Urinary tract infections (UTI’s) include inflammation of the urethra (urethritis), the bladder (cystitis), prostate (prostatitis) and kidneys (pyelonephritis). UTI’s are among the most common infections seen in patients of varying age and gender. Women suffer more frequently from UTI’s than men, and the risk of infection seems to increase with age. However, it appears to be a serious common disease in infants and young children as well.

In most cases UTI’s are acute, symptomatic, and uncomplicated infections in otherwise healthy individuals. Complicated UTI’s are less frequent and occur in both men and women with structural or functional abnormalities or underlying diseases, which may predispose infection. Thus, pregnant females and patients with diabetes, renal obstruction or transplantation are especially prone to complicated UTI’s.

Acute cystitis and urethritis are inflammations of the bladder and the urethra caused by bacteria that usually inhabit the intestines (Enterbacteriaceae). The most frequently found pathogen is Escherichia coli. These bacteria enter the urinary tract and manage to grow in the usually sterile urine. Therefore, the occurrence of bacteria in urine can be an indicator for UTI’s. Poor hygiene after urination, sexual intercourse, and withholding urination can be responsible for the development of an infection. Symptoms usually appear suddenly and are characterized by a strong and frequent need to urinate accompanied by a sharp pain or burning sensation, as well as a low volume of cloudy urine containing blood.

If these lower UTI’s are ignored or insufficiently treated, bacteria might ascend into the kidneys causing acute uncomplicated pyelonephritis, a painful inflammation of the kidneys. The main pathogens are Escherichia coli, Proteus mirabilis and enterococci. Complications like bacteremia and sepsis are possible, if bacteria spread into the blood circulation.

The recurrence or re-infection rate of UTI’s is relatively high, especially in elderly, homosexual men and in some young sexually active females (honeymoon cystitis).

Prostatitis is the inflammation of the prostate gland surrounding the neck of the bladder and the urethra in men. Acute bacterial prostatitis is accompanied by systemic and local signs of infection. Bacterial prostatitis is mostly caused by Escherichia coli. Klebsiella, and Proteus are also commonly found. Bacteria usually spread via the urethra. Symptoms of acute bacterial prostatitis can be dramatic with chills, fevers, pain in the lower back and genital region, as well as voiding difficulties. Chronic bacterial prostatitis is caused by an underlying defect in the prostate. Repeated urinary tract infections have been reported in these patients as well. Still, bacterial prostatitis is less common than nonbacterial inflammation of the prostate gland.