Urinary tract infections

Symptoms

• Flank pain
• fever
• vomiting

Tests

• CBC
• RFT
• Ultrasound scan
• CT scan
• Urine culture

Treatment

• Injectable antibiotics
• Surgical treatment in select cases

Renal Abcess –

• Collection of Pus in the kidney.It is detected by CT scan or Uktrasound in patients with pyelonephritis. Small abcesses can be treated with antibiotics while large abcesses need to be drained by percutaneous or open procedures.
• DJ stenting - Small tube is placed through the urethra to help relieve obstruction and facilitate drainage of pus and infected urine from the kidney. This tube is removed usually after 2-4 weeks
• PCN insertion – Small tube placed directly into the kidney from back via a small cut to drain the pus and infected urine . It’s done in cases where stenting is not possible .
• Nephrectomy – removal of kidney - Rarely needed in severe cases that do not respond to above .

Cystitis

• Cystitis (Infection of the bladder) - Commonly seen in females and elderly males

Symptoms

• Lower abdominal pain
• fever
• burning /painful micturition
• increased frequency
• urgency
• retention of urine
• Usually accompanied by bladder outlet obstruction

Treatment

• Antibiotics
• Catheterisation
• treatment for bladder outlet obstruction

Urethritis

• Urethritis ( Infection of the urethra) – seen in diabetic men , sexually active men .

Symptoms

• painful/burning micturition
• white discharge per urethra

Treatment

• Antibiotics

Balanoposthitis

• Balanoposthitis ( infection of the tip of penis or glans and prepuce )

Seen commonly in uncircumcised diabetic men

Symptoms

• Redness
• pain
• white flakes at the tip of penis
• associated with inability to freely retract the prepuce( phimosis)
• pain during passage of urine
• cracking at the foreskin

Treatment

• Antibiotics
• oral and local ointment along with circumscision

Epididymoorchitis

• Epididymoorchitis ( infection of the testes and epididymis)

Seen in all age groups , especially diabetic men, sexually active men and men on long standing indwelling catheter.

Symptoms

• Painful swelling of testes
• fever
• burning micturition

Tests

• Ultrasound scrotum
• CBC
• Urine culture

Treatment

• Scrotal support
• Oral or IV antibiotics
• incision and drainage may be required if there is any pus collection ( pyocele or abscess )

Prostatitis

• Prostatitis – Infection of prostate gland. Seen in diabetic or immunocompromised patients ,or patients on long standing indwelling catheters, or patients with bladder outlet obstruction, patients who have recently underwent any surgical procedure. In some patients pus collection might occur resulting in prostatic abcess formation.

Seen in all age groups , especially diabetic men, sexually active men and men on long standing indwelling catheter.

Symptoms

• Pain during passage of urine
• burning micturition
• pain in the perineal region
• lower abdomen
• fever

Tests

• MRI of prostate
• CBC
• Urine culture

Treatment

• IV antibiotics
• Prostate abcess may need Transurethral drainage or transrectal aspiration of pus depending on the size and symptoms.