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  • 590.9 Infection of kidney, unspecified
  • Associated ICD-9-CM PT diagnoses/treatment diagnosis that may be directly related to urogenital (UG) disorders or consequences from bed rest, surgery, or inactivity or directly related to UG disorders specifically
    • 315.4 Developmental coordination disorder
    • 718.45 Contracture of joint; pelvic region and thigh
    • 719.70 Difficulty in walking
    • 728.2 Muscular wasting and disuse atrophy
    • 728.89 Other disorders of muscle, ligament, and fascia
    • 729.9 Other and unspecified disorders of soft tissue
    • 780.7 Malaise and fatigue
    • 781.2 Abnormality of gait
    • 782.3 Edema
    • 786.0 Dyspnea and respiratory abnormalities
    • 786.05 Shortness of breath

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  • N15.9 Renal tubulointerstitial disease, unspecified

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  • As of January 2013, 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.

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Description

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  • Swelling and Inflammation of the urethra
  • Males and females frequently asymptomatic1
  • Females present with symptoms of urinary tract infection: burning with urination
  • Males present with a clear or purulent discharge1
  • If spread to kidneys, symptoms more severe and pain is located in the low back with possible tenderness to palpation of the kidneys

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Essentials of Diagnosis

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  • Difficulty urinating
  • Painful urination
  • Malodorous urine
  • Pelvic pain in women
  • Change in color of urine
  • Positive cultures

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General Considerations

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  • Most infections of the urethra are sexually transmitted
  • Most common bacterial causes in males1
    • N gonorrhoeae
    • C trachomatis
    • Coliforms in males practicing insertive anal intercourse
  • May refer pain to back, pelvic region
  • May result in secondary problems such as
    • Reiter syndrome
    • Epididymitis or Prostatitis
    • Aerobic capacity and muscle endurance impairment
    • Sarcopenia
    • Weakness/impaired muscle performance
    • Neuromuscular problems
    • Weight loss or weight gain indicating the need for PT intervention depending on severity
  • May mimic colon cancer or tumors, irritable bowel, colitis, or gynecological problems in females such as endometriosis, uterine fibroids, or ectopic pregnancies
  • There are specific UG pathologies that may be appropriate for PT, but PT usually does not have a role specifically in the treatment

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Demographics

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  • Women more susceptible to cystitis, secondary to the anatomical proximity of the urethra to the anus and the urethra to the bladder
  • Frequently associated with sexual intercourse
  • E. coli is common bacterial cause
  • Women more susceptible to urethritis because of anatomical proximity of urethra to vagina and can be caused by sexually transmitted diseases such as herpes, gonorrhea, and chlamydia

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Signs and Symptoms

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  • Symptoms are frequently referred to the back and abdominal area; it may be more common than previously identified for patients to be inappropriately referred to PT
  • Urethra (urethritis) main symptom
    • Severe pain with or without attempts at urination in males and females, or no pain at all, especially in the elderly and children
    • Burning with urination
    • Discharge from the penis
    • Blood in the ...

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