PREFERRED PRACTICE PATTERN
As of June 2014, the APTA Guide to Physical Therapist Practice does not include practice patterns for organ system pathology. Therefore, the associated or secondary musculoskeletal, cardiovascular/pulmonary, or potential neuromuscular patterns would be indicated.
4C: Impaired Muscle Performance1
A 45-year-old woman reports that 3 years ago she had a urinary tract infection (UTI) that was treated with antibiotics. She had recurrent symptoms of UTIs every 2 to 3 months for the next 2 years until during the last episode, she was told by the physician that the urinalysis was negative. The burning with urination was painful. In the past year she has developed more symptoms. She has noticed that she has to urinate more frequently, at least 10 times per day. She wakes up at least three times at night to urinate. Pain is temporarily relived by urination.
Causes and predisposing factors of bladder infections. Most cases are due to ascending infections caused by enteric bacteria such as E coli and Proteus species. (From Chandrasoma P, Taylor CR. Concise Pathology. 3rd ed. www.accessmedicine.com. Copyright © The McGraw-Hill Companies, Inc. All rights reserved.)
Chronic inflammation of the bladder wall
Frequent, painful urination
Severe pain with or without attempts at urination, or no pain at all, especially in elderly and children
Often misdiagnosed as UTI
Some urogynecologic (UG) pathologies may be appropriate for PT, though PT does not usually treat UG disorders specifically
Diagnosis for occult problems may take time, require intensive diagnostic testing
May refer pain to back, pelvic region
UG disorders frequently refer pain to other body areas; individuals may be inappropriately referred to PT
May mimic colon cancer or tumor, irritable bowel, colitis
May mimic gynecologic problems in females: Endometriosis, uterine fibroids, ectopic pregnancy
Can have periods of remission
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