Slow urine flow

Introduction The reason why women are susceptible to urinary tract infections is mainly because of the special structure of female reproductive system, female vaginal secretions are also a better medium, the use of bacteria is easier to breed, the urine flow is slow to form a mild effusion, etc. Caused. Urinary tract infection, also known as urinary tract infection, refers to the urinary tract inflammation caused by pathogens growing in the urinary tract of the body and invading the mucosa or tissues of the urinary tract. Bacteria are the most common pathogens, and fungi, viruses, parasites, etc. can also cause infection.

Cause

It is generally believed that there are four ways of urinary tract infections: ascending infection, blood infection, lymphatic infection and direct infection.

(1) Ascending infection: Most of the urinary sensation is caused by ascending infection. Under normal circumstances, there are bacterial parasites in and around the urethra, but generally do not cause infection. When the body's resistance is reduced or the urethral mucosa is slightly damaged, or the virulence of the bacteria is large, the ability to adhere to the urethral mucosa and ascending is strong, and it is easy to invade the bladder and kidneys, causing infection. Because the female urethra is close to the anus, and the female urethra is much shorter and wider than the male, the urethral opening of the baby girl is often contaminated by feces, so it is more likely to cause disease.

(2) Bloodstream infection: bacteria invade the bloodstream from the infected lesions in the body (such as tonsillitis, sinusitis, caries or skin infections), reach the kidneys, first cause multiple small abscesses in the renal cortex, and then along the renal tubules. It spreads down to the renal papilla and renal pelvis, and the renal pelvis mucosa, but the inflammation can also start from the nipple collecting tube (such as urinary crystal damage) with slight damage in the head of the kidney, and then spread up and down. The route of blood infection is relatively rare, less than 10%. Bloodstream infections are more common in neonatal, or hematogenous renal infections in patients with staphylococcus aureus sepsis.

(3) Lymphatic infection: There are many traffic branches in the lymphatic vessels of the lower abdomen and pelvic organs and lymphatic vessels around the kidney, and lymphatic communication is also between the ascending colon and the right kidney. When pelvic organ inflammation, appendicitis, and colitis, bacteria can also infect the kidneys from the lymphatics. This route of infection is even rarer, and even the existence of this route of infection is currently debated.

(4) Direct infection: When an infection occurs in an organ that is traumatic or adjacent to the kidney, the bacteria can directly invade the kidney to cause infection, but this situation is very rare clinically.

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Bladder neck elevation test urine routine

The typical clinical symptoms of urinary tract infections are mainly in the following three aspects:

(1) Abnormal urine: urinary tract infection can cause abnormal changes in urine, such as bacterial urine, pyuria, hematuria and pneumoconiosis.

(2) abnormal urination: common urinary tract infections are frequent urination, urgency, dysuria, urinary incontinence and urinary retention. Chronic renal failure caused by chronic pyelonephritis may have polyuria in the early stage, and oliguria or anuria may occur in the later stage.

(3) low back pain: low back pain is a common clinical symptom, and kidney and kidney surrounding diseases are one of the common causes of low back pain. When the kidney capsule, renal pelvis, ureter is stimulated or the tension is increased, the waist can be painful, and the lower urinary tract infection generally does not cause low back pain. Inflammation around the kidneys and kidneys, such as kidney abscess, peri-renal inflammation, peri-renal abscess, acute pyelonephritis, often causes severe pain in the waist, and low back pain caused by chronic pyelonephritis is often sore.

Differential diagnosis

Urinary tract infections are generally classified into upper urinary tract infections and lower urinary tract infections. Urinary tract infections can be further divided into: bloody infections, ascending infections, and descending infections. Most of the women are ascending infections. This is because the female urethra is straight and short, and the bacteria tend to rise up to the bladder to cause infection. In addition, the female urethra is close to the vaginal opening and anus, and is easily contaminated by bacteria excreted in the feces and the Mingdao. In addition, the ability of the elderly woman to completely empty the bladder, bacteria can easily multiply in the residual urine. Clinically common is lower urinary tract infection, cystitis, which is a common and frequently-occurring disease in older women. Its incidence is 8-10 times higher than that of males, so prevention is very important.

