Special kind of Urinary Tract Infections:

Abacteriuric frequency or, dysuria ('urethral syndrome')

Causes of classical abacteriuric frequency/dysuria are: postcoital bladder trauma, vaginitis, atrophic vaginitis or urethritis in the elderly, and interstitial cystitis (Hunner's ulcer). In Chlamydia infection and tuberculosis there are sterile pyuria, means presence of pus cells but no bacteria. In symptomatic young women with sterile pyuria these conditions should be kept in mind.

Interstitial cystitis is an infrequent but worrying complaint, usually affecting women more than 40 years of age. The symptoms are frequency, dysuria and often severe suprapubic pain. Urine cultures are found to be sterile . Cystoscopic findings are typical inflammatory changes along with ulceration of the bladder base. It is normally believed to be an autoimmune disorder. A variety of treatments are tried with varying degree of success. These therapies include oral prednisolone therapy, instillation of bladder with sodium cromoglicate or dimethyl sulphoxide and stretching of bladder under anaesthesia.


Frequency and passing of small volumes of urine each time also known as irritable bladder is possibly the result of earlier UTI or conditioned by psychosexual factors. These subjects must be differentiated from those with frequency due to polyuria, means excess volume of urine too. Frequent courses of antibiotics in patients with real abacteriuric frequency or dysuria are quite unsuitable and true natire of the problem is missed unfortunately.


Bacteriuria in pregnancy


The urine of pregnant women almost always be cultured as 2-6% have asymptomatic bacteriuria. Though asymptomatic bacteriuria in the non-pregnant female hardly ever leads to acute pyelonephritis and usually does not need treatment, acute pyelonephritis is quiet frequent in pregnancy under these conditions. Failure to treat this asymptomatic condition may thus result in severe symptomatic pyelonephritis later in pregnancy, with the likelihood of premature labour. Asymptomatic bacteriuria, associated with previous renal disease, may predispose to pre-eclamptic toxaemia, anaemia of pregnancy, and small or premature babies. That why bacteriuria must always be treated and to be eradicated as will be seen from the culture report. Reinfection may necessitate prophylactic therapy. Tetracycline, trimethoprim, sulphonamides and 4-quinolones must be avoided in pregnancy. Amoxicillin and ampicillin, nitrofurantoin and oral cephalosporinsmay safely be used in pregnancy.

How UTI Occurs?
Complicated, Uncomplicated, recurrent and relapsing UTI
Symptoms and diagnosis of UTI
Treatment of UTI
Special types of UTI