pelvis
↓
Inflammatory response
↓
Fibrosis or scar tissue formation
↓
Decreased tubular reabsorption & secretion
↓
Impaired renal function

24. SIGNS AND SYMPTOMS
 Fever
 Chills
 Tachycardia
 Tachypnea
 Flank , back or loin pain
 Tender CVA
 Abdomen , often colicky & discomfort
 Nausea & vomiting
 General malaise & fatigue
 Burning , urgency or frequency of urination
 Nocturia

25. SIGNS AND SYMPTOMS

26. SIGNS AND SYMPTOMS

27. SIGNS AND SYMPTOMS
Hypertension
Inability to conserve sodium
Nocturia
Hyperkalemia
Acidosis

28. SIGNS AND SYMPTOMS

29. DIAGNOSTIC EVALUATION
 History collection
 Physical examination
 Psychological examination
 Laboratory examination
→Urinalysis
→ Presence of WBC , bacteria , RBC and protein
→ ESR
 Imaging examination
 X-ray kidney
 KUB
 IV Urography

30. IV Urography

31. Abdominal sonography

33. Cystoscope

34. Rigid Cystoscope

35. Flexible cystoscope

37. Retrograde pyelography

38. NON SUGICAL THERAPY
1.Drug therapy
2.Nutritional therapy
3. Fluid therapy
4. Health education

39. 1.DRUG THERAPY
Broad spectrum antibiotics
Gentamicin
250 – 500 mg/day
it has both bactriostatic & bactericidal action.
also act against gram †ve and gram –ve
organisms.
Nitrofurantoin
100mg every 12 hour.
it has bacteriostatic action

40. SURGICAL THERAPY
PYELOLITHOTOMY
Stone removal from the kidneys
NEPHRECTOMY
Removal of the kidneys.
URETROPLASTY
Ureter revision or repair

41. CYSTITIS

42. Cystitis
It is the inflammation of the urinary
bladder
It if the most common among UTI.

43. INCIDENCE
It is the second most condition after
RTI.
The incidence of symptoms is more
than 5 million per year.
About half of them are reported and
diagnosed as UTI.

44. TYPES
INFECTIOUS - It is caused by Escherichia collie.(E.coli)
NON INFECTIOUS - It is caused from chemical exposure such as
drugs
 Chemotherapy drugs , cyclophosphamide and ifosfamide, radiation
therapy and auto immune disorder.
INTERSTITIAL - It is a rare and chronic inflammation of the entrie
urinary tract (bladder , urethra , adjacent pelvic mucles).
• It is not a result of infection (diabetes , kidney stones, an
enlargement prostate or spinal cord injuries)
• It occurs 10 times more in women than men.
• Features are intense urgency & bladder pain
•
•

45. causes
Infection Bacteria
Virus
(cytomegalo
virus)
Fungus
(Candida)

46. Parasites (
schistosomiasis)
Irradiation
of urethra
Catheterization trauma

47. PATHOPHYSIOLOGY
Bacteria from out side the body enters into the urinary
tract due to any procedures or irritation of urethra
↓
Urosepsis occurs
↓
Organ failure
↓
Sepsis
↓
Death

48. Clinical features
Frequency ,Urgency
Dysuria , Hesitancy
Nocturia , Pyuria

49. Clinicalfeatures
Hematuria
Lower back pain
Supra pubic tenderness

50. Clinicalfeatures
Feeling of incomplete bladder
emptying.
Cloudy , foul smelling blood
tinged urine.
Retention

51. Rare clinical features
Fever
Chills
Nausea & vomiting
Malaise
Flank pain

52. Diagnostic studies
 History collection
 Physical examination
 Laboratory examinations
→ Pyuria
→Hematuria
 Imaging studies
 IV Urography
 Abdominal sonography
 CT
 Cystoscopy
 Retrograde pyelography

53. MEDICAL MANAGEMENT
1) Anti microbial
Quinolones
 Ciprofloxacin
 250 mg orally twice
daily
 It has bacteriostatic
and bactericidal
action.