Upper urinary tract infection refers to pyelonephritis, an infectious inflammation of the renal parenchyma and renal pelvis, which is caused by bacterial invasion of the kidney. Pyelonephritis is clinically divided into acute pyelonephritis and chronic pyelonephritis. Acute pyelonephritis is mostly pathogenic bacteria that reach the kidney through the bladder and ureter, causing inflammation, mainly showing acute interstitial inflammation and different degrees of necrosis of renal tubular epithelial cells. Regarding the definition of chronic pyelonephritis, at present, most scholars believe that this diagnosis is too abused in the past, and that chronic pyelonephritis should be limited to those with clear inflammation, fibrosis and deformation of the renal pelvis and renal pelvis. If this diagnostic criteria are used, the vast majority of chronic pyelonephritis is caused by urinary tract infarction, poor urinary flow, or bladder-ureteral reflux. If this is not the case, urinary tract infections often do not cause severe chronic kidney disease. Therefore, the identification of acute and chronic pyelonephritis should not be divided by the length of the disease or the number of recurrent episodes, but should be distinguished by imaging whether the renal pelvis and renal pelvis are deformed. Lower urinary tract infections are mainly urethritis and cystitis, and its infectious inflammation is limited to the urethra and bladder.

Lower urinary tract infections are classified into cystitis and urethritis. Older women are prone to urinary tract infections because of the many predisposing factors, both congenital and acquired:

1. Female external urethra is adjacent to the vaginal opening and anus, which is easily contaminated by vaginitis (vaginitis, cervicitis) and feces.

2. Due to the decline of ovarian function, the level of estrogen in the body decreases, and the urethral epithelium, which is also affected by estrogen, shrinks and thins, and the defense ability is greatly weakened, and bacteria are easily invaded.

3. Female urethra is born straight, wide and short, only 3 to 4 cm in length. Once the bacteria invade, it is easy to enter the bladder from the urethra.

4. With the increase of age, the structure and function of the bladder changes, and the urination is often incomplete. Residual urine is a good medium for bacterial growth and reproduction.

Acute lower urinary tract infections generally have a sudden onset, no fever, no chills, frequent urination, urgency and dysuria, and some have pain in the lower abdomen and perineum when urinating. The amount of urine is small, but it is cloudy, and occasionally hematuria is also seen. If accompanied by urinary retention, often accompanied by persistent lower abdominal pain and tenderness. If the urinary tract infection (pyelonephritis) is complicated, systemic symptoms such as chills, fever, backache and gastrointestinal discomfort will occur.

When the acute urinary tract and bladder are inflamed, the most important thing is to rest in the bedroom, drink plenty of water, increase nutrition and avoid irritating food (no spicy, alcohol). Hot water bath can improve blood circulation and relieve symptoms. Oral alkaline drugs (baking soda), antispasmodic drugs (belladonna, saponin, probensin, etc.) can reduce bladder irritation and spasm.

According to the results of urine culture, the anti-inflammatory and antibacterial drugs sensitive to pathogenic bacteria are selected. If the treatment is timely, the symptoms mostly disappear in about 1 week. In order to prevent repeated infections, you should pay special attention to the cleansing of the vulva and change your underwear. Drink plenty of water to diure the urine and wash the bladder. If it is often acutely irritated, oral estrogen or intravaginal estrogen suppository is administered to promote tension and epithelial growth of the urethral and external sphincters, and to enhance local resistance.

According to the presence or absence of urinary tract function or anatomical abnormalities, urinary tract infections are classified into complex urinary tract infections and simple urinary tract infections. Complex urinary tract infections are:

1 urinary tract has organic or functional abnormalities, causing urinary tract obstruction, poor urine flow.

2 There are foreign bodies in the urinary tract, such as stones, indwelling catheters, etc.

3 There are obstructions in the kidney, such as urinary tract infections that occur on the basis of chronic renal parenchymal diseases, most of which are pyelonephritis, which can cause damage to kidney tissue. Long-term repeated infection or incomplete treatment can progress to chronic renal failure. Simple urinary tract infections do not have the above-mentioned conditions, and the symptoms and bacteriuria can disappear by themselves without treatment, or become asymptomatic bacteriuria. Pawlowski et al found that 3.1% of chronic pyelonephritis was found in 4596 autopsy tests. Therefore, it is considered that adult pyelonephritis is simple and rarely causes end-stage renal disease or pathological chronic pyelonephritis.

According to the medical history, urinary tract infections are divided into initial and recurrent, and the latter are divided into recurrence and reinfection. The first episode of urinary tract infection is the first episode; recurrence refers to incomplete treatment, often recurring within 6 weeks after stopping the drug, and the same strain of the original infected bacteria with the same serotype, more common in pyelonephritis; reinfection refers to the original The infection has been cured and re-infected by different strains, often occurring after 6 weeks of initial treatment discontinuation, more common in cystitis. Those who have frequent recurrences must look for reasons.

Past urinary tract infections studied in the past have mostly referred to infections caused by common bacteria, especially E. coli. In recent years, with the development of medical research, there has been a new understanding of L-type bacteria, fungi, parasitic urinary tract infections, and special urinary tract infections such as urinary tract infections in men, children, pregnancy, and chronic renal failure.

The material in this site is intended to be of general informational use and is not intended to constitute medical advice, probable diagnosis, or recommended treatments.