54. Penicillin's
Amoxicillin
500mg orally every 12
hour
It has bactericidal action

55. Cephalosporin's
Cefadroxil
1 gm orally every 12 hour
It has bactericidal action

56. MEDICAL MANAGEMENT
BLADDER ANALGESICS
Phenazophyridine
200 mg orally 3 times
after meals it reduces
bladder pain and
burning by exerting a
topical anaesthetics or
local anaesthetics effect
on the bladder mucosa.

57. MEDICAL MANAGEMENT
Antispasmodics
Hyoscyamine
0.125 – 0.25 mg orally , 3
to 4 times daily.
It relives bladder spasms
by inhibiting nerve
stimulation to the bladder
muscle.

58. URETHERITIS

59. URETHERITIS
It is the infection &
inflammation of urethra
Causes
In man – STD
In women – low estrogens level

60. Clinical features
Painful or difficulty urination
Discharge from penis or
vagina
Discomfort in lower abdomen
Pyuria

61. Management
Management
Estrogens vaginal cream in
women
It increases the amount of
estrogens in the vagina thereby
reduces the irritation

63. Prosatitis

64. Prosatitis
It is the inflammation of prostate
gland.

65. Etiological factor
Bacterial infection
 Escherichia coli , Enterobacter, pseudomonas
 STD (Chlamydia & gonorrhoea)
 Auto immune disorders
 Neuromuscular cause
 Primary vesicle neck obstruction , pseudodyssynergia
( failure of the external sphincter to relax during
voiding), impaired detrusor contractility, or
contractile detrusor muscle.
 Allergy medicated reactions
 Psycho sexual problems (pelvic floor tension )

66. Types OF Prosatitis
Acute bacterial
Chronic bacterial
Non bacterial/chronic pelvic pain
syndrome
Asymptomatic inflammatory
prosatitis.

67. Acute bacterial
It may occurs with urethritis
or an infection of the lower
urinary tract.
Organisms may reach the
prostate via blood stream or
the urethra.

68. clinical features
Fever
Chills
Dysuria
Urethral discharge
Boggy tender prostate

69. chronicbacterial
chronic bacterial prosatitis is a rare
condition that causes recurring
infections in the prostate and results
in swelling , inflammation and
frequent urinary tract infections
it may occur in older men

70. clinical features
Hesitancy
Urgency
Dysuria
Difficulty initiating and terminating the flow
of urine
Decreased strength and volume of urine
Discomfort in perineum, scrotum and penis
Irregular enlarged prostate , firm and slightly
tender when palpate

71. MANAGEMENT
sitZ bath
stool softeners
NSAIDS
Alpha blocker

72. MANAGEMENT
Sitz bath
It reduce prostatic irritation

73. Alpha blockers
Tamsulosin
0.4 mg /day
It constrict the
prostate gland ,
thereby reduce
urethral pressure and
improving urine flow

74. Stool softeners
Stool softeners
To prevent straining
and rectal irritation of
the prostate during a
bowel movement

75. Muscle relaxants
Hyoscyamine
0.125 – 0.25 mg orally
, 3 to 4 times daily.
It relieves bladder
spasms by inhibiting
nerve stimulation to
the bladder muscle

76. Non bacterial/ chronic pelvic pain syndrome
 Pelvic or perineal pain without evidence of urinary
tract infection, lasting longer than 3 months
 Pain may radiate to the back and rectum making
sitting uncomfortable. Pain canbe present in the
perineum, testicles, tip ot penis, pubic or bladder
area.
 Dysuria, arthralgia, myalgia,unexplained fatigue,
abdominal pain, constant burning pain in the penis
, and frequence may all be present

77. Asymptomatic inflammatory prosatitis
Asymptomatic inflammatory
prosatitis is a painless inflammation
of the prostate gland where is no
evidence of infection.
Its is a common finding in men with
BPH.

78. HEALTH EDUCATION
Instruct to avoid alcohol, coffee, tea
and spicy foods that irritate
symptoms.
Instruct to avoid decongestants and
antihistamines that may irritate.
Explain the importance of antibiotic
therapy and fluid management.